Could cognitive road tests help to screen aging drivers?

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Traffic safety experts have been running enhanced road tests in the search for a way to determine whether aging drivers should remain behind the wheel – rather than relying on a measure of age alone.

“Historically there’s been a reliance on age-based approaches to driver fitness,” Traffic Injury Research Foundation (TIRF) president and CEO Robyn Robertson said Wednesday, during a Private Motor Truck Council of Canada (PMTC) webinar.

Aging truck drivers with cognitive issues can struggle with increasingly complex tasks, even if they can keep a vehicle between the lines. (Photo: istock)

“The challenge is, how do you identify those individuals who are unsafe to drive, and how do you respond to them, because age alone is insufficient for licensing conditions.”

Aging is “complex”, she explained. Put two elderly drivers next to each other. One person may be fit to drive, while the next driver with the same level of experience might face challenges linked to medical issues like dementia.

“The cognitive road test is really about performance-based testing to identify drivers who simply are unsafe or unfit to drive [because of] a cognitive impairment that may result from a medical conditions or simply mental deficits that are the result of aging.”

Ultimately, cognitive testing would build on traditional road tests and better reflect how well drivers process tasks and apply their best judgment.

Aging truck drivers

The issue becomes increasingly relevant against a backdrop of aging truck drivers.

“The average age of the truck driver in Canada is approaching 54 years old, and it’s an industry that’s aging – more every year,” said PMTC president Mike Millian. “Cognitive impairment may be a concern, and especially if you have longhaul [work], there’s going to be some different environments.”

The population of older drivers continues to age in other vehicle classes as well.

“We’ll see significant growth in older drivers over the next decade or two,” Robertson said. “We need a more sophisticated road test for cognitive impairment.”

TIRF and Washington University ran a recent pilot project for the Ontario Ministry of Transportation, looking to see if an enhanced road test could help screen car drivers with that very issue.

The province already applies some additional checks and balances for older drivers. Class A drivers between the ages of 65 and 79 need to pass vision, knowledge, and road tests after an at-fault collision or when saddled with three or more demerit points. Those 80 and over need to pass such tests before renewing their licence.

More than aging driver

But the cognitive challenges are not limited to older drivers alone. Up to 10% of dementia cases begin before the age of 65, Robertson said, citing research by the Alzheimer’s Society. Other younger drivers could struggle with the lingering effects of sports-related head injuries.

Regardless of age, Robertson believes road tests continue to be the “gold standard” when it comes to identifying challenges. The tests simply need to incorporate another layer.

“Conventional road tests focus on basic driving skills – and even cognitively impaired drivers can execute those skills adequately,” she explained. “Driving is an over-learned task.”

The cognitive test that was applied during the Ontario pilot study ran for up to 50 minutes, incorporating increasingly more complex tasks. Someone with a cognitive challenge might be able to keep the vehicle in its lane, but struggle to quickly identify an emerging threat or navigate from memory.

“Drivers who have more cognitive impairment are more likely to demonstrate errors during that complex part of the test, and that complex part of the test comes closer to the end where there’s already some mental fatigue.”

An enhanced test might only be a step in the process, flagging drivers who require another layer of screening, she said. And it isn’t always about pulling drivers off the road. Other options could be found in conditional licences, such as those that restrict where some drivers can operate vehicles in jurisdictions like California, some Australian states, Sweden, Belgium, the Netherlands, and Finland.

There’s plenty still to think about.

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John G. Smith is Newcom Media's vice-president - editorial, and the editorial director of its trucking publications -- including Today's Trucking,, and Transport Routier. The award-winning journalist has covered the trucking industry since 1995.

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  • I’m 62 this year. Driving AZ since 16 yrs old. I was was very disappointed reading this article. The most dangerous truck drivers on the road , I see very day , are younger inexperienced, poorly trained and unprofessional . Truck driving schools should be looked at.

    • It is true what you are saying Mark and for my part what the new generation are trying to do is to me discrimination against older drivers , we might be old but if the job get done let the older guy a go at it till he has enough of this trade.
      Than it would be only fair to leave such of non rewarding job.

  • So if I am found to be cognitive impaired will I be able to apply for my pension for health reasons
    Or just told after driving for 25 years that I have to find a new profession

  • Well I started Driving Truck full time at 58, was a part-time school bus driver and drove Charter Busses also.
    While getting all these licences I was tested often and finally got on the road full time at 58. After watching all the terrible drivers truck drivers, car drivers and what ever else you want to call them.
    I believe everyone should have to take a refresher course for driving any vehicle on the highway as the rules change and I can’t believe they have a licence to begin with.
    The age does not seem to matter much except for reflexes.

  • A great amount of collisions are caused by “the other driver”, not the Class 1 driver. Perhaps if time were spent with young drivers; showing them how to act and react around commercial vehicles and even other vehicles…I understand reaction time may slow over time – but to assume this only happens to truck drivers is not fair. Perhaps cognitive testing should be part of ALL drivers road tests…..

  • I’m 70 and still go long haul twice a month. I am a much better driver than some of these “new” drivers on the road today. For instance, I have never run a stop sign and killed a bunch of teenagers and I have never smashed into a stopped car and incinerated a whole family! Pick on the problem, not the professionals!

  • Yes keep hounding us old truck drivers in 10 years this country will be so short on drivers that the government people Will not know what to do with the supply chain. The old drivers are the best drivers young drivers The young drivers are the ones with no experience that have the most accidents there is not enough training for a young drivers need to go back to the old system the driver goes on a truck as a team driver as a cadet out for three months before he’s put out on his own then your problem will be solved till then leave us old drivers alone. We are very professional out here and very caring so sad that the trucking Industry in North America gets nothing in return but grief thank you

  • I completely disagree with Robertson that older truck driver’s are the problem and forcing them to do another road test.
    Is not going to solve the problem.
    Truck drivers that have to many points or at fault accidents the insurance company will not insure them so they have to look for another profession instead.
    Truck drivers over 65 have a medical test done every year already wen something is admis he is not passing the test.
    So putting more tests and stress on a driver having already a stressful job is just not right.

  • Well as a professional driver and not like a lot of these new career drivers coming in . A lot of us know whats happening around us . But the problem is is the new car drivers not being taught the safety around big trucks is not to well . And nothing is being done about that . The amount of work we have to do just to make ends meet is pathetic. Rates are going down fuel prices rising repairs are rising and the cost of a new truck is up . Its the stress and the things that goes with it . With all the changes that are coming I can see nobody driving trucks today because of all the political brown sugar . There making it more stressful for any body to drive . That’s all I can say .

  • In fact, I do not agree with you in this article for the reason that is The accident depends on three components the driver . The Road. Vehicle I got a driver’s license since 1999, and from my experience as a drivers coach, I believe that the cause of accidents does not depend on the drivers ’aging, but rather on the personality and ability of the driver to read the street and assess the situation in a timely manner. Because old drivers have a high level of responsibility, unlike young people who enjoy aggression. Experience plays a big role in such matters. I think that there must be a condition for the age of the applicant for the examination (I mean new drivers) Thank you

  • Reaction time may be slightly slower with age, but the experienced driver will recognize potential problems much faster than those lacking experience.

  • There are no validated cut scores for current cognitive tests, which forces physicians to work in an evidence-based vacuum. Candrive, which is funded by the Canadian Institutes of Health Research , wasn’t able to find any association between cognitive test scores and actual crashes. They followed a large cohort of older drivers, testing them in every possible way, and allowing all of them to continue driving, regardless of how they scored. When used for driving and then compared to the results of a subsequent driver’s test, the MMSE has a false positive rate of 50%, the MoCA has a specificity of 50%, and a fail on the Trail Making B test could lead to an incorrect diagnosis nine times of ten. The standards for fitness to drive are based almost entirely on class three evidence, habit and opinion.
    Is there anything else in modern medicine that is more poorly supported by science?