Conclusions The Timed Up- and -Go test measure appears not to be a useful measure of physical functioning for the driving outcomes included here .
The Rapid Pace Walk may be useful in studies of driving ability and exposure .
Background Improving physical functioning may be a future intervention to keep older adults driving safely longer as it can help maintain both physical and cognitive health longer .
This systematic review assesses the evidence on the association between three physical functioning measures : the Short Physical Performance Battery , the Timed Up- and -Go test , and the Rapid Pace Walk with driving outcomes in older adults .
Determining the validity of the AMA guide: A historical cohort analysis of the assessment of driving related skills and crash rate among older drivers.
BACKGROUND Chronic health conditions associated with ageing can lead to changes in driving ability . The Canadian Driving Research Initiative for Vehicular Safety in the Elderly ( C and rive II ) is a 5-year prospect i ve study funded by the Canadian Institutes of Health Research aim ing to develop an in-office screening tool that will help clinicians identify potentially at-risk older drivers . Currently , no tools exist to directly predict the risk of motor vehicle collision ( MVC ) in this population . The American Medical Association ( AMA ) , in collaboration with the National Highway Traffic Safety Association , has design ed an opinion-based guide for assessing medical fitness to drive in older adults and recommends that physicians use the Assessment of Driving Related Skills ( ADReS ) as a test battery to measure vision , cognition and motor/somatosensory functions related to driving . The ADReS consists of the  Snellen visual acuity test , visual fields by confrontation test , Trail Making Test part B , clock drawing test , Rapid Pace Walk  , and  manual tests of range of motion and motor strength .  We used baseline data from the C and rive/Ozc and rive common cohort of older drivers to evaluate the validity of the ADReS subtests . We hypothesized that participants who crashed in the 2 years before the baseline assessment would have poorer scores on the ADReS subtests than participants who had not crashed . METHODS In the C and rive/Ozc and rive study , 1230 participants aged 70 years or older were recruited from 7 Canadian cities , 1 Australian city and 1 New Zeal and city , all of whom completed a comprehensive clinical assessment at study entry . The assessment included all tests selected as part of the ADReS. For this historical cohort study , data on all crashes ( at-fault and non-at-fault ) that occurred within 2 years preceding the baseline assessment were obtained from the respective licensing jurisdictions . Those who crashed were compared to those who had not crashed on their ADReS subtest scores using Pearson 's chi-squared test and Student 's t-test . RESULTS Sixty-three of the 1230 participants ( 5.1 % ) were involved in an MVC within the 2 years preceding the baseline assessment . Contrary to our hypothesis , there were no statistically significant associations between abnormal performance on the tests constituting the  ADReS  and history of crash in the previous 2 years ( p>0.01 ) . DISCUSSION We found that a history of crash in the previous 2 years was not associated with abnormalities on the subtests comprising the ADReS. This suggests the need for prospect i ve analyses of risk factors over time to establish sensitive , valid predictors of crash that can be incorporated in clinical practice guidelines
Conclusions The Timed Up- and -Go test measure appears not to be a useful measure of physical functioning for the driving outcomes included here .
The Rapid Pace Walk may be useful in studies of driving ability and exposure .
Background Improving physical functioning may be a future intervention to keep older adults driving safely longer as it can help maintain both physical and cognitive health longer .
This systematic review assesses the evidence on the association between three physical functioning measures : the Short Physical Performance Battery , the Timed Up- and -Go test , and the Rapid Pace Walk with driving outcomes in older adults .