Most Cognitive Tests Fall Short for Predicting Driving Ability

Quick fact: Only 1 out of 56 cognitive assessment tools met both scientific validity and practical usability standards for predicting older adults' driving performance.

Researchers reviewed 77 studies examining cognitive tests used to evaluate whether someone can drive safely. Out of 56 different assessment tools analyzed, just four met rigorous scientific standards for accuracy. Of those four, only one—DriveSafe DriveAware—was also practical enough for everyday clinical use. The review focused on older adults and people with health conditions affecting thinking and memory. While many tools showed promise for practical application, their lack of scientific rigor meant they couldn’t reliably replace actual on-road driving tests. The findings suggest that behind-the-wheel assessments remain the gold standard, though combining functional assessments with clinical judgment may help predict who needs further evaluation. The gap between available tools and reliable options highlights the challenge of balancing thoroughness with practicality in assessing fitness to drive.

Source: PMID 40457824 (Disability and rehabilitation, 2026)