There are various reasons why persons holding a driver’s license no longer retain the ability to drive a car. This might be e.g. stroke, traumatic brain damage, or early dementia. In order to assess the driving ability in persons with suspected cognitive impairment, there is a need for good tests that can categorize persons into three groups: (1) inability to drive a car, (2) sufficient ability to drive a car, (3) should be referred to a more comprehensive assessment of cognitive ability.

In this report, we have provided an overview of existing cognitive screening tests for assessing functions of relevance for ability to drive a car, and how good the tests are for predicting who will pass an on-road driving test or who will experience a car accident during the first years after the screening test.

Our key messages are:

• We have not found any cognitive screening tests that have good documentation of diagnostic test accuracy for predicting results on on-road driving tests. Tests that could detect at least 65 percent of dangerous drivers in all studies were the Montreal Cognitive Assessment (MoCa, detected 70-85%), the Clock Drawing Test (detected 65-71%) and the Trail-Making Test-B (detected 70-77%). We have in most cases little or very little confidence in the results
• There was large variation in how good the tests were for predicting results on an on-road test
• There is a need for standardization of the outcome measures and the test batteries in research about screening tests for driving ability
• We can therefore not conclude about which tests are best for detecting persons with a reduced ability to drive among persons with a suspected cognitive impairment