Fig 1 - uploaded by Linda Hill
Content may be subject to copyright.
DOSCI roadside screening tool  

DOSCI roadside screening tool  

Source publication
Article
Full-text available
Background: An estimated one in five drivers will be over 65 by 2030. Compared with their younger counterparts, older adults are more likely to experience health and functional impairments, including cognitive dysfunction, which may interfere with their ability to drive safely. Law enforcement officers, as part of the public safety community, need...

Context in source publication

Context 1
... complement the training officers received and help them implement it in their day-to-day traffic work, the TREDS group developed an easy-to-use screening tool for disorientation (Fig. 1), called the DOSCI. The tool was to be used to help clarify whether the confused and possibly disheveled patient was disoriented, and to provide a re- minder and guidance for reporting medically impaired drivers. The expert interviews and focus group (described above) produced recommendations that the ...

Similar publications

Article
Full-text available
Motor performance and cognitive function both decline with aging. Older adults for example are usually less steady for a constant-force task than young adults when performing low-intensity contractions with limb muscles. Healthy older adults can also show varying degrees of cognitive decline, particularly in executive function skills. It is not kno...

Citations

... There are nine total questions asked in the DOSCI and a failure of three or more is considered inadequate by the Iowa DOT. The DOSCI has been used to identify individuals with possible cognitive impairment during roadside assessments [10]. Safe Driving BASICS is a computer-administered testing battery that combines aspects of trail-making, visual memory, and visual closure (ability to visualize missing information). ...
... In our study, drivers with dementia were less likely to pass IDOT's screening battery (the Safe Driving BASICS) as well as the individual DOSCI test and the on-road driving test. The DOSCI was developed to identify drivers with cognitive impairment [10]. As expected, drivers with dementia had a much higher likelihood of failing the DOSCI. ...
Article
Full-text available
Cognitive and physical impairment can occur with dementia and reduce driving ability. In the United States, individual states have procedures to refer and evaluate drivers who may no longer be fit to drive. The license review process is not well understood for drivers with dementia. This study uses comprehensive data from the Iowa Department of Transportation to compare the referral process for drivers with and without dementia from January 2014 through November 2019. The likelihood of failing an evaluation test was compared between drivers with and without dementia using logistic regression. The risk of motor-vehicle crash after referral for review of driving ability was compared using a Cox proportional hazard model. Analysis controlled for the age and sex of the referred driver. Drivers with dementia performed worse on all tests evaluated except the visual screening test. After the referral process, the risk of crash was similar between those with and without dementia. Drivers with dementia were denied their license more frequently than referred drivers without dementia. However, drivers with dementia who successfully kept their license as a result of the license review process were not at an increased risk of crash compared to other referred drivers.
... 4 Nationally, several educational programs aim to improve officers' knowledge and skills in specific aspects of their interactions with older adults, such as responding to elder abuse 16 and identifying unsafe drivers. 17 However, these programs do not address officers' requests to learn basic knowledge about aging-related health that would allow them to more effectively assess and triage older adults. A brief geriatrics training was developed, implemented, and evaluated to address these educational needs. ...
... The 2015 President's Task Force on 21st Century Policing called on police departments to develop policies and procedures for working with older adults. 26 Nationally, training programs exist that focus on improving officers' knowledge and skills in specific interactions with older adults, such as identifying impairment in aging drivers, 17 responding to wandering in dementia, 27 preventing crimes, 28 and responding to elder abuse. 16 This training provides a critical foundation for such programs by educating police more broadly about the role that agingrelated health plays in the safe and effective policing of older adults and in approaches to mobilizing local resources. ...
Article
Objectives: To develop, implement, and evaluate a training program in aging-related health for police officers. Design: Cross-sectional. Setting: Crisis intervention training program for police officers in San Francisco. Participants: Police officers attending one of five 2-hour trainings (N = 143). Intervention: A lecture on aging-related health conditions pertinent to police work followed by three experiential trainings on how it feels to be "old." Measurements: Participants evaluated the quality of the training and the likelihood that they would apply new knowledge to their work and rated their knowledge using a retrospective pre-post evaluation. In open-ended responses, participants reported work-related changes they anticipated making in response to the training. Results: All 143 participants completed the evaluation. Eighty-four percent reported interacting with older adults at least monthly; 45% reported daily interactions. Participants rated the training quality at 4.6/5 and the likelihood they would apply new knowledge to their work at 4.4/5. Retrospective pre-post knowledge scores increased for all domains, including how to identify aging-related health conditions that can affect safety during police interactions (2.9/5 to 4.2/5; P < .001). In open-ended responses, participants anticipated having more empathy for and awareness of aging-related conditions and greater ability to provide older adults with appropriate community referrals. Conclusion: A brief training in aging-related health significantly increased police officers' self-reported knowledge and skills. Clinicians have an important opportunity to help enhance safe and effective community policing for older adults.
Article
Introduction: Driver retirement and determination of fitness-to-drive are important aspects of reducing the risk of motor-vehicle collision for an older driver. A lack of information about the review process may lead to poor evaluation of drivers or an increased testing burden to referred drivers. Methods: This paper evaluates the license review process for the state of Iowa. We evaluated data from January 2014 to January 2018 and described the source of referral, testing process, and ultimate license disposition. Cox proportional hazards for competing risk were used to determine the risk of having a change in restrictions on the license and the risk of license denial. Results: 20,742 individuals were followed through the medical referral process. The most common source of referrals was licensing officials (39.7%). Drivers referred by licensing officials were less likely to be denied their license when compared to drivers from other sources (HR = 0.92 95%CI: 0.87-0.98); however, licensing official referrals were more likely to result in license restrictions compared to other sources (HR = 1.91, 95%CI: 1.82-2.00). Drivers referred by either law enforcement or a physician were more likely to ultimately have their license denied. Conclusions: Physician and law enforcement referred the drivers most likely to have their license denied. A smaller proportion of drivers were referred by physicians and law enforcement compared to licensing officials. Practical Applications: Licensing agencies should work with physicians and law enforcement to identify drivers who may need a review of their license. Comprehensive tracking of all medical referrals for a driver's license review is important for individual states to understand the burden of their driver referral process and for identifying referral sources with a high proportion of referrals with no licensing change for targeted outreach and education.