With the aim of exploring differences in performance and exposure between older drivers who are cognitively intact and those with mild cognitive impairment (MCI), researchers conducted a literature search encompassing the definition, operationalization, and domains of cognition affected, as well as measures used to diagnose this condition. The review focused on studies addressing the impact of MCI on driving safety and performance published in 2003 and later. While an underlying premise in the research design was that clinicians could apply widelyaccepted criteria for diagnosing MCI, distinct from higher levels of cognitive impairment, the results of the literature review called this assumption into question. Evidence in the form of neuropsychological testing is necessary, but not sufficient, to define MCI. Perceptions of changes in cognition by the affected person or those close to them, coupled with greater difficulty performing instrumental activities of daily living, also factor into a diagnosis of MCI.Two consulting certified driver rehabilitation specialists (CDRS) in Richmond, and Roanoke, Virginia, recruited study participants under OMB Control Number 2127-0712. In each area, one CDRS solicited participants through presentations in community settings such as health fairs and continuing care retirement centers (CCRCs) while also receiving referrals from physicians and other health care professionals. Participants also included drivers who had been advised by the Virginia DMV that they must complete CDRS driving evaluations as a condition of continued licensure. Participants took part in a clinical assessment and received comprehensive driving evaluations by a CDRS. When participants completed the evaluations, they were offered additional compensation for allowing their driving exposure to be monitored for a month via a miniature camera and GPS logger installed in their personal vehicles. Thirty eight participants 62 to 88 years old completed the clinical and on-road assessments. Of these, 31 consented to participate in the exposure data collection, and 29 completed it.

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