Cognitive Impairment Screening Test for Senior Drivers

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Cognitive Impairment Screening Test for Senior
Drivers
Guidance (Pattern C)
National Police Agency Traffic Bureau License
Division
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Introduction
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• It has been shown that the cognitive function
  for driving declines with aging.
• Now, you, the drivers who are aged 75 or older,
  will be administered Cognitive Impairment
  Screening Test to examine your cognitive
  function, when renewing your driving license.
• After reading this page, please raise your hand
  to let us know.

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• Based on the test results, the most appropriate
  course will be given to each senior driver.
• When your test results show cognitive impairment
  and you have a history of a specific traffic
  violation (e.g. ignoring a traffic light,
  ignoring a stop signal etc.), you would be
  requested by the police to take an additional
  medical examination.
• After reading this page, please raise your hand
  to let us know.

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• This simple test will take only about 30
  minutes.
• Instruction of the test is shown on this screen,
  and we will explain it step by step. Please read
  the instruction carefully.
• You will be notified the test results later.
• The test results will be sent to the police.
  However, this information will not be released to
  the public.
• After reading this page, please raise your hand
  to let us know.

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Instruction before starting the Test
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• Please pay attention to the following
  instruction before starting the Test.
• Please put a watch and a cell phone into your
  bag or your pocket.
• Please do not turn pages of your sheets until
  the instruction will be given.
• After reading this page, please raise your hand
  to let us know.

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• Now, please fill out your information in the
  boxes printed on the front page.
• First, the top box is for "Name." Please write
  your full name.
• You cannot use an eraser.
• When making a correction, cross out the wrong
  letters with double line.
• Do the same method when you want to make a
  correction in the following questions.
• After reading this page, please raise your hand
  to let us know.

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• The second box is for "Date of Birth." Please
  write your date of birth.
• The third box is for "Sex." Please circle the
  number which applies to you.
• The last box is for "Frequency of Driving."
  Please circle the number which applies to you.
• That's it for the front page.
• Please put your pencil on the desk.

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• Now, we are going to start the test.
• First, we explain the test procedure.
• After the explanation is done, you will be asked
  to write the answers.
• If you need assistance, please let us know.
• After reading this page, please raise your hand.

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Orientation for Time
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• Now, you are going to start the first test.
  Please turn to the next page.
• You will see the page SHEET 1". There are five
  questions.
• Please answer each question.
• Please write your answers in the answer boxes
  next to each question.
• Even if you dont have the correct answer, please
  write something you believe to be correct.
• Please do not leave them blank.
• After reading this page, please raise your hand
  to let us know.

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• Do you have any questions?
• If you have some questions, please feel free to
  ask us.
• If you dont, please take a pencil and raise your
  hand to let us know.
• After the instruction on this screen, please turn
  to the next page and start writing the answers.

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Please turn to the next page and start writing
the answers.
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Time is up. Please put your pencil on the desk.
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Cued Recall
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• Now you are going to start the second test. You
  will see some drawings.
• There will be drawings of four objects on each
  sheet.
• Later on, you will be asked to write down all the
  objects you see.
• So, please memorize what the objects are drawn on
  the sheets.
• After reading this page, please raise your hand
  to let us know.

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• Do you have any questions?
• If you have any questions, please feel free to
  ask us.
• If you dont, please raise your hand to let us
  know.

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There is a musical instrument among them. Which
one? Please say it aloud.
There is an electric appliance among them. Which
one?
Yes, a microwave.
Yes, a Japanese harp.
You see a machine gun.
You see a Japanese harp.
You see a microwave.
You see a thumb.
There is a weapon among them. Which one?
There is a part of human body among them. Which
one?
Yes, a machine gun.
Yes, a thumb.
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There is an animal among them. Which one?
There is a kitchen appliance among them. Which
one?
Yes, a cow.
Yes, a pot.
You see a snail.
You see a cow.
You see corn.
You see a pot.
There is vegetables among them. Which one?
There is an insect among them. Which one?
Yes, a snail.
Yes, corn.
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There is clothing among them. Which one?
There is stationery among them. Which one?
Yes, scissors.
Yes, a dress.
You see a truck.
You see scissors.
You see a dress.
You see melon.
There is fruits among them. Which one?
There is a means of transportation among them.
Which one?
Yes, melon.
Yes, a truck.
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There is a carpenters' tool among them. Which
one?
There is flowers among them. Which one?
Yes, a screwdriver.
Yes, tulips.
You see a peacock.
You see tulips.
You see a screwdriver.
You see a chair.
There is a bird among them. Which one?
There is a furniture among them. Which one?
Yes, a peacock.
Yes, a chair.
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• How was it?
• Later, you will be asked what objects you saw.
• So please do not forget what you saw.
• After reading this page, please raise your hand
  to let us know.

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• Now, you will be given another simple test.
  Please turn to the next page.
• You see the page "SHEET 2.
• Next, you will be asked to write the alphabets in
  reverse order.
• For example, when you are asked to write "A, B,
  C, D, E" in reverse order, you should write "E,
  D, C, B, A" as you see on the sheet.
• After reading this page, please raise your hand
  to let us know.

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• Do you have any questions?
• If you have some questions, please feel free to
  ask us.
• If you dont, please raise your hand to let us
  know.

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• Please turn to the next page. There are two
  rows of five squares, one in the top and the
  other in the bottom.
• First, please write "F, G, H, I, J" in reverse
  order in the top row of five squares.
• After reading this page, please take a pencil
  and raise your hand to let us know.
• After the instruction, please start writing the
  alphabets.

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Please start writing the alphabets.
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Time is up. Please put your pencil on the desk.
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• Next, please write "K, L, M, N, O" in reverse
  order in the bottom row of five squares.
• After reading this page, please take a pencil
  and raise your hand to let us know.
• After the instruction, please start writing the
  alphabets.

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Please start writing the alphabets.
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Time is up. Please put your pencil on the desk.
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• Please turn to the next page. You see the page
  SHEET 3.
• A little while ago, you were shown some drawings
  of the objects.
• Do you remember the objects what you saw?
• Please write as much as you can recall. You may
  write them in no special order.
• After reading this page, please take a pencil,
  and raise your hand to let us know.

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• Do you have any questions?
• If you have some questions, please feel free to
  ask us.
• If you dont, please take a pencil and raise your
  hand to let us know.
• After the instruction on the screen, please turn
  to the next page and start writing the answers.

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Please turn to the next page and start writing
the answers.
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Time is up. Please put your pencil on the desk.
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• Now, you will have some hints for the objects you
  saw. Please turn to the next page. You see the
  page "SHEET 4.
• You will have some hints in the left on the page.
  
• Use the hints and try to recollect the objects
  what you saw as much as possible.
• You can write only one answer for each hint. Do
  not write more than one.
• After reading this page, please raise your hand
  to let us know.

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• Do you have any questions? If you have some
  questions, please feel free to ask us.
• If you dont, please take a pencil and raise your
  hand to let us know.
• After the instruction on this screen, please
  turn to the next page and start writing the
  answers.

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Please turn to the next page and start writing
the answers.
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Time is up. Please put your pencil on the desk.
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Drawing a Clock
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• You will start the next test. Please turn to the
  next page. You see the page "SHEET 5".
• In this test, you will be asked to draw a clock.
• First, you are going to draw a clock board.
• Draw a large circle, and write all the numbers
  which should be on the clock. Draw as large as
  possible.
• Later, we will tell you a specific time, and you
  are asked to draw the hands in the clock which
  show the time you were told.
• After reading this page, please raise your hand
  to let us know.

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• If you made a mistake, please raise your hand to
  let us know. We will give you another sheet of
  paper.
• Do you have any questions? If you have some
  questions, please feel free to ask us.
• If you dont have any questions, please take a
  pencil and raise your hand to let us know.
• After the instruction on this screen, please turn
  to the next page and draw a clock board.

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Please turn to the next page and draw a clock
board.
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Time is up. Please put your pencil on the desk.
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• Next, please draw the hands in the clock which
  show 820.
• Please take a pencil.
• After reading this page, please raise your hand
  to let us know.
• After the instruction, please start writing the
  answers.

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Please start writing the answers.
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Time is up. Please put your pencil on the desk.
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The test is over. Thank you for taking the
test. We will collect the test sheets. Please
remain seated.
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Scoring the Test Results
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• We will start scoring the test, and we will let
  you know the scores.
• It will take a few minutes to score the tests and
  to make notifications.
• You may take a break, but please be sure to come
  back.
• After reading this page, please raise your hand
  to let us know.

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Notifying the Scores
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• Now, you will be notified the scores of the test
  individually.
• So please remain seated.
• After reading this page, please raise your hand
  to let us know.

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• Please take a look at the score.
• Your name, your score, your results and the
  advice based on your score are written on the
  front side of the notification.
• Based on your score, your cognitive function is
  judged whether impaired, slightly impaired or not
  impaired.
• After reading this page, please raise your hand
  to let us know.

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• The test you took is a brief test to judge your
  cognitive function.
• So, though your cognitive function is judged to
  be impaired, it does not directly mean that you
  are demented.
• However, please consult your doctor or talk with
  your family.
• After reading this page, please raise your hand
  to let us know.

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• Though your cognitive function is impaired, you
  can renew your driving license.
• However, please be sure that if a person with
  impaired cognition made a specific traffic
  violation (e.g. ignoring a traffic light,
  ignoring a stop signal etc.), one would be
  requested by the police to take an additional
  medical examination.
• If it is judged that you have dementia, your
  permit would be relocated.
• After reading this page, please raise your hand
  to let us know.

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• On the back side of the notification, how the
  test results are scored and how the level of
  cognitive function is judged are described.
  Please use it as a reference.
• Which course you should take is based on the
  scores of the test.
• Please make sure to bring this notification when
  taking a course.
• If you have any questions with your scores,
  please ask later or ask to the police.
• You are all set. Thank you for taking the
  Cognitive Function Screening Test for Senior
  Drivers.