Validation and Clinical Application of a Developed Pedal Coordination Assessment Device for Older Drivers.

: Automobiles are vital for older adults to maintain health and independence, yet aging-related declines in physical and cognitive functions may impair driving abilities. Compensatory driving behaviors can help maintain driving safety. : This study aims to (1) validate a newly developed pedal coordination assessment device reflecting aging effects and (2) examine its potential application by analyzing the relationship between pedal coordination ability, physical and cognitive functions, and driving abilities. : A total of 48 older adults (mean age 73.5 ± 4.9 years) and 56 younger adults (mean age 21.1 ± 0.7 years) participated. Older adults underwent on-road evaluations, driving simulator (DS) tests, and assessments of grip strength, Short Physical Performance Battery (SPPB), Mini-Mental State Examination (MMSE), and Trail Making Test. Pedal coordination ability was measured using the device, requiring participants to maintain pedal positions across target speeds. Correlations between pedal coordination ability and physical, cognitive, and driving-related indicators were analyzed. : Older adults required significantly more time than younger adults to maintain pedal positions. Within older adults, women showed poorer performance than men. Limited correlations were found between pedal coordination ability and physical or cognitive functions. Positive correlations were observed with DS accident frequency and sudden braking incidents. : The device effectively reflected age-related declines in pedal coordination ability. Its primary application should focus on helping older adults recognize aging-related changes and promoting compensatory driving behaviors. Future studies should explore its use in group-based preventive programs.