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Abstract: Considerable research has shown that neuropsychological tests are predictive of real-world driving ability. The Mini-Mental State Examination (MMSE) is a brief cognitive test that has been commonly used in the assessment of older drivers. However, this test has inherent problems that limit its validity to evaluate cognitive abilities related to driving and to screen for driving impairments in non-demented people. Therefore, it is useful to test new screening instruments that may predict potential unsafe drivers who require an in-depth neuropsychological assessment in a specialised centre. To date, the utility of the Addenbrooke''s Cognitive Examination Revised (ACE-R) as an indicator of driving ability has not been established. In the current study, fifty older drivers (mean age=73.1years) who were referred for a psychological assessment, the protocol of which included the ACE-R, underwent an on-road driving test. Using linear discriminant analyses, the results highlighted the higher classification accuracy of the ACE-R compared to the MMSE score, particularly for detecting unsafe drivers. Measures of visuospatial and executive functions, which are not incorporated in the MMSE score, had an incremental value in the prediction of driving ability. This emerging brief cognitive test may warrant additional study for use in the fitness to drive assessment of older adults. [Copyright &y& Elsevier]

• In nursing homes, neuropsychiatric symptoms (NPS) are particularly frequent. • Cognition, functional status, needs and psychotropic drugs all correlate with NPS. • Unmet needs and hypnotic/sedatives shown to increase the risk of presenting NPS. • Identifying and modifying these factors would benefit residents' symptomatology. • Findings conform with the unmet needs model, placing emphasis on needs assessment. This study aimed to explore neuropsychiatric symptoms' (NPS) risk factors in a sample of nursing home residents. A cross-sectional study was conducted. Residents over 65 years were included, unless they had a known major psychiatric diagnosis. The Neuropsychiatric Inventory (NPI) was completed, and other measures included residents' sociodemographic characteristics, cognition, functional impairment, regular drugs and number of needs. To explore potential risk factors, a logistic regression was conducted with the presence of NPS (NPI-10 ≥ 1) as dependent variable. Additional exploratory analyses were conducted based on a sub-syndrome approach, and three multivariate models were repeated considering the psychotic, affective and behaviour syndromes as dependent variables. A total of 140 residents were included (age: 83.71 ± 7.29 years). More than half (50.4%) presented at least one NPS. NPI-10 showed significant correlations with cognition (r s =-0.177, p = 0.042), functional impairment (r s = 0.174, p = 0.043), unmet needs (r s = 0.245, p = 0.004) and nervous system-acting drugs (r s = 0.271, p = 0.002), particularly anxiolytics (r s = 0.175, p = 0.047), antidepressants (r s = 0.204, p = 0.019) and hypnotics/sedatives (U = 2434.5, p = 0.028). However, in the multivariate analysis only unmet needs (OR = 1.30; 95% CI: 1.008–1.670) and hypnotic/sedatives (OR = 4.66; 95% CI: 1.132–19.144) showed an independent association with the presence of NPS. Regarding the additional models, unmet needs and literacy, antidepressants and hypnotic/sedatives, and cognitive status, showed to contribute to explain the variability of psychotic, affective and behaviour syndromes, respectively. Identifiable and modifiable factors, including unmet needs and prescribed psychotropic drugs, could have contributed to NPS in this sample, suggesting a role for targeted non-pharmacological and person-centred approaches directed to residents' unmet needs. [ABSTRACT FROM AUTHOR]