Examining the association between driver perceptions with clinical tests and simulated driving performance in Canadian long-haul truck drivers

• LHTD report higher comfort driving during the day than at night. • Visual and cognitive tests predict comfort in high-demand nighttime scenarios. • Poor mobility and cognition tied to reduced comfort in adverse driving settings. • Drivers’ often overestimate ability, leading to more errors in complex conditions. • Simulated training may boost insight, safety, and skills in aging LHTD drivers. Long-haul truck drivers (LHTD) routinely navigate challenging driving environments, which requires high levels of visual, cognitive, and physical functioning. While prior studies in older adults have demonstrated significant associations between functional abilities, self-perceptions, and driving performance, these relationships have not been examined among LHTD. The objectives of this study are to: (1) describe LHTD perceptions; (2) examine the associations between clinical test scores and driver perceptions; and (3) examine the associations between driver perceptions and simulated driving errors. LHTD were recruited from various provincial and federal trucking associations and trucking companies across Canada. A sample of 36 LHTD completed a demographic questionnaire; objective health measures; Driving Comfort Scales (DCS) and Perceived Driving Abilities Scale (PDA); cognitive, visual, and motor tests; and two simulated drives with different environmental conditions. The mean age of the sample was 47.9 ± 12.3 years (range 22–69); 94.4 % were men. LHTD were highly comfortable driving during the day (DCS-D: 85.3 ± 9.2) and at night (DCS-N: 80.8 ± 12.3), however, their DCS-N scores were significantly positively associated with vehicle position, speed regulation, and adjustment to stimuli errors. Poorer scores on the RPWT, TMTA, and TMTB were significantly associated with lower driving comfort in scenarios that require quick decision-making (e.g., heavy traffic, other drivers not signaling). The study highlights the significant role of physical and cognitive abilities in shaping LHTD self-perceptions, particularly in challenging conditions. To improve cognitive and on-road driving performance, future research should explore the development of a continuing education course for LHTD.