Driving simulation has become popular in the context of assessment of driving ability, as it provides a safe and economical method of assessing driving behaviors in comparable, controlled and repeatable driving conditions. The present paper is a review of studies on driving performance assessment with the use of driving simulators, aiming at: (i) identifying and summarizing studies investigating driving performance as assessed on simulators in relation to cognitive impairments, particularly those which are age-related or caused by neurodegenerative disorders including mild cognitive impairment (MCI), Alzheimer‟s disease, Parkinson‟s disease and stroke; (ii) identifying issues that should be considered in the design of simulator experiments. Summaries of the studies are presented, which include information on the research questions, the characteristics of the subjects, the type of simulators used (level of fidelity), the driving scenarios and tasks used, simulator outcomes, dependent measures (e.g. behavioral data, crashes), and the main findings, as well as further research suggestions. Moreover, consideration is given to the studies‟ limitations and the interpretation of the findings (as noted or discussed by the authors) in an effort to identify issues which may limit the generalisability of research results and should be considered in the design of simulator experiments.