Visual attention and self-regulation of driving among older adults (original) (raw)
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Self-Regulation of Driving by Older Adults: A LongROAD Study
AAA Foundation for Traffic Safety., 2015
Founded in 1947, the AAA Foundation in Washington, D.C. is a not-for-profit, publicly supported charitable research and education organization dedicated to saving lives by preventing traffic crashes and reducing injuries when crashes occur. Funding for this report was provided by voluntary contributions from AAA/CAA and their affiliated motor clubs, from individual members, from AAA-affiliated insurance companies, as well as from other organizations or sources. This publication is distributed by the AAA Foundation for Traffic Safety at no charge, as a public service. It may not be resold or used for commercial purposes without the explicit permission of the Foundation. It may, however, be copied in whole or in part and distributed for free via any medium, provided the AAA Foundation is given appropriate credit as the source of the material. The AAA Foundation for Traffic Safety assumes no liability for the use or misuse of any information, opinions, findings, conclusions, or recommendations contained in this report. If trade or manufacturer's names are mentioned, it is only because they are considered essential to the object of this report and their mention should not be construed as an endorsement. The AAA Foundation for Traffic Safety does not endorse products or manufacturers.
Self-regulation of driving and its relationship to driving ability among older adults
Accident Analysis & Prevention, 2006
Although it is known that older drivers limit their driving, it is not known whether this self-regulation is related to actual driving ability. A sample of 104 older drivers, aged between 60 and 92, completed a questionnaire about driving habits and attitudes. Ninety of these drivers also completed a structured on-road driving test.
Self-Regulation of Driving and Older Drivers' Functional Abilities
Clinical Gerontologist, 2006
A sample of 90 adults aged between 60 and 91 completed a questionnaire about their driving behaviour, a battery of functional tests, and a structured on-road test. The section of the questionnaire featuring items about avoidance of difficult driving situations was used as an index of self-regulation of driving behaviour. The functional test battery consisted of mood, vision, physical functioning and neuropsychological tests. The on-road test used in the study was a standard assessment procedure developed by the Driver Assessment Rehabilitation Service to determine fitness to drive. Of the 90 participants in the study, 68 passed the driving test, 8 passed but were recommended to have lessons and 14 failed the test. Driving test scores for the study were based on the number of errors committed in the driving tests, with weightings given according to the seriousness of the errors. In order to identify risk factors for inadequate driver self-regulation, comparisons were made between the functional tests most strongly related to driving performance and the functional tests most strongly related to self-regulation. It was concluded that self-regulation of driving behaviour is inadequate among older drivers with poor contrast sensitivity, poor speed of information processing and poor visuospatial ability.
Changes in Self-Regulatory Driving Among Older Drivers Over Time
Traffic Injury Prevention, 2011
The primary goal of the study was to identify to what extent older people modify their driving, what influences them to do so, and how self-regulatory behavior changes over time in relation to changes in perceived impairments and lifestyle characteristics. Participants 65 and older (n = 2650) were recruited while renewing their driver's licenses in Connecticut, Kentucky, and Rhode Island and were interviewed by telephone about current driving patterns, recent changes in driving, functional abilities related to driving (i.e., vision, memory, physical mobility, diagnosed medical conditions), crash involvements, and lifestyle characteristics. Participants were called annually to participate in follow-up telephone interviews; 2057 completed a second interview, 1698 completed 3 interviews, and 1437 completed all 4 interviews. Stepwise regression analyses examined how changes in impairments and life events (i.e., retiring, becoming widowed or divorced) related to changes in the number of miles driven during a typical week and in the number of driving situations avoided. Based on information provided in the initial survey, participants who completed all 4 surveys were slightly younger, more likely to be married, slightly less impaired in terms of physical mobility and medical conditions, and drove more weekly miles and avoided fewer driving situations compared with those who dropped out. Participants who completed all 4 interviews reported driving an average of 94 miles per week in year 1 compared with 78 miles in year 4. Reported impairments generally were low to moderate and changed little. Analyses comparing years 1 and 4 indicated that drivers drove 35 fewer miles per week if they retired or lost their job and 61 fewer miles if they moved from a retirement home to a private home or assisted living. They drove 25 more miles per week on average if they became widowed or divorced. Small increases in the number of driving situations avoided were associated with increasing impairments in memory and mobility. Lifestyle changes such as becoming widowed or divorced or retiring were associated with changes in mileages. Older drivers with worsening memory and physical mobility regulated their driving to some extent by avoiding more driving situations, confirming the hypothesis that some older drivers do take steps to compensate for increases in some perceived impairments. However, during the 3-year study period, reported changes were not large, perhaps because older drivers with larger changes were among those who dropped out (46% of those who took the first survey).
Vision and Driving Self-Restriction in Older Adults
Journal of the American Geriatrics Society, 2003
The purpose of this study was to evaluate gender differences in the relationship between night driving self-restriction and vision function in an older population. Methods. Night driving self-restriction patterns (assessed by questionnaire) were examined cross-sectionally in relation to age, gender, health and cognitive status, depression, and vision function in a sample of 900 elders (mean age, 76 years) living in Marin County, California. Results. Of the total sample, 91% of men and 77% of women were current drivers. The mean age of the drivers was 73.3 years (range, 58-96 years). Among current drivers, women had slightly better vision function than men on most measures (low-contrast acuity, contrast sensitivity, low-contrast acuity in glare, low-contrast, low-luminance acuity, and glare recovery) but were twice as likely as men to restrict their driving to daytime. Men showed significant associations with avoidance of night driving on four spatial vision measures (high-and low-contrast acuity, lowcontrast, low-luminance acuity, and contrast sensitivity). For women, in addition to these measures, a significant association was seen for low-contrast acuity in glare. Neither men nor women showed significant associations between driving restriction and performance on the other vision measures examined (glare recovery time, attentional field integrity, or stereopsis). The vision measures most predictive of self-restriction were contrast sensitivity for men and low-contrast acuity in glare for women. Conclusions. Including both cessation and self-restriction, men over age 85 years are 6.6 times more likely than women to be driving at night. For both genders, vision plays a significant role in the self-restriction decision. A higher percentage of men than women continue to drive at night with poor vision. Men's night-driving cessation was associated with contrast sensitivity and depression, whereas women's night-driving cessation was associated with low-contrast acuity in glare as well as age.
Visual Attention Problems as a Predictor of Vehicle Crashes in Older Drivers
Investigative Ophthalmology Amp Visual Science, 1993
Purpose. To identify visual factors that are significantly associated with increased vehicle crashes in older drivers. Methods. Several aspects of vision and visual information processing were assessed in 294 drivers aged 55 to 90 years. The sample was stratified with respect to age and crash frequency during the 5-year period before the test date. Variables assessed included eye health status, visual sensory function, the size of the useful field of view, and cognitive status. Crash data were obtained from state records. Results. The size of the useful field of view, a test of visual attention, had high sensitivity (89%) and specificity (81%) in predicting which older drivers had a history of crash problems. This level of predictability is unprecedented in research on crash risk in older drivers. Older adults with substantial shrinkage in the useful field of view were six times more likely to have incurred one or more crashes in the previous 5-year period. Eye health status, visual sensory function, cognitive status, and chronological age were significantly correlated with crashes, but were relatively poor at discriminating between crash-involved versus crash-free drivers. Conclusions. This study suggests that policies that restrict driving privileges based solely on age or on common stereotypes of age-related declines in vision and cognition are scientifically unfounded. With the identification of a visual attention measure highly predictive of crash problems in the elderly, this study points to a way in which the suitability of licensure in the older adult population could be based on objective, performance-based criteria. Invest Ophthalmol Vis Sci. 1993;34:3110-3123. A he elderly represent the most rapidly growing segment of the driving population in industrialized societies, both in the total number of drivers on the road, and the number of miles driven annually per driver. 1 It is estimated that by the year 2024 one out of four drivers in the United States and Western Europe will be older than 65 years. Older drivers as a group have more traffic convictions and crashes and incur more fatalities per mile driven than any other adult age
Reprint of “Driving avoidance by older adults: Is it always self-regulation?”
Accident Analysis & Prevention, 2013
Self-regulation shows promise as a means by which older adults can continue to drive at some level without having to stop altogether. Self-regulation is generally described as the process of modifying or adjusting one's driving patterns by driving less or intentionally avoiding driving situations considered to be challenging, typically in response to an awareness that driving skills have declined. However, most studies asking older adults whether they avoid certain driving situations or have reduced the amount of driving they do under certain circumstances have not delved deeper into the motivations for such avoidance or driving reduction. There are many reasons for modifying driving that have nothing to do with self-regulation, such as no longer needing to take trips at certain times of day because of changes in preferences or lifestyles. The purpose of this study was to examine self-regulatory practices among older adults at multiple levels of driver performance and decision making, taking into account the specific motivations for avoiding particular driving situations or engaging in other driving practices. Study participants completed a computer-based questionnaire on driving self-regulation. Results suggest that self-regulation is a complex process that cannot be defined simply by the reported driving modifications made by drivers. Understanding the motivations for these behaviors is necessary and the study showed that they are varied and differ considerably across driving situations. Reasons for driving avoidance or other practices were often more closely related to lifestyle or preferences than to self-regulation. Based on these findings, three distinct groups were identified with regard to whether and for what reasons participants modified their driving.
Accident Analysis & Prevention, 2006
Using structural equation modeling techniques, this study examines causal models of driving avoidance and exposure among older adults. Prior studies have revealed that past incidence of falls, Useful Field of View (UFOV ® ) test performance, and Trails Making test performance are predictive of subsequent motor vehicle crash involvement [Owsley, C., Ball, K., McGwin Jr., G., Sloane, M.E., Roenker, D.L., White, M.F., Overley, E.T., 1998. Visual processing impairment and risk of motor vehicle crash among older adults. . Do older drivers with visual and cognitive impairments drive less? J. Am. Geriatr. Soc. 46, 854-861]. Data analyses used these indices, along with age, health, measures of physical functioning, and additional measures of cognitive functioning, to examine driving exposure and avoidance behaviors. A field sample of 4234 drivers, 55 years of age and older, were recruited from the Maryland Motor Vehicles Administration after renewing their driver's licenses. A performance-based assessment, which included the Gross Impairment Screening battery and task 2 of the UFOV ® test, was completed by participants. A sub-sample of participants (n = 815) were interviewed by telephone about their health and mobility 3-6 months following the initial assessment at a renewal center. In addition to age and gender, latent variables for health status, physical functioning, cognitive functioning, driving exposure, and driving avoidance were created. Direct and indirect causal paths were specified. Age, gender, health status, and cognitive functioning had direct effects on both driving exposure and driving avoidance; physical functioning did not have a direct effect on driving exposure or avoidance. The implications of these findings are discussed as they relate to designing interventions to promote mobility.
Journal of Geriatric Psychiatry and Neurology, 2013
Previous findings that older drivers engage in strategic self-regulatory behaviors to minimize perceived safety risks are primarily based on survey reports rather than actual behavior. This study analyzed in-car video recording of naturalistic driving of 18 patients with Alzheimer disease (AD) and 20 age-matched controls in order to (1) characterize self-regulatory behaviors engaged by older drivers and (2) assess how behaviors change with cognitive impairment. Only participants who were rated ''safe'' on a prior standardized road test were selected for this study. Both groups drove primarily in environments that minimized the demands on driving skill and that incurred the least risk for involvement in major crashes. Patients with AD displayed further restrictions of driving behavior beyond those of healthy elderly individuals, suggesting additional regulation on the basis of cognitive status. These data provide critical empirical support for findings from previous survey studies indicating an overall reduction in driving mobility among older drivers with cognitive impairment.