Cognitive Functioning Predicts Driver Safety on Road Tests 1 and 2 Years Later

Abstract

BACKGROUND Our ability to predict aging related declines in driving performance from off-road assessments have clinical practice and social policy implications. OBJECTIVES 1) To describe longitudinal changes in mean-level and evaluate rank-order stability in potential predictors of driving safety (visual sensory, motor, visual attention, and cognitive functioning) and safety errors during an 18-mile on-road-drive-test among older adults. 2) To evaluate the relative predictive power of earlier visual sensory, motor, visual attention, and cognitive functioning on future safety errors controlling for earlier driving capacity. DESIGN A three-year longitudinal observational study; SETTING A large teaching hospital in the Mid-West; PARTICIPANTS 111 neurologically normal older adults (60 to 89 years at baseline); MEASUREMENTS Safety errors based on video review of a standard 18-mile on-road driving test served as the outcome measure. Comprehensive battery of tests on the predictor side included visual sensory functioning, motor functioning, cognitive functioning, and a measure of Useful Field of View. RESULTS Longitudinal changes in mean-levels of safety errors and cognitive functioning were small from year-to-year. Relative rank-order stability between consecutive assessments was moderate in overall safety errors, it was moderate to strong in visual attention and cognitive functioning. While prospective bivariate correlations ranged from fair to moderate between safety errors and predictors, only functioning in the cognitive domain predicted future driver performance one and two-years later in multivariate analyses. CONCLUSION Normative aging related declines in driver performance as assessed by on-road tests emerge slowly. The findings clearly demonstrated that even in the presence conservative controls, such as previous driving ability, age, visual sensory and motor functioning, cognitive functioning predicted future driving performance on-road one and two-years later.

Individual differences in cognitive functioning predict effectiveness of a heads-up lane departure warning for younger and older drivers

“…larger reductions in correction RTs) compared to their lower speed of processing peers. Hence this finding is very consistent with those from several other studies indicating that cognitive speed of processing is important in predicting driving performance; it is often associated with better performance in on-road tests, fewer safety errors, and better state-driving records 6,7,24–33,51 .…”

“…The findings regarding the importance of cognitive function to LDW effectiveness in particular for older drivers support the message of many earlier studies on driving safety. Namely, several domains of functioning including vision, motor function, and distinct aspects of cognition should be considered in identifying those drivers who could stand to benefit from ADAS 6,24,25,53 .…”

“…As noted by several groups, individual differences in functional declines associated with aging are large 6,9,22,23 and many of these impairments in basic visual, motor function as well as cognition have been shown to affect driving safety in vehicles that are not equipped with modern safety technologies 6–8,10,24–30 . Bivariate associations of these domains of functioning and driving safety measures range from fair to moderate.…”

Sensorimotor and cognitive factors associated with the age-related increase of visual field dependence: a cross-sectional study

“…Our results support the hypothesis that increased visual field dependence with age relates to both sensory and cognitive decline. In addition, UFOV assessment is associated with driving cessation, unsafe driving, and crash risk amongst old adults as it implies both visual sensory abilities and higher order attentional skills for old adults (Ball et al 1993(Ball et al , 2006Goode et al 1998;Mathias and Lucas 2009;Owsley et al 1991Owsley et al , 1998Wood et al 2012)-although there is some ambiguity with respect to the UFOV test's validity as a predictor of safe driving (Aksan et al 2012;Emerson et al 2012). Our data are in agreement with older studies relating perceptual style and selective attention/visual search in the context of driving performance and crash risk (Guerrier et al 1999;McKnight and McKnight 1999;Mihal and Barrett 1976).…”

Cognitive functioning differentially predicts different dimensions of older drivers’ on-road safety

“…Understanding which aspects of cognitive functioning predict specific facets of driving performance can inform design of off-road screening tests for driver licensure, clinician evaluations of driver fitness, and interventions for specific driving difficulties. Visual sensory function, motor, and cognitive functions including Useful Field of View (UFOV) predict driving safety outcomes (e.g., Aksan et al, 2012; Anstey et al, 2005; Anderson et al, 2012; Anstey & Woods, 2011; Ball et al, 1993; Ball et al, 2006; Dawson et al, 2010; Ross et al, 2009; Wood et al, 2008). Bivariate associations among predictors and driving safety measures range from fair to moderate.…”