Neuropsychological Predictors of Driving Errors in Older Adults

Abstract

Objectives To identify neuropsychological factors associated with driving errors in older adults. Design Cross-sectional observational study. Setting Neuropsychological assessment laboratory and an instrumented vehicle on a 35-mile route on urban and rural roads. Participants One hundred eleven older adult drivers (ages 65-89 years; mean age 72.3 years) and 80 middle-aged drivers (age 40 to 64 years; mean age 57.2 years). Measurements Explanatory variables included age, neuropsychological measures (cognitive, visual, and motor), and a composite cognitive score (COGSTAT). The outcome variable was the safety error count, as classified by video review using a standardized taxonomy. Results Older drivers committed an average of 35.8 safety errors/drive (SD=12.8), compared to an average of 28.8 (SD=9.8) for middle-age drivers (P<0.001). Among older drivers, there was an increase of 2.6 errors per drive observed for each five-year age increase (P=0.026). After adjustment for age, education, and gender, COGSTAT was a significant predictor of safety errors in older drivers (P=0.005), with approximately a 10% increase in safety errors observed for a 10% decrease in cognitive function. Individual significant predictors of increased safety errors in older drivers included poorer scores on Complex Figure Test-Copy, Complex Figure Test-Recall, Block Design, Near Visual Acuity, and the Grooved Pegboard task. Conclusion Driving errors in older adults tend to increase, even in the absence of neurological diagnoses. Some of this increase can be explained by age-related decline in cognitive abilities, vision, and motor skills. Changes in visuospatial and visuomotor abilities appear to be particularly associated with unsafe driving in old age.

Chronological age and age-related cognitive deficits are associated with an increase in multiple types of driving errors in late life.

“…A second study, using an in-vehicle driver monitoring system to focus specifically on lane-change errors (N ϭ 1080), found that poorer performance on the Brief Test of Attention and the BeeryBuktenicka Test of Visual-Motor Integration was predictive of these driving errors (Munro et al, 2010). A study of 111 older drivers and 80 middle-aged drivers found that performance on the Complex Figure Test, Block Design, and Grooved Pegboard Task was associated with total driving errors in the older group (Dawson, Uc, Anderson, Johnson, & Rizzo, 2010).…”

Road safety in an aging population: risk factors, assessment, interventions, and future directions

“…A consistent body of research has demonstrated that memory deficits are not typically associated with unsafe driving (Reger et al, 2004;Anstey et al, 2005;Aksan et al, 2015), which may explain why patients with early AD may continue to drive safely. In contrast, deficits in executive function, visual selective attention, and processing speed predict crashes in older drivers (Ball et al, 2006;Dawson et al, 2010;Anstey et al, 2012). As dementia progresses and multiple domains of cognitive function are affected, driving cessation is inevitable.…”

Comparison of brake reaction time in younger and older drivers

“…Especially the decline in accuracy and speed of visuo-motor processing leads to unsafe driving. 12 David et al have identified that older adults have well preserved driving skills than the younger drivers. 13 There are evidences to show that age related attention deficits and task switching can be improved by practice, experience or training.…”