Age differences in simulated driving performance: Compensatory processes

In the context of driving, the reported experiment examines compensatory processes for age-related declines in cognitive ability. Younger (26–40 years) and older (60+ years) participants (n = 22 each group) performed a car following task in a driving simulator. Several performance measures were recorded, including assessments of anticipation of unfolding traffic events. Participants also completed a range of measures of cognitive ability – including both fluid and crystallised abilities. Three examples of age-related compensation are reported: (i) older drivers adopted longer headways than younger drivers. Data were consistent with this being compensation for an age-related deficit in complex reaction time; (ii) older drivers with relatively higher cognitive ability anticipated traffic events more frequently, whereas the reverse pattern was found for younger drivers; and, (iii) older drivers with greater crystallised ability were less reliant on spatial ability to maintain lane position. Consistent with theories of ‘cognitive reserve’, interactions between crystallised ability and age for self-report workload suggested that compensation for age-related cognitive ability deficits required investment of additional effort. Results are considered in the context of the prospects of further assessment of older drivers.     

Predictors of driving exposure and avoidance in a field study of older drivers from the state of Maryland

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. J. Am. Med. Assoc. 279 (14), 1083-1088; Sims, R.V., McGwin, G., Pulley, L., Roseman, J.M., 2001. Mobility impairments in crash-involved older drivers. J. Aging Health 13 (3), 430-438; Stutts, J.C., 1998. Do older drivers with visual nd 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 4,234 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.     

The relationship between cognitive ability,insight and self-regulatory behaviors: Findings from the older driver population

Self-regulation is often promoted as a coping strategy that may allow older drivers to drive safely for longer. Self-regulation depends upon drivers making an accurate assessment of their own ability and having a willingness to practice self-regulatory behaviors to compensate for changes in ability. The current study explored the relationship between older drivers’ cognitive ability, their driving confidence and their use of self-regulation. An additional study aim was to explore the relationship between these factors and older drivers’ interest in driving programs. Seventy Australian drivers aged 65 years and over completed a questionnaire about their driving and a brief screening measure of cognitive ability (an untimed Clock Drawing Test). While all participants reported high levels of confidence regarding their driving ability, and agreed that they would continue driving in the foreseeable future, a notable proportion performed poorly on the Clock Drawing Test. Compared to older drivers who successfully completed the Clock Drawing Test, those who failed the cognitive test were significantly less likely to report driving self-regulation, and showed significantly less interest in being involved in driving programs. Older drivers with declining cognitive abilities may not be self-regulating their driving. This group also appears to be unlikely to self-refer to driving programs.     

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

Considerable research has shown that neuropsychological tests are predictive of real-world driving ability. The Mini-Mental State Examination (MMSE) is a brief cognitive test that has been commonly used in the assessment of older drivers. However, this test has inherent problems that limit its validity to evaluate cognitive abilities related to driving and to screen for driving impairments in non-demented people. Therefore, it is useful to test new screening instruments that may predict potential unsafe drivers who require an in-depth neuropsychological assessment in a specialised centre. To date, the utility of the Addenbrooke's Cognitive Examination Revised (ACE-R) as an indicator of driving ability has not been established. In the current study, fifty older drivers (mean age = 73.1 years) who were referred for a psychological assessment, the protocol of which included the ACE-R, underwent an on-road driving test. Using linear discriminant analyses, the results highlighted the higher classification accuracy of the ACE-R compared to the MMSE score, particularly for detecting unsafe drivers. Measures of visuospatial and executive functions, which are not incorporated in the MMSE score, had an incremental value in the prediction of driving ability. This emerging brief cognitive test may warrant additional study for use in the fitness to drive assessment of older adults.     

Older drivers: On-road and off-road test results

Eighty-five volunteer drivers, 65–85 years old, without cognitive impairments impacting on their driving were examined, in order to investigate driving errors characteristic for older drivers. In addition, any relationships between cognitive off-road and on-road tests results, the latter being the gold standard, were identified. Performance measurements included Trail Making Test (TMT), Nordic Stroke Driver Screening Assessment (NorSDSA), Useful Field of View (UFOV), self-rating driving performance and the two on-road protocols P-Drive and ROA. Some of the older drivers displayed questionable driving behaviour. In total, 21% of the participants failed the on-road assessment. Some of the specific errors were more serious than others. The most common driving errors embraced speed; exceeding the speed limit or not controlling the speed. Correlations with the P-Drive protocol were established for NorSDSA total score (weak), UFOV subtest 2 (weak), and UFOV subtest 3 (moderate). Correlations with the ROA protocol were established for UFOV subtest 2 (weak) and UFOV subtest 3 (weak). P-Drive and self ratings correlated weakly, whereas no correlation between self ratings and the ROA protocol was found. The results suggest that specific problems or errors seen in an older person's driving can actually be “normal driving behaviours”.     

Does attention capacity moderate the effect of driver distraction in older drivers?

With age, a decline in attention capacity may occur and this may impact driving performance especially while distracted. Although the effect of distraction on driving performance of older drivers has been investigated, the moderating effect of attention capacity on driving performance during distraction has not been investigated yet. Therefore, the aim was to investigate whether attention capacity has a moderating effect on older drivers’ driving performance during visual distraction (experiment 1) and cognitive distraction (experiment 2). In a fixed-based driving simulator, older drivers completed a driving task without and with visual distraction (experiment 1, N = 17, mean age 78 years) or cognitive distraction (experiment 2, N = 35, mean age 76 years). Several specific driving measures of varying complexity (i.e., speed, lane keeping, following distance, braking behavior, and crashes) were investigated. In addition to these objective driving measures, subjective measures of workload and driving performance were also included. In experiment 1, crash occurrence increased with visual distraction and was negatively related to attention capacity. In experiment 2, complete stops at stop signs decreased, initiation of braking at pedestrian crossings was later, and crash occurrence increased with cognitive distraction. Interestingly, for a measure of lane keeping (i.e., standard deviation of lateral lane position (SDLP)), effects of both types of distraction were moderated by attention capacity. Despite the decrease of driving performance with distraction, participants estimated their driving performance during distraction as good. These results imply that attention capacity is important for driving. Driver assessment and training programs might therefore focus on attention capacity. Nonetheless, it is crucial to eliminate driver distraction as much as possible given the deterioration of performance on several driving measures in those with low and high attention capacity.     

Designing in-vehicle technologies for older drivers: Application of sensory-cognitive interaction theory

Drivers over the age of 65 are increasing rapidly in numbers and are driving more frequently. It is well recognized that older driver safety may be compromised due to age-related changes in cognitive functioning. Less well appreciated, however, is that sensory loss may interact with cognitive changes to compound the threat to safety. A sensory-cognitive interaction theory of ageing is described and its implications are discussed for the design of in-vehicle technologies. A particular area of focus is the difficulties of older drivers in carrying out navigational tasks while simultaneously maintaining safe control of the motor vehicle. Advanced automotive technologies including in-vehicle route guidance and navigational displays have the potential to improve safety and mobility if designed in accordance with the sensory/cognitive abilities of older drivers.     

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

The extent to which deficits in specific cognitive domains contribute to older drivers’ safety risk in complex real-world driving tasks is not well understood. We selected 148 drivers older than 70 years of age both with and without neurodegenerative diseases (Alzheimer disease–AD and Parkinson disease–PD) from an existing driving database of older adults. Participant assessments included on-road driving safety and cognitive functioning in visuospatial construction, speed of processing, memory, and executive functioning. The standardized on-road drive test was designed to examine multiple facets of older driver safety including navigation performance (e.g., following a route, identifying landmarks), safety errors while concurrently performing secondary navigation tasks (“on-task” safety errors), and safety errors in the absence of any secondary navigation tasks (“baseline” safety errors). The inter-correlations of these outcome measures were fair to moderate supporting their distinctiveness. Participants with diseases performed worse than the healthy aging group on all driving measures and differences between those with AD and PD were minimal. In multivariate analyses, different domains of cognitive functioning predicted distinct facets of driver safety on road. Memory and set-shifting predicted performance in navigation-related secondary tasks, speed of processing predicted on-task safety errors, and visuospatial construction predicted baseline safety errors. These findings support broad assessments of cognitive functioning to inform decisions regarding older driver safety on the road and suggest navigation performance may be useful in evaluating older driver fitness and restrictions in licensing.     

To call or not to call—That is the question (while driving)

We studied whether decisions to engage in cell phone conversation while driving and the consequences of such decisions are related to the driver's age, to the road conditions (demands of the driving task), and to the driver's role in initiating the phone call (i.e. the driver as caller vs. as receiver). Two experiments were performed in a driving simulator in which driver age, road conditions and phone conversation, as a secondary task, were manipulated. Engagement in cell phone conversations, performance in the driving and the conversation tasks, and subjective effort assessment were recorded. In general, drivers were more willing to accept incoming calls than to initiate calls. In addition, older and younger drivers were more susceptible to the deleterious effects of phone conversations while driving than middle aged/experienced drivers. While older drivers were aware of this susceptibility by showing sensitivity to road conditions before deciding whether to engage in a call or not, young drivers showed no such sensitivity. The results can guide the development of young driver training programs and point at the need to develop context-aware management systems of in-vehicle cell phone conversations.     

Age and inconsistency in driving performance

Research in cognitive neuropsychology suggests that investigation of the within-person variability, or inconsistency, of cognitive performance may provide valuable insights into ageing mental processes. It is rare though, for this interest in intraindividual variability to extend to everyday activities. As this may provide important information about driving behaviour, we therefore assessed age differences in driving inconsistency in younger (n = 24, M age = 21.29 years) and older (n = 21, M age = 71.24 years) persons who drove in residential, urban and motorway conditions in a fully immersive driving simulator. In measures of headway (maintaining a safe distance to a preceding vehicle) and lateral lane position, older drivers exhibited significantly greater performance inconsistency, and this was particularly marked in the faster motorway condition. Older drivers also recorded greater perceived mental demands associated with driving, and greater within-person variability across a range of cognitive measures. The findings suggest that age-related deficits in attentional and executive control may affect the consistency of driving performance in older persons. Discussion considers interventions to introduce in-vehicle systems to help maintain attention in older drivers, and to intervene when safety-critical boundaries are exceeded.     

Older drivers and rapid deceleration events: Salisbury Eye Evaluation Driving Study

Drivers who rapidly change speed while driving may be more at risk for a crash. We sought to determine the relationship of demographic, vision, and cognitive variables with episodes of rapid decelerations during five days of normal driving in a cohort of older drivers. In the Salisbury Eye Evaluation Driving Study, 1425 older drivers aged 67–87 were recruited from the Maryland Motor Vehicle Administration's rolls for licensees in Salisbury, Maryland. Participants had several measures of vision tested: visual acuity, contrast sensitivity, visual fields, and the attentional visual field. Participants were also tested for various domains of cognitive function including executive function, attention, psychomotor speed, and visual search. A custom created driving monitoring system (DMS) was used to capture rapid deceleration events (RDEs), defined as at least 350 milli-g deceleration, during a five day period of monitoring. The rate of RDE per mile driven was modeled using a negative binomial regression model with an offset of the logarithm of the number of miles driven. We found that 30% of older drivers had one or more RDE during a five day period, and of those, about 1/3 had four or more. The rate of RDE per mile driven was highest for those drivers driving <59 miles during the 5-day period of monitoring. However, older drivers with RDE's were more likely to have better scores in cognitive tests of psychomotor speed and visual search, and have faster brake reaction time. Further, greater average speed and maximum speed per driving segment was protective against RDE events. In conclusion, contrary to our hypothesis, older drivers who perform rapid decelerations tend to be more “fit”, with better measures of vision and cognition compared to those who do not have events of rapid deceleration.     

The development,factor structure and psychometric properties of driving self-regulation scales for older adults: Has self-regulation evolved in the last 15 years?

The term driving self-regulation is typically used to describe the practice of drivers who avoid driving in situations that they regard as unsafe because of perceived physical impairment. Older adults report using this strategy to improve safety while retaining mobility. Self-regulation is typically assessed using the driving avoidance items from the driving habits questionnaire (DHQ) and the driver mobility questionnaire (DMQ-A). However, the psychometric properties of these measures are not well understood. Using data from 277 older drivers, exploratory factor analysis was used to test the homogeneity of three driving self-regulation scales: the DHQ, DMQ-A, and an extended DMQ-A. Good internal consistency for each of the scales was identified (all αs ≥ .9). A one factor solution was identified for two of the measures (DHQ, DMQ-A) and a two factor solution accounting for over 70% of the score variance was identified for the third measure. The two factors assessed situations that may be avoided while driving because of the “external” (e.g., weather-related) or “internal” (e.g., passenger-related) driving environments, respectively. The findings suggest that the interpretation of an overall summated scale score, or single-item interpretations, may not be appropriate. Instead, driving self-regulation may be a multifaceted construct comprised of distinct dimensions that have not been identified previously but can be reliably measured. These data have implications for our understanding of driving self-regulation by older adults and the way in which this behavior is measured.     

Cognitive problems,self-rated changes in driving skills,driving-related discomfort and self-regulation of driving in old drivers

Ageing in general is associated with functional decline that may have an adverse effect on driving. Nevertheless, older drivers have been found to show good judgement and to self-regulate their driving, which may enable them to continue driving safely despite functional decline. The process of the self-monitoring of driving ability and the awareness of functional decline, and its association with the self-regulation of driving is, however, not fully understood. The aim of the present study was to examine the perceived changes in driving skills, the discomfort experienced in driving, and the self-regulation of driving as measured by the avoidance of certain driving situations by older drivers with different levels of self-rated cognitive problems. Eight hundred and forty Danish drivers aged 75–95 completed a structured telephone interview. The results showed that the recognition of cognitive problems was associated with an experience of improvement in higher level driving skills but also of a decline in lower level driving skills. Moreover, cognitive problems recognised by drivers were associated with discomfort in, and avoidance of, driving situations. Finally, a linear relationship between discomfort in driving and avoidance was found and this tended to be stronger for drivers recognising cognitive problems. The results indicate that older drivers who recognise problems with cognitive functions display good self-assessment of changes in their driving skills. In addition, the results suggest that driving-related discomfort is an important factor affecting the self-regulation of driving. Finally, the findings indicate that driving-related discomfort functions as an indirect self-monitoring of driving ability and may contribute to the safe driving performance of Danish older drivers.     

Personality traits and executive functions related to on-road driving performance among older drivers

The present study investigated how executive functions and personality traits are related with driving performance among older drivers. Forty-two participants aged 60 and over were recruited to complete a battery of cognitive tests, measures of personality traits and an on-road driving test. Significant correlations were found between poor driving performances and low scores on tests assessing shifting and updating functions. In addition, extraversion had a negative relation with driving performance and made the only contribution, among the psychological factors, to the prediction of driving performance. Finally, gender and age emerged as the best predictors of on-road driving performance. Gender, personality traits and executive functions should be taken into account when studying safety among older drivers.     

Driving with pets as a risk factor for motor vehicle collisions among older drivers

Increasing rates of distraction-related motor vehicle collisions (MVCs) continue to raise concerns regarding driving safety. This study sought to evaluate a novel driving-related distraction, driving with a pet, as a risk factor for MVCs among older, community dwelling adults. Two thousand licensed drivers aged 70 and older were identified, of whom 691 reported pet ownership. Comparing pet owners who did and did not drive with their pets, neither overall MVC rates (rate ratio [RR] 0.97, 95% confidence interval [CI] 0.75–1.26) nor at-fault MVC rates (RR 0.84, 95% CI 0.57–1.24) were elevated. However, those who reported always driving with a pet in the vehicle had an elevated MVC rate (RR 1.89, 95% CI 1.10–3.25), as compared to those who did not drive with a pet. The MVC rate was not increased for those reporting only sometimes or rarely driving with a pet in the vehicle. The current study demonstrates an increased risk of MVC involvement in those older drivers who always take a pet with them when they drive a vehicle. When confronted with an increased cognitive or physical workload while driving, elderly drivers in prior studies have exhibited slower cognitive performance and delayed response times in comparison to younger age groups. Further study of pet-related distracted driving behaviors among older drivers as well as younger populations with respect to driver safety and performance is warranted to appropriately inform the need for policy regulation on this issue.     

Identifying crash involvement among older drivers: agreement between self-report and state records

Older drivers have a high crash rate per vehicle mile of travel. Coupled with the growth of the number of older drivers on the road, this has generated interest in the identification of factors which place older drivers at increased risk. However, much of the existing research on medical and functional risk factors for crash involvement has generally been inconsistent. Methodological differences between studies have been hypothesized as being partly responsible for such inconsistencies. The source of information used to identify crash-involved drivers has been identified as one such difference. This paper reports on the agreement between self-report and state record for identifying crash involved-older drivers. We also sought to determine whether the prevalence of visual and cognitive impairment differs across crash-involved drivers identified by either or both sources. Finally, we assessed whether risk factors for crash involvement differed when crash-involved drivers were identified by either self-report or state records. Results indicated that there was a moderate level of agreement between self-reported and state-recorded crash involvement (kappa=0.45). However, we did find significant differences between crash-involved drivers identified via state records and/or self-report with respect to demographic (age, race), driving (annual mileage, days per week driven), and vision impairment (acuity, contrast sensitivity, peripheral visual field sensitivity, useful field of view). We also found that the possibility for biased measures of association is real. Useful field of view impairment was associated with both self-reported and state-recorded crash involvement; however, the magnitude of the associations was disparate. Moreover, glaucoma was identified as a significant risk factor when considering state-recorded crashes but not self-reported crashes. While validation of these findings is required, research designed to identify risk factors for crash involvement among older drivers should carefully consider the issue of case definition, particularly if self-report is used to identify crash-involved older drivers.     

Driver Behaviour Questionnaire: a follow-up study

The aim of the present study was to investigate time-across stability of different factor solutions (two to six factors) of the Driver Behaviour Questionnaire (DBQ) and to examine the changes on self-reported driving pattern in a follow-up sample (n=622) after three years of the first responses. Repeated measures ANOVA indicated that there was a significant change between Time 1 and Time 2 scores in six items of the DBQ. Drivers reported less competitiveness while driving at Time 2 but more speeding, drinking and driving, driving to wrong destinations and having no recollection of the road just travelled. Significant Time x Sex x Age interactions were found in change scores of four items. Young males and middle-aged female drivers emerged as a group of drivers who changed their self-reported driving pattern over three years. Additionally, sex, age or both had main effects on scores of 21 items. Males and young drivers reported more violations than females and older drivers, whereas female drivers reported more errors and lapses. After running possible factor solutions with Tucker's Phi agreement coefficients, the results indicated that the four- and two-factor solutions were the most stable and interpretable ones. The two-factor solution showed better time-across stability than the four-factor structure did, although the factor solutions found at Time 1 and Time 2 were not as identical as expected. Separate analysis revealed that drivers who had high annual mileage at Time 1 and Time 2 showed the strongest two-factor time-across stability. The test-retest reliability was 0.50 for errors, 0.76 for violations and 0.61 for the whole scale.     

Impact of age and cognitive demand on lane choice and changing under actual highway conditions

Previous research suggests that drivers change lanes less frequently during periods of heightened cognitive load. However, lane changing behavior of different age groups under varying levels of cognitive demand is not well understood. The majority of studies which have evaluated lane changing behavior under cognitive workload have been conducted in driving simulators. Consequently, it is unclear if the patterns observed in these simulation studies carry over to actual driving. This paper evaluates data from an on-road study to determine the effects of age and cognitive demand on lane choice and lane changing behavior. Three age groups (20–29, 40–49, and 60–69) were monitored in an instrumented vehicle. The 40's age group had 147% higher odds of exhibiting a lane change than the 60's group. In addition, drivers in their 60's were less likely to drive on the leftmost lane compared to drivers in their 20's and 40's. These results could be interpreted as evidence that older adults adopt a more conservative driving style as reflected in being less likely to choose the leftmost lane than the younger groups and less likely to change lanes than drivers in their 40's. Regardless of demand level, cognitive workload reduced the frequency of lane changes for all age groups. This suggests that in general drivers of all ages attempt to regulate their behavior in a risk reducing direction when under added cognitive demand. The extent to which such self-regulation fully compensates for the impact of added cognitive demand remains an open question.     

Self-reported wayfinding ability of older drivers

Some older drivers experience difficulties driving whilst wayfinding in unfamiliar areas. Difficulties in wayfinding have been associated with poorer driving performance and reduced driving mobility. The objective of the current study was to identify cognitive and demographic predictors in older drivers of perceived wayfinding difficulty, avoidance of unfamiliar areas and the use of wayfinding strategies. Five hundred and thirty-four drivers aged 65 years and over (excluding those with dementia or Parkinson's disease) completed a mail-out survey. Drivers commonly reported difficulties with wayfinding, with 59.5% reporting their abilities as poor or fair rather than good. Those significantly more likely to report difficulty were older, reported poorer health and cognition, and had less driving experience. A small proportion of drivers reported regularly avoiding unfamiliar areas (13.8%); these drivers were significantly more likely to be female and to report poorer wayfinding abilities. The most common wayfinding strategies regularly used by older drivers were using a street directory whilst driving (61.9%) and pulling over to check the map (55.1%). Regular passenger guidance (23.9%) or use of a navigation system (9.9%) was less common. The implications of this study are wide and include collecting further information about: (1) the role of cognitive processes in wayfinding ability; (2) the relationship between perceived wayfinding difficulty and restriction of driving in unfamiliar areas; and (3) older drivers’ preferences for different wayfinding strategies.