Investigating multilevel cognitive processing within error-free and error-prone feedback conditions in executed and observed car driving.

Accident analyses repeatedly reported the considerable contribution of run-off-road incidents to fatalities in road traffic, and despite considerable advances in assistive technologies to mitigate devastating consequences, little insight into the drivers' brain response during such accident scenarios has been gained. While various literature documents neural correlates to steering motion, the driver's mental state, and the impact of distraction and fatigue on driving performance, the cortical substrate of continuous deviations of a car from the road - i.e., how the brain represents a varying discrepancy between the intended and observed car position and subsequently assigns customized levels of corrective measures - remains unclear. Furthermore, the superposition of multiple subprocesses, such as visual and erroneous feedback processing, performance monitoring, or motor control, complicates a clear interpretation of engaged brain regions within car driving tasks. In the present study, we thus attempted to disentangle these subprocesses, employing passive and active steering conditions within both error-free and error-prone vehicle operation conditions. We recorded EEG signals of 26 participants in 13 sessions, simultaneously measuring pairs of Executors (actively steering) and Observers (strictly observing) during a car driving task. We observed common brain patterns in the Executors regardless of error-free or error-prone vehicle operation, albeit with a shift in spectral activity from motor beta to occipital alpha oscillations within erroneous conditions. Further, significant frontocentral differences between Observers and Executors, tracing back to the caudal anterior cingulate cortex, arose during active steering conditions, indicating increased levels of motor-behavioral cognitive control. Finally, we present regression results of both the steering signal and the car position, indicating that a regression of continuous deviations from the road utilizing the EEG might be feasible.

Cervical Health Parameters in Car Drivers: Assessing the Influence of Driving on Neck Pain, Mobility, Proprioception and Craniovertebral Angle - A Cross-Sectional Study.

Purpose: Prolonged sitting during driving is linked to neck pain, uncomfortable body positions, and repetitive motions. Recognizing these challenges, this study aimed to investigate Cervical Health Parameters in Car Drivers. Methods: The sample consisted of 160 car drivers between 25 and 45 years. This subject was then divided into two groups based on neck pain. Participants met the required criteria, such as being between 25-45 years of age, maintaining a BMI of 18-24, and driving for at least 2 hours each day for at least 3-5 years. To evaluate the results, we employed a clinometer and compass app on a smartphone to measure the Cervical Range of Motion (CROM). We used Surgimap software to estimate the Craniovertebral Angle (CVA), and a (Cervical range of motion) CROM device was used for proprioception assessment. Results: The result shows the participants in neck pain group displayed lower Cervical Range of Motion (CROM) values than without neck Pain Group. Similarly, the Craniovertebral Angle (CVA) was smaller in the neck Pain Group (mean difference of -6.3°), indicating a more forward head posture. Neck pain resulted in a mean difference of -4.5° in proprioception accuracy. This indicates that neck pain affects CROM, CVA, and proprioception in car drivers. Conclusion: Car driving significantly impacts cervical parameters in individuals with neck pain, reducing cervical range of motion, altered craniovertebral angle, and diminished proprioceptive accuracy. These findings emphasize the need for ergonomic interventions and proprioceptive training tailored for drivers. Future research should broaden demographic parameters and consider potential confounders to provide a holistic understanding of the relationship between car driving and neck health.

Effects of repetition of a car-driving pedal maneuver and neural output in older adults.

Understanding the ability of older adults to control pedal position angle and investigating whether this ability can be enhanced through practice may contribute to the prevention of traffic accidents. This study aimed to investigate repetitive effects on variability of the pedal position and neural drive during car-pedal operation in older adults. Thirteen older and 11 young adults performed 105 (21 sets × 5 repetitions) pedal angle control tasks with plantar flexor contraction. High-density surface electromyograms were recorded of triceps surae muscles. A cumulative spike train as a neural drive was calculated using continuously active motor unit activities. The coefficient of variation of the angle was higher in older (1.47 ± 1.06 %) than young (0.41 ± 0.21 %) adults in the first sets, and improved to 0.67 ± 0.51 % in the final sets in older adults only. There was no significant difference in neural drive variability between older and young adults. Our results suggest that repetition improves angular steadiness in older adults. However, this effect could not be explained by neural output which is estimated from lower threshold motor units that are continuously active.

The impact of environmental noise on drivers' cognitive abilities: A case study on in-vehicle voice interaction interfaces.

To investigate the impact of environmental noise on the cognitive abilities of drivers, this study, using in-vehicle voice interaction as an example, conducted laboratory experiments to assess the effects of road traffic noise, entertainment noise, and white noise stimuli on drivers' attention and short-term memory. The noise levels simulated to mimic acoustic conditions during car driving ranged from 35 dB(A) to 65 dB(A). The conclusions drawn were as follows: (1) Noise levels directly influenced subjective annoyance levels, with annoyance linearly increasing as noise levels escalated; (2) Both attention and short-term memory task reaction times of drivers were significantly influenced by noise types. Compared to traffic noise and white noise, drivers' cognitive efficiency was lower under entertainment noise. (3) Performance in complex cognitive tasks was more susceptible to noise levels compared to simple cognitive tasks; (4) Experimentally, it was found that drivers exhibited the highest cognitive efficiency in cognitive tasks when the environmental noise level was 55 dB(A), as opposed to noise levels of 35 dB(A), 45 dB(A), and 65 dB(A).

Visual and steering behaviours during lane departures: a longitudinal study of interactions between lane departure warning system, driving task and driving experience.

Lane Departure Warning Systems (LDWS) generate a warning in case of imminent lane departure. LDWS have proven to be effective and associated human-machine cooperation modelled. In this study, LDWS acceptance and its impact on visual and steering behaviour have been investigated over 6 weeks for novice and experienced drivers. Unprovoked lane departures were analysed along three driving tasks gradually more demanding. These observations were compared to a baseline condition without automation. The number of lane departures and their duration were dramatically reduced by LDWS, and a narrower visual spread of search during lane departure events was recorded. The findings confirmed LDWS effectiveness and suggested that these benefits are supported by visuo-attentional guidance. No specific influence of driving experience on LDWS was found, suggesting that similar cognitive processes are engaged with or without driving experience. Drivers' acceptance of LDWS lowered after automation use, but LDWS effectiveness remained stable during prolonged use.Practitioner summary: Lane Departure Warning Systems (LDWS) have been designed to prevent lane departure crashes. Here, LDWS assessment over a 6-week period showed a major drop in the number of lane departure events increasing over time. LDWS effectiveness is supported by the guidance of drivers' visual attention during lane departure events.

Is it safe to control the car pedal with the lower limb of the unaffected side in patients with stroke?

OBJECTIVES: Few studies have examined motor function in determining the suitability of patients with stroke to resume driving a car. Patients with hemiplegia usually control car pedals with the unaffected lower limb. However, motor control on the unaffected side is also impaired in patients with stroke. This study aimed to clarify the neurophysiological characteristics of pedal switching control during emergency braking in patients with hemiplegia. METHODS: The study participants consisted of 10 drivers with left hemiplegia and 10 age-matched healthy drivers. An experimental pedal was used to measure muscle activity and kinematic data during braking, triggered by the light from a light-emitting diode placed in front of the drivers. RESULTS: The patient group took the same reaction time as the healthy group. However, from the visual stimulus to the release of the accelerator pedal, the patient group had higher muscle activity in the tibialis anterior and rectus femoris and had faster angular velocities of hip and knee flexion than the healthy group. In addition, the patient group had higher co-contraction activities between flexors and extensors. From the accelerator pedal release to brake contact, the patient group had slower angular velocities of hip adduction, internal rotation, ankle dorsiflexion, internal return, and internal rotation than the healthy group. CONCLUSIONS: Patients with hemiplegia exhibited poor control of pedal switching using their unaffected side throughout the pedal-switching task. These results indicate that the safety related to car-pedal control should be carefully evaluated while deciding whether a patient can resume driving a car after a stroke.

Hands off, brain off? A meta-analysis of neuroimaging data during active and passive driving.

BACKGROUND: Car driving is more and more automated, to such an extent that driving without active steering control is becoming a reality. Although active driving requires the use of visual information to guide actions (i.e., steering the vehicle), passive driving only requires looking at the driving scene without any need to act (i.e., the human is passively driven). MATERIALS & METHODS: After a careful search of the scientific literature, 11 different studies, providing 17 contrasts, were used to run a comprehensive meta-analysis contrasting active driving with passive driving. RESULTS: Two brain regions were recruited more consistently for active driving compared to passive driving, the left precentral gyrus (BA3 and BA4) and the left postcentral gyrus (BA4 and BA3/40), whereas a set of brain regions was recruited more consistently in passive driving compared to active driving: the left middle frontal gyrus (BA6), the right anterior lobe and the left posterior lobe of the cerebellum, the right sub-lobar thalamus, the right anterior prefrontal cortex (BA10), the right inferior occipital gyrus (BA17/18/19), the right inferior temporal gyrus (BA37), and the left cuneus (BA17). DISCUSSION: From a theoretical perspective, these findings support the idea that the output requirement of the visual scanning process engaged for the same activity can trigger different cerebral pathways, associated with different cognitive processes. A dorsal stream dominance was found during active driving, whereas a ventral stream dominance was obtained during passive driving. From a practical perspective, and contrary to the dominant position in the Human Factors community, our findings support the idea that a transition from passive to active driving would remain challenging as passive and active driving engage distinct neural networks.

Comparison of Experienced and Novice Drivers' Visual and Driving Behaviors during Warned or Unwarned Near-Forward Collisions.

Forward collision warning systems (FCWSs) monitor the road ahead and warn drivers when the time to collision reaches a certain threshold. Using a driving simulator, this study compared the effects of FCWSs between novice drivers (unlicensed drivers) and experienced drivers (holding a driving license for at least four years) on near-collision events, as well as visual and driving behaviors. The experimental drives lasted about six hours spread over six consecutive weeks. Visual behaviors (e.g., mean number of fixations) and driving behaviors (e.g., braking reaction times) were collected during unprovoked near-collision events occurring during a car-following task, with (FCWS group) or without FCWS (No Automation group). FCWS presence reduced the number of near-collision events drastically and enhanced visual behaviors during those events. Unexpectedly, brake reaction times were observed to be significantly longer with FCWS, suggesting a cognitive cost associated with the warning process. Still, the FCWS showed a slight safety benefit for novice drivers attributed to the assistance provided for the situation analysis. Outside the warning events, FCWS presence also impacted car-following behaviors. Drivers took an extra safety margin, possibly to prevent incidental triggering of warnings. The data enlighten the nature of the cognitive processes associated with FCWSs. Altogether, the findings support the general efficiency of FCWSs observed through a massive reduction in the number of near-collision events and point toward the need for further investigations.

Influence of pedal characteristics on pedaling control and neural drive in older adults.

This study was aimed to investigate whether pedal characteristics and age affect pedal position accuracy, fluctuation, and neural drive variability during a position control task. Twelve older (age: 72.8 ± 3.6 years) and twelve young (age: 23.8 ± 4.4 years) adults performed trapezoidal position control tasks involving holding plantar flexor contraction for 10 s with four pedal conditions (regular and pulley types × standard and low forces). Neural drive of the triceps surae muscle was estimated with high-density surface electromyograms and individual motor unit decomposition methods. The central 5 s of the sustained contraction phase was used for analysis. Variabilities of the angle and neural drive are presented by the coefficient of variation. We observed that the angle fluctuation was greater in older than young adults for four pedal conditions (p < 0.05). Regardless of age, using pulley pedals increased angle fluctuation more than regular pedals (p < 0.05). No significant interaction was found for pedal conditions and age in pedal position accuracy, angle fluctuation, or neural output. Our results suggest that older adults have poor control ability to maintain pedal angles, and pulley pedals make it difficult to adjust the pedal angles regardless of age. However, the neural output estimated by the continuously active motor units failed to explain these differences.

Do Impulse Control Disorders Impair Car Driving Performance in Patients with Parkinson's Disease?

BACKGROUND: Based on data regarding the prevalence of Parkinson's disease (PD), the prevalence of impulsive control disorders (ICD) in PD, and the percentage of PD patients driving a car, it has to be assumed that at least 50,000 PD patients with ICD in Germany actively drive a car. However, these patients might be at risk for unsafe driving due to ICD-related dysfunctions such as failure to resist an impulse or temptation, to control an act or other altered neurobehavioral processes. OBJECTIVE: This study determines the influence of ICD on driving ability in PD. METHODS: We prospectively compared driving simulator performance of 23 PD patients with and 23 matched patients without ICD. ICD had to be socially compensated and presence was defined clinically for primary and questionnaire-based (QUIP-RS) for post-hoc analyses. Furthermore, between-group comparisons of driving-relevant neuropsychological tests were executed. RESULTS: Except from a lower blinking frequency when changing lanes, overall driving safety of patients with ICD did not differ significantly from those without-regardless of the clinical or QUIP-RS-based ICD definition. ICD severity did not correlate with driving performance, but the latter correlated significantly with mean reaction times and certain neuropsychiatric tests (MoCA, TMT-A, TAP-M "flexibility" and DBQ "error"). CONCLUSION: Clinically compensated ICD does not seem to impair driving safety in PD patients. Rather, cognitive and attentional deficits appear to be clinical markers for driving uncertainty.

Lifestyle Matters: Effects of Habitual Physical Activity on Driving Skills in Older Age.

Research on multitasking driving has suggested age-related deterioration in driving performance. It has been shown that physical and cognitive functioning, which are related to driving performance and decline with aging, are positively associated with physical activity behavior. This study aimed to explore whether driving performance decline becomes severe with advancing age and whether physical activity behavior modifies age-related deterioration in driving performance. A total of one hundred forty-one healthy adults were categorized into three groups based on their age; old-old (74.21 ± 2.33 years), young-old (66.53 ± 1.50 years), and young adults (23.25 ± 2.82 years). Participants completed a realistic multitasking driving task. Physical activity and cardiorespiratory fitness levels were evaluated. Older groups drove more slowly and laterally than young adults, and old-old adults drove slower than young-old ones across the whole driving course. Physical activity level did not interact with the aging effect on driving performance, whereas cardiovascular fitness interacted. Higher-fitness young-old and young adults drove faster than higher-fitness old-old adults. Higher-fitness old adults drove more laterally than higher-fitness young adults. The present study demonstrated a gradual decline in driving performance in old adults, and cardiorespiratory fitness interacted with the aging effect on driving performance. Future research on the interaction of aging and physical activity behavior on driving performance in different age groups is of great value and may help deepen our knowledge.

Dual-task interference in simulated car driving: The psychological refractory period effect when not only the second, but also the first task is ecologically relevant.

The psychological refractory period (PRP) effect denotes the finding that shortening the temporal interval between two tasks leads to increased reaction time in the second task. Earlier work in driving simulators confirmed the emergence of a PRP effect even if the second task (T2) was ecologically relevant, such as in a car-braking task. Here we evaluate the PRP effect if the first task (T1) is ecologically relevant as well. In a driving simulator, participants had to warn pedestrians against crossing the street (T1), and had to brake when the lead car braked (T2). As the temporal interval between tasks decreased, reaction time in T2 increased, confirming once more the emergence of a PRP effect. The PRP effect in our study was larger than in previous studies where T1 was artificial rather than ecologically relevant. This suggests that an ecologically relevant T1 is processed more elaborately, resulting in stronger interference with T2.

Neuroimaging Examination of Driving Mode Switching Corresponding to Changes in the Driving Environment.

Car driving is supported by perceptual, cognitive, and motor skills trained through continuous daily practice. One of the skills that characterize experienced drivers is to detect changes in the driving environment and then flexibly switch their driving modes in response to the changes. Previous functional neuroimaging studies on motor control investigated the mechanisms underlying behaviors adaptive to changes in control properties or parameters of experimental devices such as a computer mouse or a joystick. The switching of multiple internal models mainly engages adaptive behaviors and underlies the interplay between the cerebellum and frontoparietal network (FPN) regions as the neural process. However, it remains unclear whether the neural mechanisms identified in previous motor control studies also underlie practical driving behaviors. In the current study, we measure functional magnetic resonance imaging (fMRI) activities while participants control a realistic driving simulator inside the MRI scanner. Here, the accelerator sensitivity of a virtual car is abruptly changed, requiring participants to respond to this change flexibly to maintain stable driving. We first compare brain activities before and after the sensitivity change. As a result, sensorimotor areas, including the left cerebellum, increase their activities after the sensitivity change. Moreover, after the change, activity significantly increases in the inferior parietal lobe (IPL) and dorsolateral prefrontal cortex (DLPFC), parts of the FPN regions. By contrast, the posterior cingulate cortex, a part of the default mode network, deactivates after the sensitivity change. Our results suggest that the neural bases found in previous experimental studies can serve as the foundation of adaptive driving behaviors. At the same time, this study also highlights the unique contribution of non-motor regions to addressing the high cognitive demands of driving.

Sex differences in cognitive-motor components of braking in older adults.

Fast and accurate braking is essential for safe driving and relies on efficient cognitive and motor processes. Despite the known sex differences in overall driving behavior, it is unclear whether sex differences exist in the objective assessment of driving-related tasks in older adults. Furthermore, it is unknown whether cognitive-motor processes are differentially affected in men and women with advancing age. We aimed to determine sex differences in the cognitive-motor components of the braking performance in older adults. Fourteen men (63.06 ± 8.53 years) and 14 women (67.89 ± 11.81 years) performed a braking task in a simulated driving environment. Participants followed a lead car and applied a quick and controlled braking force in response to the rear lights of the lead car. We quantified braking accuracy and response time. Importantly, we also decomposed response time in its cognitive (pre-motor response time) and motor (motor response time) components. Lastly, we examined whether sex differences in the activation and coordination of the involved muscles could explain differences in performance. We found sex differences in the cognitive-motor components of braking performance with advancing age. Specifically, the cognitive processing speed is 27.41% slower in women, while the motor execution speed is 24.31% slower in men during the braking task. The opposite directions of impairment in the cognitive and motor speeds contributed to comparable overall braking speed across sexes. The sex differences in the activation of the involved muscles did not relate to response time differences between men and women. The exponential increase in the number of older drivers raises concerns about potential effects on traffic and driver safety. We demonstrate the presence of sex differences in the cognitive-motor components of braking performance with advancing age. Driving rehabilitation should consider differential strategies for ameliorating sex-specific deficits in cognitive and motor speeds to enhance braking performance in older adults.

Effect of arm position on spatial distribution of upper trapezius muscle activity during simulated car driving.

The present study aimed to investigate the upper trapezius muscle activity during simulated car driving while adopting three different arm positions. Ten participants were instructed to maintain the following positions: hands on the steering wheel (Hands-On), hands not on the steering wheel (Hands-Off) and hands not on the steering wheel but arms on armrests (Armrests). During the tasks, multi-channel surface electromyography (EMG) was recorded from the upper trapezius muscle with 64 two-dimensionally distributed electrodes. Amplitudes of surface EMG in Armrests were lower than in Hands-On (p = 0.004). The spatial distribution of surface EMG changed with time in Hands-Off and Armrests (p < 0.05), but not in Hands-On (p > 0.05). These findings suggest that being freed from steering leads to the recruitment of various muscle fibers/motor units within the upper trapezius muscle and the use of armrests may help reduce the physiological burden loaded on the muscle of drivers.

Sex Differences in the Amount and Patterns of Car-Driving Exposure in Spain, 2014 to 2017: An Application of a Quasi-Induced Exposure Approach.

We designed a cross-sectional study in Spain, from 2014 to 2017. Our objective was to assess sex-related differences in the amount of driving exposure of car drivers, overall and stratified by the main environment-related driving conditions. We compared the sex distribution across three populations: (1) total number of person-years aged > 18 years; (2) total number of person-years aged > 18 years holding a valid car-driving license; and (3) total number of non-responsible car drivers involved in crashes with another offending driver, stratified by different environmental variables. The quasi-induced exposure approach was applied: the non-responsible drivers were considered as representative of the entire population of drivers on the road at the place and time at which the crash occurred. We calculated the female-to-male odds ratio (OR) by comparing population 2 versus 1, and population 3 versus 2. Finally, we performed separate regression models in population 3 for each environment-related variable as the dependent variable and driver's age and sex as the independent variables. The female-to-male OR for the first comparison was 1.12, but values below 1 were found for extreme age groups. In the second comparison, an OR of 0.50 (0.49-0.51) was found, with progressively lower OR values as age increased. In population 3, women were found to drive less than men in environments known to be high risk (i.e., open roads, night-time, poor light conditions, and weekends). A significant gender gap exists in the amount and type of driving exposure. Although women obtain a driving license more frequently than men, they drive much less and tend to avoid high-risk environments. These results emphasize the need to incorporate a gender perspective in the development and implementation of road safety interventions.

Saudi Women and Vision 2030: Bridging the Gap?

(1) Background, Travel characteristics of Saudi women contrast significantly from those in the west. This is not only because they have different culture, attitudes and preferences but also until recently, Saudi women were not allowed to drive. In 2018, they were granted the right to drive. It has been anticipated that enabling women to drive will improve their mobility and employability. (2) Methods: This study presents a qualitative study into factors affecting Saudi women's travel decisions "before" and "after" enabling women to drive in the Kingdom. Two six "before" and "after" focus groups have been carried out to investigate the decision-making process associated with Saudi women's travel, available options of travel and perception of Saudi women towards private car driving. (3) Results: The results reveal that main travelling options for professional and high-income women is a private driver in the "before" scenario and a ride-share option with a family member. In the "after" scenario, high income professional women prefer "drive own car" option. Moreover, many of the participants indicated that it is likely that they might keep private drivers as well. (4) Conclusion. The results from this research indicate that there has been significant change in travel characteristics, attitudes and behaviour of Saudi women since they were granted the right to drive. This is likely to have significant implications for decision and policy makers. Further research into potential impacts of the current situation on car ownership and use, impacts on public transport system, environmental impacts and sustainability is needed.

Kinematic and Electrophysiological Characteristics of Pedal Operation by Elderly Drivers during Emergency Braking.

Age-related decline in lower limb motor control may cause errors in pedal operation when driving a car. This study aimed to clarify the kinematics and electrophysiological characteristics of the pedal-switching operation associated with emergency braking in the case of elderly drivers. The participants in this study consisted of 11 young drivers and 10 elderly drivers. An experimental pedal was used, and the muscle activity and kinematic data during braking action were analyzed using the light from a light-emitting diode installed in the front as a trigger. The results showed that elderly drivers took the same time from viewing the visual stimulus to releasing the accelerator pedal as younger drivers, but took longer to switch to the brake pedal. The elderly drivers had higher soleus muscle activity throughout the process, from accelerator release to brake contact; furthermore, the rectus femoris activity was delayed, and the simultaneous activity between the rectus femoris and biceps femoris was low. Furthermore, elderly drivers tended to have low hip adduction velocity and tended to switch pedals by hip internal rotation. Thus, the alteration in joint movements and muscle activity of elderly drivers can reduce their pedal operability and may be related to the occurrence of pedal errors.

Distracting tasks have persisting effects on young and older drivers' braking performance.

It is well established that car driving performance suffers when the driver concurrently engages in a distracting activity, such as talking on a cell phone. The present study investigates whether the effects of driver distraction are short-lived, or rather persist for some time. Age-related differences are evaluated as well. Sixty-three young and 61 older adults were tested in a driving simulator. They were asked to follow a lead car that drove at a constant speed, and to concurrently engage in a pseudorandom sequence of distracting tasks (typing, reasoning, memorizing). When the lead car braked, participants had to brake as well to prevent a collision. The stimulus onset asynchrony between the braking task and the last preceding distraction was 11.49 ± 1.99 s. Each person was tested once in a multitasking condition (as described above), and once in a control condition without distracting tasks. Outcome measures quantified distance keeping and lane keeping while participants braked to the lead car. We found that braking responses differed significantly between conditions; this difference could be interpreted as a combination of performance deficits and compensatory strategies in the multitasking condition compared to the control condition. We also found significant differences between age groups, which could be interpreted similarly. Differences between age groups were less pronounced in the multitasking than in the control condition. All observed effects were associated with participants' executive functioning. Our findings confirm that distractions have an impact on braking responses, and they document for the first time that this impact can persist for about 11.5 s. We attribute this persistence to a task set effect, and discuss the practical relevance of our findings.

Benefits of Higher Cardiovascular and Motor Coordinative Fitness on Driving Behavior Are Mediated by Cognitive Functioning: A Path Analysis.

Driving is an important skill for older adults to maintain an independent lifestyle, and to preserve the quality of life. However, the ability to drive safely in older adults can be compromised by age-related cognitive decline. Performing an additional task during driving (e.g., adjusting the radio) increases cognitive demands and thus might additionally impair driving performance. Cognitive functioning has been shown to be positively related to physical activity/fitness such as cardiovascular and motor coordinative fitness. As such, a higher fitness level might be associated with higher cognitive resources and may therefore benefit driving performance under dual-task conditions. For the first time, the present study investigated whether this association of physical fitness and cognitive functioning causes an indirect relationship between physical fitness and dual-task driving performance through cognitive functions. Data from 120 healthy older adults (age: 69.56 ± 3.62, 53 female) were analyzed. Participants completed tests on cardiovascular fitness (cardiorespiratory capacity), motor coordinative fitness (composite score: static balance, psychomotor speed, bimanual dexterity), and cognitive functions (updating, inhibition, shifting, cognitive processing speed). Further, they performed a virtual car driving scenario where they additionally engaged in cognitively demanding tasks that were modeled after typical real-life activities during driving (typing or reasoning). Structural equation modeling (path analysis) was used to investigate whether cardiovascular and motor coordinative fitness were indirectly associated with lane keeping (i.e., variability in lateral position) and speed control (i.e., average velocity) while dual-task driving via cognitive functions. Both cardiovascular and motor coordinative fitness demonstrated the hypothesized indirect effects on dual-task driving. Motor coordinative fitness showed a significant indirect effect on lane keeping, while cardiovascular fitness demonstrated a trend-level indirect effect on speed control. Moreover, both fitness domains were positively related to different cognitive functions (processing speed and/or updating), and cognitive functions (updating or inhibition), in turn, were related to dual-task driving. These findings indicate that cognitive benefits associated with higher fitness may facilitate driving performance. Given that driving with lower cognitive capacity can result in serious consequences, this study emphasizes the importance for older adults to engage in a physically active lifestyle as it might serve as a preventive measure for driving safety.