Driving difficulties as reported by older drivers with mild cognitive impairment and without neurological impairment.

Objective: Considerable evidence indicates that medical conditions prevalent among older individuals lead to impairments in visual, cognitive, or psychomotor functions needed to drive safely. The purpose of this study was to explore the factors determining driving difficulties as seen from the viewpoint of 30 older drivers with mild cognitive impairment (MCI) and 30 age-matched controls without cognitive impairment. Methods: Perceptions of driving difficulties from both groups were examined using data from an extensive questionnaire. Samples of drivers diagnosed with MCI and age-matched controls were asked to report the frequency with which they experienced driving difficulties due to functional deficits and knowledge of new traffic rules and traffic signs. Results: The analysis revealed that 2 factors underlie MCI perceptions of driving difficulties, representing (1) difficulties associated with late detection combined with slowed response to relevant targets in the peripheral field of view and (2) difficulties associated with divided attention between tasks requiring switching from automatic to conscious processing particularly of long duration. The analysis for healthy controls revealed 3 factors representing (1) difficulties in estimating speed and distance of approaching vehicles in complex (attention-dividing) high-information-load conditions; (2) difficulties in moving head, neck, and feet; and (3) difficulties in switching from automatic responses to needing to use cognitive processing in new or unexpected situations. Conclusions: Though both group analyses show difficulties with switching from automatic to decision making, the difficulties are different. For the control group, the difficulty in switching involves switching in new or unexpected situations associated with high-information-load conditions, whereas this switching difficulty for the MCI group is associated with divided attention between easier tasks requiring switching. These findings underline the ability of older drivers (with MCI and without cognitive impairment) to indicate probable impairments in various driving skills. The patterns of difficulties perceived by the MCI group and the age-matched healthy control group are indicative of demanding driving situations that may merit special attention for road designers and road safety engineers. They may also be considered in the design of older drivers' fitness to drive evaluations, training programs, and/or vehicle technologies that provide for older driver assistance.

Simulator Measures and Identification of Older Drivers With Mild Cognitive Impairment.

This study examined whether a sign recall task on a driving simulator, self-report of driving ability, or age predicted differences in performance between drivers with mild cognitive impairment (MCI) and control participants. For the dependent measure, gathered using a driving simulator, working memory was subjected to interference at varying levels of driving task demands. Reliable between-groups differences in sign recall accuracy were demonstrated; recall declined under higher task demands. Recall scores, self-reported frequency of avoiding driving, and driver age did not predict MCI; only self-reported decline in global driving ability was significant. Findings support the use of driving simulators in practice and suggest that screening for age-related cognitive impairment should incorporate self-reported changes in driving proficiency for early identification of drivers who merit medical review. The results, although exploratory, have implications for practitioners.

Exploring the association between working memory and driving performance in Parkinson's disease.

OBJECTIVE: The aim of this study was to explore whether varying levels of operational and tactical driving task demand differentially affect drivers with Parkinson's disease (PD) and control drivers in their sign recall. METHODS: Study participants aged between 50 and 70 years included a group of drivers with PD (n = 10) and a group of age- and sex-matched control drivers (n = 10). Their performance in a sign recall task was measured using a driving simulator. RESULTS: Drivers in the control group performed better than drivers with PD in a sign recall task, but this trend was not statistically significant (P =.43). In addition, regardless of group membership, subjects' performance differed according to varying levels of task demand. Performance in the sign recall task was more likely to drop with increasing task demand (P =.03). This difference was significant when the variation in task demand was associated with a cognitive task; that is, when drivers were required to apply the instructions from working memory. CONCLUSIONS: Although the conclusions drawn from this study are tentative, the evidence presented here is encouraging with regard to the use of a driving simulator to examine isolated cognitive functions underlying driving performance in PD. With an understanding of its limitations, such driving simulation in combination with functional assessment batteries measuring physical, visual, and cognitive abilities could comprise one component of a multitiered system to evaluate medical fitness to drive.

Investigating the self-reported behavior of drivers and their attitudes to traffic violations.

INTRODUCTION: Driving behavior theoretical models consider attitudes as an important determinant of driver behavior. Moreover, the association between the self-reported tendency to commit violations and accident involvement is widely recognized. This research investigates drivers' self-reported behavior and attitudes to risky behaviors related to the traffic violations of speeding, drink-driving, and cell phone use using cluster analysis. METHOD: A sample of 601 Greek drivers participating at the SARTRE 4 pan-European survey is utilized. The analysis identified three clusters of drivers. Drivers in Cluster 1 commit traffic violations more often; drivers in Cluster 2 favor traffic violation countermeasures while having moderate views toward compliance with traffic rules; and drivers in Cluster 3 strongly support traffic violation countermeasures and also have strong views toward compliance with traffic rules. Risky behaviors and related attitudes that differentiate the three distinct groups of drivers (clusters) were determined. RESULTS: The findings indicate that differences in attitudes and behaviors may be attributed to factors such as age, gender, and area of residence. The research findings also provided some insight about the current level of drivers' attitudes to traffic violations, especially those that negatively affect traffic safety. The pattern of their views on violations may form the basis of risk behavior-related interventions tailored to the identified groups, aiming at informing, educating, and raising the awareness of the public. IMPACT ON INDUSTRY: Agencies focused on safety interventions could exploit this information in designing and implementing education campaigns, enforcement programs and in defining relevant priorities.

Investigation of the acceptance of a handbook for safe driving at an older age.

The objective of this research is the investigation of older drivers' attitudes towards a handbook for safe driving at an older age. The handbook was developed with the purpose of increasing elderly drivers' awareness of their driving abilities and providing information about the effects of ageing on driving and about safe driving practices and compensation strategies. A survey was carried out in which 64 active drivers between 65 and 74 years of age participated. Participants regard the handbook for safe driving as useful, interesting, providing knowledge and relevant information. More than half of them reported that they had become more aware of changes in their driving after reading it. Binary logistic analysis was conducted to identify individual driver characteristics that might predict acceptance of the handbook by active older drivers in terms of reported increased awareness and intended repeated use. The findings of the research indicate a positive attitude of elderly active drivers towards the handbook, implying acceptance by its users. The characteristics of the drivers' who reported increased awareness after reading have been identified.