Predictors of driving outcomes in advancing age

This study aimed to develop predictive models for real-life driving outcomes in older drivers. Demographics, driving history, on-road driving errors, and performance on visual, motor, and neuropsychological test scores at baseline were assessed in 100 older drivers (ages 65-89 years [72.7]). These variables were used to predict time to driving cessation, first moving violation, or crash. Using Cox proportional hazards regression models, significant individual predictors for driving cessation were greater age and poorer scores on Near Visual Acuity, Contrast Sensitivity, Useful Field of View, Judgment of Line Orientation, Trail Making Test-Part A, Benton Visual Retention Test, Grooved Pegboard, and a composite index of overall cognitive ability. Greater weekly mileage, higher education, and "serious" on-road errors predicted moving violations. Poorer scores from Trail Making Test-Part B or Trail Making Test (B-A) and serious on-road errors predicted crashes. Multivariate models using "off-road" predictors revealed (a) age and Contrast Sensitivity as best predictors for driving cessation; (b) education, weekly mileage, and Auditory Verbal Learning Task-Recall for moving violations; and (c) education, number of crashes over the past year, Auditory Verbal Learning Task-Recall, and Trail Making Test (B-A) for crashes. Diminished visual, motor, and cognitive abilities in older drivers can be easily and noninvasively monitored with standardized off-road tests, and performances on these measures predict involvement in motor vehicle crashes and driving cessation, even in the absence of a neurological disorder. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Self-perception of driving abilities in older age: A systematic review

Older adults have become the fastest growing age group worldwide and will continue to make up a more significant portion of the driving population. Given the increased potential for age-related perceptual, cognitive, and physical declines, it is important to understand the perception that older drivers have regarding their own driving abilities. This awareness often motivates their driving behavior and patterns.A systematic review was conducted to synthesize the literature regarding the self-perception of driving abilities in older age. The PRISMA method was used and 10 databases (SCOPUS, TRID, PsycINFO, AgeLine, Web of Science, Abstracts in Social Gerontology, Inspec, Compendex, PubMed, and Medline) were searched to identify relevant articles. A total of 25 articles met the search criteria and were included in the qualitative synthesis.Overall, methods used to assess self-perception of driving abilities in older adults vary considerably. Some studies employ only subjective questionnaires, while others administer questionnaires in addition to on-road driving or simulated evaluations. Nonetheless, the studies overwhelmingly report that older drivers tend to rate highly, and often overestimate, their driving abilities. They perceive their driving abilities to be better than themselves at a younger age, their cohorts, and all other drivers. However, more work is needed to develop improved subjective assessments that guide drivers in more accurately estimating their true driving abilities, as well as to compare subjective ratings to objective performance-based measures of driving abilities.This review may assist researchers in better understanding the characteristics that influence driving self-perception and may inform the development of interventional strategies that help older drivers to better calibrate how they perceive their driving.     

Bias in older adults’ driving self-assessments: The role of personality

A convenience sample of 50 older drivers (M_age = 73.14, SD = 4.85) completed the Myers-Briggs Type Indicator® (MBTI®) Step III™ instrument and rated their own driving abilities (compared to all other drivers, same age drivers, and their own driving 20 years prior) and their ability to perform 68 specific driving-related behaviors. Each subject’s driving performance was also evaluated in a comprehensive on-road assessment conducted by a certified driving rehabilitation specialist, who rated the same 68 driving behaviors as well as driving performance. Drivers identified by the MBTI Step III instrument as Extraverted, Sensing, and (above median) Confident rated their driving significantly more favorably than Introverts, Intuitives, and below median Confidence drivers. Step III Sufficiency scales were associated with on-road performance: drivers with scores indicating low Confidence, low Stamina, or critical high levels of Compensatory Strain received significantly lower evaluations. Drivers with a Sensing preference or critical Strain score rated their driving significantly more favorably than evaluators did. These findings present preliminary evidence for the utility of personality assessments in identifying self-serving bias in driving self-evaluations, essential for safe self-regulation of driving.     

Indicators of Self-rated Driving across 3 Years among a Community-based Sample of Older Adults

These secondary analyses were conducted to identify predictors of self-rated driving ability over three years in community-dwelling older adults. From the Staying Keen in Later Life (SKILL) study, baseline and 3-year follow-up data for 426 older drivers were analyzed. Health, visual, physical, psychological and cognitive abilities were examined as prospective predictors of self-rated driving ability over a 3-year period, controlling for baseline self-rated driving. Results indicated that lower baseline ratings of self-efficacy and a diagnosis of osteoporosis independently predicted lower self-rated driving ability at 3-year follow-up. Interestingly, functional performance, such as visual, physical and cognitive abilities, were not predictive of self-ratings of driving ability across three years. Older drivers' self-ratings are more reflective of perceived self-efficacy rather than functional abilities. Self-screening tools for older drivers may be effective in improving the correspondence between perceived ability and actual ability in order to promote better informed decisions about driving regulation.     

Road safety education for older drivers: Evaluation of a classroom-based training initiative

Around the world, a growing proportion of drivers are aged 70 or over. Although accident rates for older drivers are lower than for young or novice drivers, increased frailty and slowed reactions mean that older drivers are at higher risk of death or serious injury when involved in a road collision. The objectives of this study were to: (a) identify driving knowledge and self-regulatory strategies among a group of older drivers with a view to planning future on-road training; (b) measure driver self-assessments of ability and confidence before and after classroom training delivered by driving instructors; (c) evaluate the utility and acceptability of training courses for older drivers using questionnaires and focus groups; d) examine the characteristics of course participants.142 drivers aged ≥75 completed a two-hour classroom-based driving course and took part in the evaluation: 94 aged 75–79, 48 aged ≥80, 68% male. Main reasons for taking part were to update knowledge, improve driving and check they were safe to drive. Results showed that females were more likely than males to avoid driving in difficult conditions (at night, in bad weather, unfamiliar roads). More drivers aged 75–79 said they did not restrict their driving (52, 57%) compared to drivers aged ≥80 (19, 43%). Pre-course, males rated their driving confidence and ability significantly higher than females. Post-course, self-ratings of confidence and ability were unchanged for 76 (60%) drivers. However, two-thirds reported improved knowledge and 80% said they would change their driving behaviour as a result of the course. Focus group results suggest that competent drivers are more likely to attend educational courses than unsafe drivers. This study provides preliminary evidence that classroom-based training can initiate behaviour change among older drivers. Future research will examine the effectiveness of on-road training in this age group.     

The relations between specific measures of simulated driving ability and functional ability: New insights for assessment and training programs of older drivers

To gain new insights for driving assessment and training, this study had two objectives: (1) to investigate the relations between specific measures of older drivers’ driving ability and demographic/functional ability measures, and (2) to verify the explained variance of these relations to determine the strength of these relations. A sample of 55 older drivers (mean age 76 years) completed a set of functional ability tests as well as a driving simulator test. Results indicate that (1) each specific driving measure is related to a specific set of functional abilities, and (2) only a small proportion of the variability observed in the specific driving measures is explained by demographic variables (3–15%) and by functional abilities (7–36%). For driving assessment programs, it will be necessary to assess several functional abilities to cover the complexity of the driving task. Furthermore, an assessment program focusing solely on demographic and/or functional ability measures, will not be successful in discriminating safe from unsafe older drivers. For driving training programs, it will be necessary to focus on the right set of functional abilities given that specific driving measures are related to different functional abilities. Moreover, a training targeting functional abilities might only have marginal effects on driving ability, given the relatively low amount of driving ability variance that is explained by functional abilities.     

Relationship of laboratory and on-road tests for driving-school students and experienced drivers

There is a pressing need to evaluate driving ability without an actual driving test but no reliable, standardised procedure is available. This study investigated the resulting distortion performance evaluation for different driver groups in on-road tests due to driving skills and driving style. Two groups, 15 female driving school students and 25 experienced male drivers were examined using cognitive and psychomotor tests and standard personality questionnaires as well as an on-road driving test. The students made significantly fewer errors on the driving test than the experienced drivers. The former group's driving performance could be predicted by errors on the laboratory tests, along with personality factors, while experienced drivers' driving errors were best predicted by slowness on laboratory tests. This study suggests that, when a series of standard cognitive and psychomotor tests are considered, different measures may apply in predicting young people's ability to drive safely based on assessing driving ability of experienced drivers, assumed lowered due to distorted driving style.     

Cognitive and psychomotor tests as predictors of on-road driving ability in older primary care patients

This study examined the accuracy with which different cognitive and psychomotor assessment tools were able to predict driving ability among older primary care patients. A cross-sectional study of 50 older drivers (with an average age of 73.1 ± 7.0 years) was conducted. Participants who had been referred by their physicians for psychological assessment following a fitness-to-drive examination underwent both an on-road driving test and a cognitive assessment protocol that included the Senior Drivers Battery (SDB) that is currently administered at the Mobility and Land Transports Institute (MLTI) in Portugal, the Useful Field of View (UFOV) test, the Stroke Drivers Screening Assessment (SDSA), Addenbrooke’s Cognitive Examination Revised (ACE-R), the Trail Making Test, the Key Search test, and the Wechsler Adult Intelligence Scale (WAIS-III) Vocabulary and Block Design tests. Logistic regression analysis revealed that the performances of the participants on the SDSA, ACE-R, UFOV and SDB were the best predictors of on-road driving. Specific measures of processing speed and divided attention, visuospatial abilities, executive functions, psychomotor speed and global cognitive functioning may be useful for predicting unsafe driving. The practical implications of these findings are discussed with a view to developing new assessment models for determining driving fitness in older adults.     

Contextual Design for driving: Developing a trip-planning tool for older adults

Independent living depends on mobility, and mobility depends on driving, particularly for people 65 years and older. The longer older adults can safely drive, the longer they can independently run errands, shop, exercise, and maintain social networks. Age-related decline of perceptual, motor, and cognitive abilities can undermine the mobility and driving safety of older drivers. Data from driving simulators, on-road tests, surveys, and crash reports describe the driving safety and mobility challenges of older adults, but these methods offer a limited view of these challenges and fail to indicate design solutions. Contextual Design—a combination of Contextual Inquiry interviews, model building, and affinity diagrams—offers a complementary approach to uncover challenges that older adult drivers’ experience. For two weeks, 39 drivers age 65 and above, had their vehicles instrumented to collect driving and video data. Applying Contextual Design to these data showed that older drivers in urban and rural settings faced different mobility challenges and adopted various strategies to mitigate risk: older drivers often involved their spouse or passenger in the driving task, avoided certain driving maneuvers such as left turns, avoided unfamiliar or poorly lit roads at night, and planned trips to avoid risky driving situations. Ridesharing and trip planning emerged as important strategies to improve the safety and mobility of older drivers. Ridesharing could serve as a potential solution to prolong mobility; however, factors such as wait time, scheduling conflicts, costs, and trust were concerns for older drivers. A paper prototype was developed to validate the driving challenges faced by older drivers, and guide the development of a customized web-based trip-planning tool. The trip-planning tool could help older drivers make safer route choices by offering routes with fewer driving challenges, thereby enhancing their driving safety, mobility, and independence.     

Distraction while driving: The case of older drivers

As the impairment of older drivers is especially found in perception and attention, one could assume that they are especially prone to distraction effects of secondary tasks performed while driving. The aim of the study was to examine the effect of age on driving performance as well as the compensation strategies of older drivers under distraction. 10 middle-aged and 10 older drivers drove in a simulator with and without a secondary task. To assess driving performance the Lane Change Task (Mattes, 2003) was used. This method aims at estimating driver demand while a secondary task is being performed, by measuring performance degradation on a primary driving-like task in a standardized manner. The secondary task – a self-developed computer-based version of “d2 Test of Attention” was presented both with and without time pressure. The results show that older participants’ overall driving performance (mean deviation from an ideal path) was worse in all conditions as compared to the younger ones. With regard to lane change reaction time both age groups were influenced by distraction in a comparable manner. However, when the lane keeping performance (standard deviation of the lateral position) was examined, the older participants were more affected than the younger ones. This pattern could be explained by compensation strategies of the older drivers. They focused on the most relevant part of the driving task, the lane change manoeuvres and were able to maintain their performance level in a similar way as did younger drivers. The driving performance of the older participants was not additionally impaired when the secondary task imposed time pressure. Overall, subjective rating of driving performance, perceived workload and perceived distraction was found to be similar for both age groups. The observed trends and patterns associated with distraction while driving should contribute to the further research or practical work regarding in-vehicle technologies and older drivers.     

Visual/cognitive correlates of vehicle accidents in older drivers

Older drivers have more accidents per miles driven than any other age group and tend to have significant impairments in their visual function, which could interfere with driving. Previous research has largely failed to document a link between vision and driving in the elderly. We have taken a comprehensive approach by examining how accident frequency in older drivers relates to the visual/cognitive system at a number of levels: ophthalmological disease, visual function, visual attention, and cognitive function. The best predictor of accident frequency as recorded by the state was a model incorporating measures of early visual attention and mental status, which together accounted for 20% of the variance, a much stronger model than in earlier studies. Those older drivers with a visual attentional disorder or with poor scores on a mental status test had 3-4 times more accidents (of any type) and 15 times more intersection accidents than those without these problems.     

Comprehensive driving assessment: neuropsychological testing and on-road evaluation of brain injured patients

The study investigates the correspondence between neuropsychological test results and on-road driving performance among 55 patients with a CT-verified brain damage or documented neurological disorder (cerebrovascular accident: 43, traumatic brain injury: 5, multiple sclerosis: 4, other: 3). 5 patients showed unimpaired test profiles and passed the on-road evaluation. 18 patients showed severe neuropsychological deficits contrary to driving and were not recommended for on-road evaluation. Of the remaining 32 patients with some neuropsychological deficits, all 100% in the minor impaired group (n = 8) passed the driving evaluation, compared to 69% in the mildly impaired (n = 16) and 38% in the moderately impaired group (n = 8). Measures of reduced visuoconstructive ability, reaction time, visual attention, and awareness of cognitive impairments, were found to discriminate between groups. It is concluded that neuropsychological assessment of targeted functions provide an ecological valid prediction of driving skill after brain damage, but that on-road evaluation is needed as supplement in cases with ambiguous test findings.     

Driving manoeuvre during lane maintenance in older adults: Associations with neuropsychological scores

Older drivers experience difficulties in lane maintenance under challenging driving sections due to age-related cognitive declines, yet there is little comprehensive evidence on associations between cognitive functions and the lane maintenance in this population. In this study, fifty older drivers completed an on-road driving assessment and a battery of standard neuropsychological tests. Mean Lane Position (MLP), Standard Deviation of Lane Position (SDLP) and manoeuvre time calculated from precise vehicle movement trajectories were used as the lane maintenance parameters. The GNSS tracking vehicle movement presents comprehensive and reliable vehicle position data, which is more sensitive for detecting subtle variations of lane maintenance in older drivers. Statistical analysis results showed that lower visual attention (selective and divided attention) was associated with higher MLP and SDLP; MLP was also correlated to spatial abilities, executive function, and motor speed; manoeuvre time was negatively correlated with drivers’ risk-taking personality (all p < .01). Selective attention was found to be the best predictor of MLP in lane maintenance. A combined eight variables from three neuropsychological tests, UFOV 2 and 3, BD and BJLO, D-KEFS TMT 1, 2, 3, and 4, correctly classified 80.4% of participants with good versus low-performing lane maintenance.     

An analysis of factors affecting wrong-way driving at a highway entrance using a driving simulator among older drivers with cognitive decline

About 200 highway wrong-way driving cases occur annually in Japan, of which about 70% are caused by older drivers. The number of these cases has remained consistent despite adoption of full-fledged measures against wrong-way driving, thus demonstrating the need for further measures. Reports indicate that older drivers include those with cognitive decline. Moreover, it has been revealed that drivers over 75 years of age who caused wrong-way driving had lower test scores in the usual cognitive function tests performed at the time of licence renewal. However, there is no clear evidence on the relationship between cognitive decline and driving behaviour that stimulates wrong-way driving. In this paper, we reproduced a wrong-way driving approaching a right turn to an expressway exit in a virtual environment using a driving simulator for older drivers, including those with mild cognitive impairment (MCI). In addition to the measurement of driving behaviour and eye-tracking during simulator driving, we conducted a cognitive function test to investigate the relationship between driving behaviour and visual behaviour factors that initiate reverse running and cognitive decline. The results revealed that the reason for the start of a highway wrong-way driving may be a human error at the recognition stage of overlooking a visual wrong-way driving countermeasure, or a human error at the judgement stage of failing to suppress action despite noticing the visual countermeasure. Additionally, attentional and executive functions were related to the wrong-way initiative, although MCI did not affect it. This suggests that those who could not control their wrong-way driving behaviour despite observing the signs had specific executive function deficits.     

Difficulties experienced by older drivers during their regular driving and their expectations towards Advanced Driving Aid Systems and vehicle automation

The aim of this study was to analyse the difficulties experienced by older drivers during their regular driving, and to identify their needs and their expectations regarding Advanced Driving Aid Systems (ADAS) and vehicle automation. More than 100 items were investigated by using a Focus Group method based on a Collective Questionnaire (named FoG-CoQS). Thirty elderly drivers, 15 females and 15 males aged from 70 to 81 years (mean age of 73.3; S.D. = 3.18) were recruited among a representative sample of 76 older drivers living in the Rhône area and having previously participated to an on-road experiment, in order to collect from this Focus Group method further information about the driving difficulties they experienced in their everyday life and their expectations towards driving aids. Seven main topics were more particularly investigated, recovering at last all the main dimensions of the driving task (from navigation to speed control, through intersection crossing).Regarding driving difficulties, one of the most interesting result collected is the high contrast between the literature review, identifying Left Turn (LT) manoeuvres at crossroads as a risky driving situation for elderly drivers, and the relatively low values of perceived difficulties (i.e. compared to other driving sub-tasks) collected during this Focus Group among our sample of older drivers. Regarding the driving aid functions investigated, 10 of them obtained high scores of “perceived utility” (i.e. overpassing 60% on scales ranging from 0% [no utility] to 100% [high utility]), and they concerned assistances liable to support all the main components of the driving task investigated in this study.Additional results are related to the differences between the elderly female and male drivers. Several driving situations were assessed as significantly more difficult to perform by the older female than by the older male drivers, like intersection crossing, entering expressways, or implementing a lane change manoeuver. By contrast, this gender effect is more limited regarding driving aids: synthetically, men and women have a positive attitude towards driving aid systems and their expectations for future ADAS are quite similar (for instance, “informative systems” are preferred than driving aids based on “vehicle automation”).Finally, from two transversal items (i.e. “difficulties” to perform a driving sub-task and “perceived utility” of ADAS), it was possible to rank older drivers’ difficulties experienced during their everyday life (from lowest difficulties to “navigate on a familiar itinerary” to highest when “interacting with bicyclists”) and their expectations towards driving aids (from lowest utility score given to “Automatic Lane Change systems” to highest utility value provided to “Speed Informer systems”). At last, older drivers’ acceptance and expectations towards highly automated cars was also investigated: full automation was assessed as an interesting solution to ensure the self-mobility of elderly peoples in their circle, but also for themselves in the future, in case of impairments of their own cognitive or physical capacities.     

Cognitive and personality determinants of safe driving performance in professional drivers

Large truck and bus crashes still cause a high rate of fatalities and costs. Considering that the human factor plays an important role it is obvious that there is great interest in predicting safe driving performance in professional drivers, especially with new technologies emerging to assist drivers. This study uses a modern theoretical framework to assess which psychometric tests are still able to predict safe driving performance in today’s professional drivers under these new circumstances.126 male professional bus drivers completed a standardized digital test battery and three driving exercises. The test battery was used to assess reaction time, concentration, ability to gain an overview, reactive stress tolerance, logical reasoning, and safety-related personality traits. The exercises consisted of an on-road driving test, an obstacle course, and a maneuvering course.The study yielded satisfactory indicators of criterion related validity. It also showed that different tests were relevant for the prediction of safe driving performance in different driving exercises. Contrary to previous research, logical reasoning showed significant effects. The results indicate that in order to assess safe driving performance in professional drivers, a comprehensive assessment with psychometric tests should be recommended.     

Other road users’ adaptations to increase safety in response to older drivers’ behaviour

Changes in physical and cognitive abilities not only challenge the driving ability of older adults, in some situations age-related changes in driving behaviour require other road users to adapt their behaviour to maintain a safe traffic situation. In this study, we aimed to map age-related differences in driving behaviour and assess the impact on other road users. A group younger and a group older adults drove four different routes containing challenging situations (e.g., merging into motorway traffic) in a driving simulator while measures of driving behaviour were collected. Other road users’ deceleration responses to the driver’s behaviour were also collected as a measure of behavioural adaptation. Our results showed similar driving performance between young and older drivers when task complexity was low, but reduced performance in older drivers when tasks requirements increased. Lower driving speed and longer waiting times that were observed in older drivers can be interpreted as compensatory behaviour aimed at creating more time to lower task requirements. Crucially, in a non-time critical situation this compensatory behaviour was found to be successful, however in a time-critical situation (merging onto a motorway) this strategy had negative side effects because other road users had to decelerate in order to keep a safe distance. Our results show the importance of anticipation and adaptation by other road users for the success of older driver’s strategies and traffic safety.     

Novel use of a virtual driving assessment to classify driver skill at the time of licensure

Motor vehicle crash rates are highest immediately after licensure, and driver error is one of the leading causes. Yet, few studies have quantified driving skills at the time of licensure, making it difficult to identify at-risk drivers before independent driving. Using data from a virtual driving assessment implemented into the licensing workflow in Ohio, this study presents the first population-level study classifying degree of skill at the time of licensure and validating these against a measure of on-road performance: license exam outcomes. Principal component and cluster analysis of 33,249 virtual driving assessments identified 20 Skill Clusters that were then grouped into 4 major summary “Driving Classes”; i) No Issues (i.e. careful and skilled drivers); ii) Minor Issues (i.e. an average new driver with minor vehicle control skill deficits); iii) Major Issues (i.e. drivers with more control issues and who take more risks); and iv) Major Issues with Aggression (i.e. drivers with even more control issues and more reckless and risk-taking behavior). Category labels were determined based on patterns of VDA skill deficits alone (i.e. agnostic of the license examination outcome). These Skill Clusters and Driving Classes had different distributions by sex and age, reflecting age-related licensing policies (i.e. those under 18 and subject to GDL and driver education and training), and were differentially associated with subsequent performance on the on-road licensing examination (showing criterion validity). The No Issues and Minor Issues classes had lower than average odds of failing, and the other two more problematic Driving Classes had higher odds of failing. Thus, this study showed that license applicants can be classified based on their driving skills at the time of licensure. Future studies will validate these Skill Cluster classes in relation to their prediction of post-licensure crash outcomes.     

Aging drivers and post delineated express lanes: Threading the needle at 70 miles per hour

Post-delineated express lanes represent a combination of driving complexities that are particularly difficult for older drivers to navigate. The narrow geometry and high speeds that are common to this treatment reflect a critical test for drivers whose depth perception, contrast sensitivity, and visual processing speed are reduced. The present study was designed to empirically examine the effects of age and color of express lane delineators on driver behavior. Three groups of participants (aged 18–39, 40–64, and 65 + years old) were required to complete a series of simulated driving scenarios consisting of combinations of single and dual lane configurations, with speed and lane position measured at the beginning and midpoint of each express lane. All drivers were pre-screened on various visual functioning abilities. Drivers in the 65 and older group show significant age-related declines in depth perception, contrast sensitivity, and phoria which were subsequently correlated with a wide range of driving measures including deceleration rate, brake time, jerk, speed, and lane position. Age related perceptual declines were statistically correlated with slower driving speed and wider lane deviations, including a statistically significant increase in the number of excursions beyond the typical 12-foot lane width. Based on these findings, the behavior of senior drivers was identified as a distinct design condition that should govern the design of high-speed, narrow geometric conditions. This age group requires wider lane widths, particularly at the beginning of single-lane post delimited sections, wider buffer areas around the post markers, and dual lane configurations wherever possible.