Who drives safely? Visual/cognitive predictors in Elders

描述：(申请人提供)驾驶汽车是老年人保持独立性和流动性的一个主要因素。失去驾驶特权和随之而来的依赖是一个非常令人担忧的老龄化后果，这可能会导致即使是那些有很高撞车风险的人也会继续驾驶。避免高风险情况以及关注驾驶性能和其他补偿策略是允许有限制的老年司机在被禁止的情况下继续安全驾驶的行为。因此，人们对确定预测采用补偿性驾驶策略的因素很感兴趣。 在这个项目中，一个多学科团队将在4年内对马里兰州索尔兹伯里的老年人口进行纵向研究，确定视觉和认知、对限制的感知以及驾驶的替代方案在采用补偿驾驶策略方面的作用。将确定三组年龄较大的司机：第一组：视力正常和孤独的司机；第三组：既有视觉缺陷又有视觉注意力缺陷的人。所有的群体都包括那些在认知测试中有缺陷的人。随着时间的推移，驾驶行为将被评估，使用一种新的系统，允许研究参与者被动记录实际驾驶行为。特别是，敏锐度、对比敏感度、视野和视觉注意的缺陷，以及这些测量随时间的变化，被假设为影响代偿性驾驶策略的采用或驾驶停止。此外，认知状态以及对限制的洞察力被假设为这种关系的预测和效果修饰者。最后，这项研究将确定采用补偿性驾驶策略以及哪些策略会影响撞车风险。具体目标如下：1)确定老年司机群体的驾驶特征，并将驾驶模式与视觉、认知和感知特征联系起来。2)纵向确定视力和认知损害以及损害的变化如何导致采用补偿性驾驶策略，以及3)确定每个风险组在四年的预期部分中采用补偿性驾驶策略以及由此对驾驶员错误率和撞车风险的影响。 这项研究将提供关于视觉、视觉注意和认知在改变老年人驾驶行为中的交互作用以及由此对驾驶员错误和撞车风险的影响的关键数据。

DESCRIPTION: (provided by applicant) Driving an automobile is a major factor in the maintenance of independence and mobility among older persons. Loss of driving privileges and resultant dependencies are a greatly feared consequence of aging, which can lead to continued driving even among those at high risk of crashes. Avoidance of high- risk situations as well as attention to driving performance and other compensatory strategies are behaviors that allow older drivers with limitations to continue driving safely under proscribed circumstances. Thus, there is much interest in determining the factors that predict adoption of compensatory driving strategies. In this project, a multi-disciplinary team will determine the role of vision and cognition, perception of limitations, and alternatives to driving, in adoption of compensatory driving strategies within a 4 year, longitudinal study of an older population in Salisbury, MD. Three groups of older drivers will be identified: Group One: those with normal vision and alone; Group Three: those with both visual deficits and deficits in visual attention. All groups include those with deficits in the tests of cognition. Driving behaviors will be assessed over time, using a novel system that allows passive recording of actual driving behavior by the study participant. In particular, deficits in acuity, contrast sensitivity, visual fields, and visual attention, and changes in these measures over time, are hypothesized to affect adoption of compensatory driving strategies or driving cessation in addition, cognitive status, as well as insight into limitations, are hypothesized to be both predictors and effect modifiers of this relationship. Finally, the study will determine how adoption of compensatory driving strategies, and which strategies, affect crash risk. The specific aims are as follows: 1) To determine the driving characteristics of the cohort of older drivers, and associate patterns of driving with visual, cognitive, and perceptual characteristics. 2) To determine longitudinally how vision and cognition impairments, and change in impairments, result in adoption of compensatory driving strategies, and 3) To determine for each risk group over the four-year prospective component, the adoption of compensatory driving strategies and resulting effect on driver error rates and crash risk. This study will provide critical data on the interactive role of vision, visual attention, and cognition in changing older persons driving behaviors, and the resulting effect on driver errors and risk of crashes.