The objective of this research is to identify how visual impairment impacts the safety and performance of older drivers. Driving cessation in older adults is tied to many negative health indicators including increased risk for depression, reduced access to healthcare services, and increased likelihood of placement into long-term-care. The societal significance of research on older drivers is dramatically apparent when we recognize that vision impairment is common in the older adult population, and that older drivers have among the highest rates of motor vehicle collisions compared to other age groups. A critical scientific challenge is to identify what aspects of vision are required for safe driving by older adults. Previous research on older driver safety and performance has focused on the study of police accident reports, brief driving evaluations, or driving simulator studies. These techniques have serious scientific limitations;crash studies do not provide information about what lead up to the collision;in on-road studies research personnel are in the vehicle potentially biasing how the driver behaves;simulator studies present artificial, cartoon-like scenarios that over-simplify the roadway environment. All these issues undermine the ability to understand the actual visual factors underlying driver performance and safety. Naturalistic driving methods overcome these limitations by unobtrusively placing multiple sensors and video cameras in the vehicle that record vehicle kinematics, driver behaviors (e.g., gaze behavior), and roadway environment. They allow driving to be studied in an objective way over lengthy time periods (months) in the driver's own vehicle where the driver chooses the route during the course of everyday life. In this research we will use naturalistic driving techniques to examine the relationships between vision and older driver safety and performance. We focus on older drivers with normal vision and those with contrast sensitivity deficits and slowed visual processing speed, since these problems are the strongest and most consistently identified visual risk factors for driving problems in the older adult population. Analyses will focus on the relationship between vision and critical safety events (crashes, near-crashes), lane-keeping, turning at intersections, driving under secondary tasks demands, and when a "co-pilot" (passenger) is present. These relationships will be examined in light of other driver characteristics, environmental factors, and vehicle factors. Driving performance as measured by naturalistic driving methods will also be compared to driving ratings provided by a driving rehabilitation specialist on a standardized driving route, which is currently the clinical gold standard. This research will stimulate the development of interventions to enhance driving mobility in visually impaired older adults and thus improve quality of life.

Public Health Relevance

Vision is critical for the safe control and effective navigation of a vehicle. Vision impairment is common in the older adult population, and older drivers have among the highest rates of motor vehicle collisions compared to other age groups. Older drivers are the fastest growing group of drivers on the road in the US, both in terms of the number of drivers and annual mileage. Research to identify how vision impairment impacts driver safety will lead to interventions that enhance both public safety and personal mobility.

National Institute of Health (NIH)
National Eye Institute (NEI)
Research Project (R01)
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Special Emphasis Panel (ZEY1-VSN (04))
Program Officer
Schron, Eleanor
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University of Alabama Birmingham
Schools of Medicine
United States
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Owsley, Cynthia; McGwin Jr, Gerald; Elgin, Jennifer et al. (2014) Visually impaired drivers who use bioptic telescopes: self-assessed driving skills and agreement with on-road driving evaluation. Invest Ophthalmol Vis Sci 55:330-6
Sandlin, Daniel; McGwin Jr, Gerald; Owsley, Cynthia (2014) Association between vision impairment and driving exposure in older adults aged 70 years and over: a population-based examination. Acta Ophthalmol 92:e207-12
Huisingh, Carrie; McGwin Jr, Gerald; Orman, Katherine A et al. (2014) Frequent falling and motor vehicle collision involvement of older drivers. J Am Geriatr Soc 62:123-9
McGwin Jr, Gerald; Mitchell, Bradford; Searcey, Karen et al. (2013) Examining the association between age-related macular degeneration and motor vehicle collision involvement: a retrospective cohort study. Br J Ophthalmol 97:1173-6
Green, Kimberly A; McGwin Jr, Gerald; Owsley, Cynthia (2013) Associations between visual, hearing, and dual sensory impairments and history of motor vehicle collision involvement of older drivers. J Am Geriatr Soc 61:252-7
Blunck, Hallie; Owsley, Cynthia; MacLennan, Paul A et al. (2013) Driving with pets as a risk factor for motor vehicle collisions among older drivers. Accid Anal Prev 58:70-4
Wood, Joanne M; McGwin Jr, Gerald; Elgin, Jennifer et al. (2013) Characteristics of on-road driving performance of persons with central vision loss who use bioptic telescopes. Invest Ophthalmol Vis Sci 54:3790-7
Friedman, Carly; McGwin Jr, Gerald; Ball, Karlene K et al. (2013) Association between higher order visual processing abilities and a history of motor vehicle collision involvement by drivers ages 70 and over. Invest Ophthalmol Vis Sci 54:778-82
Owsley, Cynthia; McGwin Jr, Gerald; Searcey, Karen (2013) A population-based examination of the visual and ophthalmological characteristics of licensed drivers aged 70 and older. J Gerontol A Biol Sci Med Sci 68:567-73
MacLennan, Paul A; McGwin Jr, Gerald; Searcey, Karen et al. (2013) Medical record validation of self-reported eye diseases and eye care utilization among older adults. Curr Eye Res 38:1-8

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