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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG023110-03
Application #
7094153
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Stahl, Sidney M
Project Start
2004-09-30
Project End
2009-07-31
Budget Start
2006-08-01
Budget End
2007-07-31
Support Year
3
Fiscal Year
2006
Total Cost
$1,157,855
Indirect Cost
Name
Johns Hopkins University
Department
Ophthalmology
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Rao, Prethy; Munoz, Beatriz; Turano, Kathleen et al. (2013) The decline in attentional visual fields over time among older participants in the Salisbury Eye Evaluation Driving Study. Invest Ophthalmol Vis Sci 54:1839-44
Keay, Lisa; Munoz, Beatriz; Duncan, Donald D et al. (2013) Older drivers and rapid deceleration events: Salisbury Eye Evaluation Driving Study. Accid Anal Prev 58:279-85
Munro, Cynthia A; Winicki, Jessica M; Schretlen, David J et al. (2012) Sex differences in cognition in healthy elderly individuals. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 19:759-68
Kaleem, Mona A; Munoz, Beatriz E; Munro, Cynthia A et al. (2012) Visual characteristics of elderly night drivers in the Salisbury Eye Evaluation Driving Study. Invest Ophthalmol Vis Sci 53:5161-7
Munro, Cynthia A; Jefferys, Joan; Gower, Emily W et al. (2010) Predictors of lane-change errors in older drivers. J Am Geriatr Soc 58:457-64
West, Sheila K; Hahn, Daniel V; Baldwin, Kevin C et al. (2010) Older drivers and failure to stop at red lights. J Gerontol A Biol Sci Med Sci 65:179-83
Keay, Lisa; Munoz, Beatriz; Turano, Kathleen A et al. (2009) Visual and cognitive deficits predict stopping or restricting driving: the Salisbury Eye Evaluation Driving Study (SEEDS). Invest Ophthalmol Vis Sci 50:107-13
Turano, Kathleen A; Munoz, Beatriz; Hassan, Shirin E et al. (2009) Poor sense of direction is associated with constricted driving space in older drivers. J Gerontol B Psychol Sci Soc Sci 64:348-55
Keay, Lisa; Jasti, Srichand; Munoz, Beatriz et al. (2009) Urban and rural differences in older drivers' failure to stop at stop signs. Accid Anal Prev 41:995-1000
Zhang, Lei; Baldwin, Kevin; Munoz, Beatriz et al. (2007) Visual and cognitive predictors of performance on brake reaction test: Salisbury eye evaluation driving study. Ophthalmic Epidemiol 14:216-22