a Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens , Athens , Greece.
b Department of Occupational Therapy, East Carolina University , Greenville , North Carolina.
Traffic Inj Prev. 2019;20(6):630-635. doi: 10.1080/15389588.2019.1626986. Epub 2019 Jun 27.
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. 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. 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. 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.
大量证据表明，老年人中常见的疾病会导致视力、认知或心理运动功能受损，从而无法安全驾驶。本研究的目的是从 30 名轻度认知障碍（MCI）老年驾驶员和 30 名年龄匹配的无认知障碍对照组的角度探讨导致驾驶困难的因素。使用广泛的问卷调查数据，检查了两组的驾驶困难感知。MCI 诊断样本和年龄匹配的对照组被要求报告由于功能缺陷以及对新交通规则和交通标志的了解而导致驾驶困难的频率。分析表明，MCI 对驾驶困难的看法有 2 个因素，分别代表（1）与晚期检测相关的困难，加上对周边视野中相关目标的反应较慢，（2）与需要从自动处理切换到意识处理的任务之间的注意力分散相关的困难，特别是持续时间较长的任务。对健康对照组的分析揭示了 3 个因素，分别代表（1）在复杂（注意力分散）高信息负荷条件下，估计接近车辆的速度和距离的困难；（2）头部、颈部和脚部移动的困难；（3）在新的或意外情况下，从自动反应切换到需要使用认知处理的困难。尽管两组分析都显示出从自动到决策的切换困难，但困难是不同的。对于对照组，切换中的困难涉及与高信息负荷条件相关的新的或意外情况，而 MCI 组的这种切换困难与需要在较容易的任务之间进行注意力分散有关。这些发现强调了老年人（患有 MCI 和无认知障碍）能够指出各种驾驶技能可能存在的缺陷的能力。MCI 组和年龄匹配的健康对照组感知到的困难模式表明了可能需要道路设计师和道路安全工程师特别关注的苛刻驾驶情况。它们也可以在设计老年人驾驶能力评估、培训计划和/或为老年人提供驾驶辅助的车辆技术时考虑。
