Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, 1720 University Blvd., Suite 609, Birmingham, AL, 35294-0009, USA.
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, 35294-0022, USA.
BMC Ophthalmol. 2020 Feb 4;20(1):47. doi: 10.1186/s12886-020-1331-7.
Older drivers have a crash rate nearly equal to that of young drivers whose crash rate is the highest among all age groups. Contrast sensitivity impairment is common in older adults. The purpose of this study is to examine whether parameters from the photopic and mesopic contrast sensitivity functions (CSF) are associated with incident motor vehicle crash involvement by older drivers.
This study utilized data from older drivers (ages ≥60 years) who participated in the Strategic Highway Research Program Naturalistic Driving Study, a prospective, population-based study. At baseline participants underwent photopic and mesopic contrast sensitivity testing for targets from 1.5-18 cycles per degree. Model fitting generated area under the log CSF (AULCSF) and peak log sensitivity. Participant vehicles were instrumented with sensors that captured continuous driving data when the vehicle was operating (accelerometers, global positioning system, forward radar, 4-channel video). They participated for 1-2 years. Crashes were coded from the video and other data streams by trained analysts.
The photopic analysis was based on 844 drivers, and the mesopic on 854 drivers. Photopic AULCSF and peak log contrast sensitivity were not associated with crash rate, whether defined as all crashes or at-fault crashes only (all p > 0.05). Mesopic AULCSF and peak log sensitivity were associated with an increased crash rate when considered for all crashes (rate ratio (RR): 1.36, 95% CI: 1.06-1.72; RR: 1.28, 95% CI: 1.01-1.63, respectively) and at-fault crashes only (RR: 1.50, 95% CI: 1.16-1.93; RR: 1.38, 95% CI: 1.07-1.78, respectively).
Results suggest that photopic contrast sensitivity testing may not help us understand future crash risk at the older-driver population level. Results highlight a previously unappreciated association between older adults' mesopic contrast sensitivity deficits and crash involvement regardless of the time of day. Given the wide variability of light levels encountered in both day and night driving, mesopic vision tests, with their reliance on both cone and rod vision, may be a more comprehensive assessment of the visual system's ability to process the roadway environment.
老年驾驶员的事故率接近年轻驾驶员，而年轻驾驶员的事故率在所有年龄段中是最高的。对比敏感度损害在老年人中很常见。本研究的目的是探讨明视觉和中间视觉对比敏感度功能（CSF）的参数是否与老年驾驶员的机动车事故发生率有关。
本研究利用了参加战略公路研究计划自然驾驶研究的老年驾驶员（年龄≥60 岁）的数据，这是一项前瞻性的、基于人群的研究。在基线时，参与者接受了 1.5-18 个周期/度的明视觉和中间视觉对比敏感度测试。模型拟合生成对数 CSF 的面积（AULCSF）和峰值对数敏感度。参与者的车辆配备了传感器，当车辆运行时（加速计、全球定位系统、前雷达、4 通道视频），这些传感器可以捕获连续的驾驶数据。他们参加了 1-2 年。通过经过培训的分析人员从视频和其他数据流中对事故进行编码。
明视觉分析基于 844 名驾驶员，中间视觉分析基于 854 名驾驶员。明视觉 AULCSF 和峰值对数对比度敏感度与事故率无关，无论是定义为所有事故还是仅归咎于事故的事故（均 p>0.05）。中间视觉 AULCSF 和峰值对数敏感度与所有事故（比率比（RR）：1.36，95%置信区间：1.06-1.72；RR：1.28，95%置信区间：1.01-1.63）和仅归咎于事故的事故（RR：1.50，95%置信区间：1.16-1.93；RR：1.38，95%置信区间：1.07-1.78）相关。
结果表明，明视觉对比敏感度测试可能无助于我们了解老年驾驶员群体的未来事故风险。结果强调了老年人中间视觉对比敏感度缺陷与事故发生之间以前未被认识到的关联，无论一天中的时间如何。鉴于白天和夜间驾驶中遇到的光照水平差异很大，中间视觉测试依赖于视锥细胞和视杆细胞，因此可能更全面地评估视觉系统处理道路环境的能力。
