Department of Ophthalmology & Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Ophthalmic Physiol Opt. 2022 Jul;42(4):879-886. doi: 10.1111/opo.12985. Epub 2022 Mar 31.
To assess associations between visual function and on-road driving performance evaluated by a certified driving rehabilitation specialist (CDRS).
Adults aged 70 and older enrolled and completed assessments of visual acuity, contrast sensitivity, visual processing speed, visual field sensitivity, motion perception and spatial ability. At follow-up, on-road driving performance was evaluated on a 15-mile route. Age-adjusted odds ratios and 95% confidence intervals (95% CIs) were used to associate worse CDRS composite score and CDRS global rating for those with poorer visual function compared to those with better scores and ratings.
For the 144 participants who enrolled, completed vision testing and the on-road driving evaluation, the mean age was 79.2 (5.1) and 45.8% were female. The odds of worse CDRS global rating and composite score were significantly associated with moderately and severely impaired visual processing speed under divided attention (all p < 0.05). Those with poorer motion perception were at greater odds of a worse CDRS composite score (OR: 2.67, 95% CI: 1.14-6.26).
The CDRS composite score of on-road driving performance by older adults was associated with slowed visual processing and impaired motion perception, suggesting that older driver performance, as rated by a CDRS, relies on visual skills. The CDRS global rating was also associated with impaired visual processing speed. The literature suggests impairments in these same visual functions elevate crash risk. While the results provide additional evidence suggesting these functional measures are associated with driving, further work is needed to identify and assess visual measures most closely related to driving safety and performance among older adults to better inform interventions, policy and future research.
评估经认证的驾驶康复专家（CDRS）评估的视觉功能与道路驾驶表现之间的关联。
年龄在 70 岁及以上的成年人参与并完成了视力、对比敏感度、视觉处理速度、视野敏感度、运动感知和空间能力的评估。随访时，在 15 英里的路线上评估了道路驾驶表现。使用年龄调整后的优势比和 95%置信区间（95%CI），将视觉功能较差的患者与视觉功能较好的患者相比，将 CDRS 综合评分和 CDRS 总体评分较差的患者与 CDRS 综合评分和 CDRS 总体评分较差的患者进行关联。
在 144 名入组、完成视力测试和道路驾驶评估的参与者中，平均年龄为 79.2（5.1）岁，45.8%为女性。在注意力分散下，视觉处理速度中度和重度受损与 CDRS 总体评分和综合评分更差的几率显著相关（均 p<0.05）。运动感知能力较差的患者 CDRS 综合评分更差的几率更大（OR：2.67，95%CI：1.14-6.26）。
年龄较大的成年人的 CDRS 道路驾驶表现综合评分与视觉处理速度减慢和运动感知能力受损有关，这表明 CDRS 评定的老年驾驶员表现依赖于视觉技能。CDRS 总体评分也与视觉处理速度受损有关。文献表明，这些相同的视觉功能障碍会增加碰撞风险。虽然这些结果提供了更多证据表明这些功能测量与驾驶有关，但需要进一步的工作来识别和评估与老年人驾驶安全和性能最密切相关的视觉测量，以更好地为干预、政策和未来研究提供信息。
