Article

OBJECTIVE: To find an association between cognitive-perceptual problems of older
drivers and unsafe driving performance during simulated automobile driving in a
virtual environment. DESIGN: Cross-sectional study. SETTING: A driver evaluation
clinic in a rehabilitation hospital. PARTICIPANTS: Fifty-five drivers aged 65
years or older and 48 drivers in their late twenties to early forties. METHODS:
All participants underwent evaluation of cognitive-perceptual function and
driving performance, and the results were compared between older and younger
drivers. The association between cognitive-perceptual function and driving
performance was analyzed. MAIN OUTCOME MEASUREMENTS: Cognitive-perceptual
function was evaluated with the Cognitive Perceptual Assessment for Driving
(CPAD), a computer-based assessment tool consisting of depth perception,
sustained attention, divided attention, the Stroop test, the digit span test,
field dependency, and trail-making test A and B. Driving performance was
evaluated with use of a virtual reality-based driving simulator. During simulated
driving, car crashes were recorded, and an occupational therapist observed unsafe
performances in controlling speed, braking, steering, vehicle positioning, making
lane changes, and making turns. RESULTS: Thirty-five older drivers did not pass
the CPAD test, whereas all of the younger drivers passed the test. When using the
driving simulator, a significantly greater number of older drivers experienced
car crashes and demonstrated unsafe performance in controlling speed, steering,
and making lane changes. CPAD results were associated with car crashes, steering,
vehicle positioning, and making lane changes. Older drivers who did not pass the
CPAD test are 4 times more likely to experience a car crash, 3.5 times more
likely to make errors in steering, 2.8 times more likely to make errors in
vehicle positioning, and 6.5 times more likely to make errors in lane changes
than are drivers who passed the CPAD test. CONCLUSION: Unsafe driving performance
and car crashes during simulated driving were more prevalent in older drivers
than in younger drivers. Unsafe performance in steering, vehicle positioning,
making lane changes, and car crashes were associated with cognitive-perceptual
dysfunction.
CI - Copyright (c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS