Avoidance Behavior Is an Independent Indicator of Poorer On-road Driving Skills in Older Adults

Metacognitive Awareness of Older Adult Drivers with Mild Cognitive Impairment: Relationships with Demographics, Subjective Evaluation of Cognition, and Driving Self-Efficacy

(1) Self-regulation of driving is a means of maintaining one's driving identity. The purpose of this study was to investigate the extent to which older drivers with Mild Cognitive Impairment (MCI) are metacognitively aware of the requirements of specific demanding driving conditions and whether this awareness is linked to subjective assessments of cognition. (2) One hundred seventeen (117) older MCI drivers participated in a telephone survey in which they reported their metacognitive experiences in nine driving conditions, listed as an aim of self-regulation. The analyses included the participants' subjective cognitive assessments, both in terms of their cognitive state and their perceived driving self-efficacy. (3) The analyses pointed out a direct and negative effect of age on the formation of the metacognitive feeling of certainty. Furthermore, an indirect effect of sex through driving self-efficacy was established. This effect was negative in the case of the metacognitive feeling of difficulty and the estimation of effort and positive in the case of the metacognitive feeling of certainty. (4) This position points out the need to establish appropriate levels of the perceived self-efficacy of older drivers with MCI, and it raises issues when it moves to fictitious levels.

Personality Is Associated with Driving Avoidance in the Canadian Longitudinal Study on Aging (CLSA)

As individuals age and become aware of changes in their driving capabilities, they are more likely to self-regulate their driving by avoiding certain driving situations (i.e., night driving, rush hour traffic, etc.). In this paper, we sought to examine the correlates of situational driving avoidance with a particular emphasis on the roles of personality traits, gender, and cognition within a large sample of mid-life and older adults from the Canadian Longitudinal Study on Aging (CLSA). Our findings show that women of older ages tend to report more driving avoidance and that personality traits, specifically extraversion, emotional stability, and openness to experience, may reduce driving avoidance. A negative association was also found between cognition and driving avoidance, such that individuals with higher cognition reported less driving avoidance.

Overestimation of on-road driving performance is associated with reduced driving safety in older drivers

OBJECTIVES

Older drivers often show less precise self-ratings with a tendency to overestimate themselves. It is unclear, however, how overestimators differ from underestimators or drivers with adequate self-ratings.

METHODS

59 healthy older drivers participated in this on-road study. Besides standardized on-road driving assessment, the study protocol included the collection of neuropsychological and driving-related data as well as different self-ratings. Statistical analyses involved correlations between different subjective and objective ratings as well as statistical comparisons between drivers who overestimated and drivers who adequately rated their on-road driving performance (no drivers underestimated their performance).

RESULTS

Despite positive correlations between different self- and expert ratings, our results revealed that 25 % of the participants overestimated their on-road driving skills. Among other things, overestimators showed poorer on-road driving performances, more prospective near and minor at-fault accidents, poorer cognitive performances in specific driving-related domains and reduced annual mileage.

DISCUSSION

Our results suggest that older drivers who overestimate their driving skills show poorer performances within a broad range of skills that directly reflect or are closely related to driving safety. Against the background that an adequate self-assessment is required by German traffic regulations, our findings suggest that overestimators represent a risk group among the population of older drivers.

Self-Reported Driving Difficulty, Avoidance, and Negative Emotion With On-Road Driving Performance in Older Adults With Glaucoma

PURPOSE

To investigate the relationship between self-perceived driving difficulty, driving avoidance, and negative emotion about driving with glaucoma severity and on-road driving performance.

DESIGN

Cohort study.

METHODS

Glaucoma patients (n = 111), aged 55 to 90 years, with mild, moderate, and advanced glaucoma in the better-eye based on the Glaucoma Staging System, and age-matched controls (n = 47) were recruited from a large tertiary academic center. Self-reported questionnaires were administered by a trained occupational therapist followed by a standardized on-road driving evaluation (pass vs "at-risk" score) with a masked and certified driving rehabilitation specialist.

RESULTS

Compared to controls, glaucoma participants reported greater driving difficulty with as early as mild glaucoma (P = .0391) and negative emotion about driving starting with moderate glaucoma (P = .0042). Glaucoma participants reporting at least 1 driving difficulty and negative emotion had a 3.3-fold (adjusted odds ratio [OR] = 3.3; 95% CI = 1.24-8.52; P = .0163) and 4.2-fold (adjusted OR = 4.2; 95% CI = 1.5-12.2; P = .0078) greater odds, respectively, of an at-risk score on the on-road test. Self-reported driving difficulty in "difficult" conditions (P = .0019), rain (P = .0096), interstates (P = .0378), and high traffic (P = .0076), driving avoidance on sunny (P = .0065) and cloudy (P = .0043) days, and driving fewer days per week (P = .0329) were also associated with at-risk driving.

CONCLUSIONS

Screening tools that assess self-perceived driving difficulty and driving avoidance in specific conditions, negative emotion about driving, and driving exposure may help identify unsafe drivers with glaucoma. Some of these drivers, particularly those with modest glaucoma, may benefit from a driving evaluation and early referral to resources that could enable them to continue driving safely and confidently.

Predicting On-Road Driving Skills, Fitness to Drive, and Prospective Accident Risk in Older Drivers and Drivers with Mild Cognitive Impairment: The Importance of Non-Cognitive Risk Factors

BACKGROUND

On-road driving behavior can be impaired in older drivers and particularly in drivers with mild cognitive impairment (MCI).

OBJECTIVE

To determine whether cognitive and non-cognitive risk factors for driving safety may allow an accurate and economic prediction of on-road driving skills, fitness to drive, and prospective accident risk in healthy older drivers and drivers with MCI, we examined a representative combined sample of older drivers with and without MCI (N = 74) in an observational on-road study. In particular, we examined whether non-cognitive risk factors improve predictive accuracy provided by cognitive factors alone.

METHODS

Multiple and logistic hierarchical regression analyses were utilized to predict different driving outcomes. In all regression models, we included cognitive predictors alone in a first step and added non-cognitive predictors in a second step.

RESULTS

Results revealed that the combination of cognitive and non-cognitive risk factors significantly predicted driving skills (R2adjusted = 0.30) and fitness to drive (81.2% accuracy) as well as the number (R2adjusted = 0.21) and occurrence (88.3% accuracy) of prospective minor at-fault accidents within the next 12 months. In all analyses, the inclusion of non-cognitive risk factors led to a significant increase of explained variance in the different outcome variables.

CONCLUSION

Our findings suggest that a combination of the most robust cognitive and non-cognitive risk factors may allow an economic and accurate prediction of on-road driving performance and prospective accident risk in healthy older drivers and drivers with MCI. Therefore, non-cognitive risk factors appear to play an important role.