Aging and decision making: driving-related problem solving

Development of a Web-Based Mini-Driving Scene Screening Test (MDSST) for Clinical Practice in Driving Rehabilitation

(1) Background: For the elderly and disabled, self-driving is very important for social participation. An understanding of changing driving conditions is essential in order to drive safely. This study aimed to develop a web-based Korean Mini-Driving Scene Screening Test (MDSST) and to verify its reliability and validity for clinical application. (2) Methods: We developed a web-based MDSST, and its content validity was verified by an expert group. The tests were conducted with 102 elderly drivers to verify the internal consistency and reliability of items, and the validity of convergence with the existing Korean-Safe Driving Behavior Measure (K-SDBM) and the Korean-Adelaide Driving Self-Efficacy Scale (K-ADSES) driving tests was also verified. The test–retest reliability was verified using 54 individuals who participated in the initial test. (3) Results: The average content validity index of MDSST was 0.90, and the average internal consistency of all items was 0.822, indicating high content validity and internal consistency. The exploratory factor analysis for construct validity, the KOM value of the data, was 0.658, and Bartlett’s sphericity test also showed a strongly significant result. The four factors were road traffic and signal perception, situation understanding, risk factor recognition, and situation prediction. The explanatory power was reliable at 61.27%. For the convergence validation, MDSST and K-SDBM showed r = 0.435 and K-ADSES showed r = 0.346, showing a moderate correlation. In the evaluation–reevaluation reliability verification, the reliability increased to r = 0.952. (4) Conclusions: The web-based MDSST test developed in this study is a useful tool for detecting and understanding real-world driving situations faced by elderly drivers. It is hoped that the MDSST test can be applied more widely as a driving ability test that can be used in the clinical field of driving rehabilitation.

Using SHRP2 NDS data to examine infrastructure and other factors contributing to older driver crashes during left turns at signalized intersections

Drivers age 65 and over have higher rates of crashes and crash-related fatalities than other adult drivers and are especially over-represented in crashes during left turns at intersections. This research investigated the use of SHRP2 Naturalistic Driving Study (NDS) data to assess infrastructure and other factors contributing to left turn crashes at signalized intersections, and how to improve older driver safety during such turns. NDS data for trips involving signalized intersections and crash or near-crash events were obtained for two driver age groups: drivers age 65 and over (older drivers) and a sample of drivers age 30-49, along with NDS pre-screening and questionnaire data. Video scoring of all trips was performed to collect additional information on intersection and trip conditions. To identify the most influential factors of crash risk during left turns at signalized intersections, machine learning and regression models were used. The results found that in the obtained NDS dataset, there was a relatively small volume of crashes during left turns at signalized intersections. Further, model results found the statistically significant variables of crash risk for older drivers were associated more with health and cognitive factors rather than the infrastructure or design of the intersections. The results suggest that a study using only SHRP2 NDS data will not lead to definitive findings or recommendations for infrastructure changes to increase safety for older drivers at signalized intersections and during left turns. Moreover, the findings of this study indicates the need to consider other data sources and data collection methods to address this critical literature gap in older driver safety.

The Context of Caution: An Examination of Age, Social Context, and Sex on Measures of Inhibitory Control and Risky Decision-Making

Understanding how older adults successfully navigate complex choices like driving requires the consideration of processing speed, inhibitory control, attentional processes, and risk management, and the context within which these decisions occur. The current study employed the Flanker task, the Stoplight task, and a personality inventory with 43 younger adults and 49 older adults either while they were alone or being observed by two same-sex, similarly aged peers. On the Flanker task, older adults performed more slowly, but with comparable accuracy. On the Stoplight task, there was a significant main effect of Context, and an Age-Group by Sex interaction, even after controlling for response time: All groups had a greater number of crashes when alone, and young adult males had significantly more crashes than any other group. These results emphasize the importance of considering the broader context of decision-making.

Effects of acute alcohol and driving complexity in older and younger adults

RATIONALE

Our previous work demonstrated differential neurobehavioral effects of low-dose alcohol consumption on older and younger adults in a driving simulator. However, the ability to enhance or suppress a response in such context has yet to be examined.

OBJECTIVES

The current study contrasted older and younger drivers' responses to specific stimuli (i.e., relevant, irrelevant) in scenarios of differing complexity following low-dose acute alcohol administration.

METHODS

Healthy older (55-70) and younger (25-35) adults completed two driving scenarios (i.e., country and metropolis) both before and after consuming beverages targeted to reach peak BrACs of 0.00, 0.04, or 0.065%. Throughout the simulation, participants encountered relevant stimuli (e.g., pedestrians walking into the street) and irrelevant stimuli (e.g., pedestrians walking parallel). Peak deceleration, range of steering, and distance until brake application were assessed within a 450-ft window preceding each stimulus.

RESULTS

Following low-dose alcohol consumption, older adults shifted from a strategy using both deceleration and steering to relying solely on deceleration in responding to relevant stimuli in the country. Older adults under both low and moderate alcohol conditions displayed an inability to withhold responses to irrelevant stimuli in the metropolis.

CONCLUSION

These findings are consistent with our prior work showing differential effects of low-dose alcohol on older, relative to younger, adults. The interactive effects of age and alcohol, however, depend on stimulus type and environmental complexity. Continued investigation of neurobehavioral mechanisms in ecologically valid paradigms is necessary for understanding the implications of the combined impairing effects of alcohol and older age.

Technology and Aging

Technological advancements have become widespread, and their implementation into products of everyday use is accelerating. Technology has the potential to improve the lives of older adults by increasing their safety, security, and independence in daily life. However, too often older adults' capabilities and limitations are not considered in the design of current and future technologies. In 1990, the National Research Council identified the importance of human factors in the design of technology for an aging population. The goal of this chapter is to review research on aging and technology since that report to determine the contributions of human factors research to issues of aging and technology design. In this chapter we address the extent to which older adults use new technologies, factors to consider in the adoption of technology (e.g., attitudes), the influence of technology design on older adults' performance (e.g., design of input devices), and ways to optimize training for older adults in using new technologies (e.g., age-specific instructional designs). We then review emerging areas of research that may direct the focus of human factors research in the next decade. These areas of research include ubiquitous computing (e.g., home monitoring systems), health care technologies (e.g., telehealth), robotics (e.g., Nursebot), and automated systems (e.g., cruise control). Finally, we consider opportunities and challenges to human factors research as the field continues to address the questions of optimizing technology for older adult users.

Age differences in simulated driving performance: compensatory processes

In the context of driving, the reported experiment examines compensatory processes for age-related declines in cognitive ability. Younger (26-40 years) and older (60+ years) participants (n=22 each group) performed a car following task in a driving simulator. Several performance measures were recorded, including assessments of anticipation of unfolding traffic events. Participants also completed a range of measures of cognitive ability - including both fluid and crystallised abilities. Three examples of age-related compensation are reported: (i) older drivers adopted longer headways than younger drivers. Data were consistent with this being compensation for an age-related deficit in complex reaction time; (ii) older drivers with relatively higher cognitive ability anticipated traffic events more frequently, whereas the reverse pattern was found for younger drivers; and, (iii) older drivers with greater crystallised ability were less reliant on spatial ability to maintain lane position. Consistent with theories of 'cognitive reserve', interactions between crystallised ability and age for self-report workload suggested that compensation for age-related cognitive ability deficits required investment of additional effort. Results are considered in the context of the prospects of further assessment of older drivers.

Judgment and Decision Making by Individuals and Teams: Issues, Models, and Applications

Consistent with technological advances, the role of the operator in many human factors domains has evolved from one characterized primarily by sensory and motor skills to one characterized primarily by cognitive skills and decision making. Decision making is a primary component in problem solving, human-automation interaction, response to alarms and warnings, and error mitigation. In this chapter we discuss decision making in terms of both front-end judgment processes (e.g., attending to and evaluating the significance of cues and information, formulating a diagnosis, or assessing the situation) and back-end decision processes (e.g., retrieving a course of action, weighing one's options, or mentally simulating a possible response). Two important metatheories—correspondence (empirical accuracy) and coherence (rationality and consistency)—provide ways to assess the goodness of each phase (e.g., Hammond, 1996, 2000; Mosier, 2009). We present several models of decision making, including Brunswik's lens model, naturalistic decision making, and decision ladders, and discuss them in terms of their point of focus and their primary strategies and goals. Next, we turn the discussion to layers in the decision context: individual variables, team decision making, technology, and organizational influences. Last, we focus on applications and lessons learned: investigating, enhancing, designing, and training for decision making. Drawing heavily on sources such as the Human Factors journal, we present recent human factors research exploring these issues, models, and applications.

A tomada de decisão em adultos jovens e em adultos idosos: um estudo comparativo

O presente estudo comparou adultos jovens e adultos idosos em seu desempenho na IGT. A amostra foi constituída por de 72 indivíduos, distribuídos em dois grupos etários: 36 adultos jovens (M = 29,86, DP = 4,63) e 36 adultos idosos (M = 66,89, DP = 5,19). Não houve diferença entre os grupos quanto às escolhas de cartas (p= 0,60), considerando o escore com base no cálculo (mental). Observaram-se, contudo, diferenças significativas no processo de aprendizagem (p = 0,026). considerando o escore com base na frequência (punição), não foram observadas diferenças significativas nas escolhas das cartas (p = 0,48) bem como no processo de aprendizagem (p = 0,076). Os resultados corroboram estudos anteriores, que minimizam a influência da idade na IGT. Sugerese que a forma de analisar os escores pode estar influenciando o entendimento do comportamento de escolha, juntamente a aspectos referentes à constituição da amostra.

Declínio de desempenho motor no envelhecimento é específico à tarefa

O declínio de desempenho motor característico do envelhecimento tem sido proposto ter como causa um fator único, originário de deterioração da capacidade de processamento central de informação. Por essa proposição, o desempenho motor em diferentes tarefas deveria ser prejudicado similarmente durante o envelhecimento. Para testar essa hipótese, o desempenho sensório-motor de indivíduos fisicamente ativos entre 19 e 73 anos de idade foi estudado em oito tarefas: tempo de reação, tempo de movimento no contato com um alvo, força manual máxima, sincronização, controle de força, toques repetidos com haste vertical, desenhos seqüenciais e toques entre os dedos. A análise dos resultados indicou perfis variáveis de desempenho entre as tarefas motoras na comparação entre as idades, com declínio motor a uma taxa moderada entre 20 e 60 anos para tempo de reação, quedas mais acentuadas de desempenho na transição entre 20 e 40 anos em tarefas requisitando velocidade de execução de movimentos simples ou precisão temporal, quedas mais acentuadas na transição entre 60 e 70 anos para força máxima e habilidade gráfica e manutenção da capacidade de desempenho com o envelhecimento para controle de força manual. Dessa forma, esses resultados revelam-se contraditórios com a hipótese de fator único e oferecem suporte à hipótese alternativa de que a taxa de declínio de desempenho sensório-motor durante o envelhecimento é específica à tarefa.

Caregiving decision making by older mothers and adult children: Process and expected outcome

Dyadic caregiving decision making was studied in 30 mother-son and 29 mother-daughter pairs (mother's age=65-94 years) who responded to a vignette depicting a caregiving decision situation. The observed decision-making process of mother-child pairs was largely naturalistic, with few alternatives proposed and quick convergence to a decision followed by a postdecision justification; a degree of more rational decision making was seen in some pairs. Among significant findings, adult children, especially sons, dominated the decision process, doing more talking and introducing more alternatives than did their mothers, who played a more subordinate role. Mother-son pairs expected more negative outcomes and greater regrets regarding their decisions than mother-daughter pairs. Closeness of the parent-child relationship influenced the decision-making process, expected outcomes, and regrets.

Age Differences in Everyday Problem-Solving and Decision-Making Effectiveness: A Meta-Analytic Review

The authors report a meta-analysis of age differences in everyday problem-solving/decision-making effectiveness (EPSE). Effect sizes were calculated to reflect 3 age group comparisons: old versus young, young versus middle-aged, and middle-aged versus old. Findings from the meta-analysis of 28 separate studies with an aggregate of 4,482 participants do not support theories of preserved EPSE in late adulthood. Although significant age differences of moderate magnitude persisted across methodological and theoretical domains, rating criteria (experimenter vs. participant) emerged as a significant moderator of the effect magnitude and direction. In addition, EPSE in older adults was bolstered when problem content was interpersonal and when samples were highly educated. Finally, the current results support the conceptual integration of findings from the everyday problem-solving and everyday decision-making literatures.

Speed-of-processing and driving simulator training result in improved driving performance

Useful field of view, a measure of processing speed and spatial attention, can be improved with training. We evaluated the effects of this improvement on older adults' driving performance. Elderly adults participated in a speed-of-processing training program (N = 48), a traditional driver training program performed in a driving simulator (N = 22), or a low-risk reference group (N = 25). Before training, immediately after training or an equivalent time delay, and after an 18-month delay each participant was evaluated in a driving simulator and completed a 14-mile (22.5-km) open-road driving evaluation. Speed-of-processing training, but not simulator training, improved a specific measure of useful field of view (UFOV), transferred to some simulator measures, and resulted in fewer dangerous maneuvers during the driving evaluation. The simulator-trained group improved on two driving performance measures: turning into the correct lane and proper signal use. Similar effects were not observed in the speed-of-processing training or low-risk reference groups. The persistence of these effects over an 18-month test interval was also evaluated. Actual or potential applications of this research include driver assessment and/or training programs and cognitive intervention programs for older adults.

Why HID headlights bother older drivers

Driving requires effective coordination of visual, motor, and cognitive skills. Visual skills are pushed to their limit at night by decreased illumination and by disabling glare from oncoming headlights. High intensity discharge (HID) headlamps project light farther down roads, improving their owner's driving safety by increasing the time available for reaction to potential problems. Glare is proportional to headlamp brightness, however, so increasing headlamp brightness also increases potential glare for oncoming drivers, particularly on curving two lane roads. This problem is worse for older drivers because of their increased intraocular light scattering, glare sensitivity, and photostress recovery time. An analysis of automobile headlights, intraocular stray light, glare, and night driving shows that brightness rather than blueness is the primary reason for the visual problems that HID headlights can cause for older drivers who confront them. The increased light projected by HID headlights is potentially valuable, but serious questions remain regarding how and where it should be projected.

Functional limitations to daily living tasks in the aged: a focus group analysis

We assessed constraints on daily living of 59 healthy, active adults 65-88 years of age in focus group interviews. Individual comments about specific problems were coded along the dimensions of (a) the locus of the problem (motor, visual, auditory, cognitive, external, or health limitations); (b) the activity involved (e.g., transportation, leisure, housekeeping); (c) whether the problem was attributable to task difficulty or the perception of risk; and (d) response to limitations (perseverance, cessation, compensation, or self-improvement). The data provide information about the types of difficulties encountered in everyday activities as well as the way in which individuals respond to such difficulties. Each comment was also coded in terms of whether it was remediable via training, design changes, or some combination of the two. More than half of the problems that were reported had the potential to be improved in some way, thus providing direction for future research in human factors and aging. Actual or potential applications of this research include identifying problems and difficulties that older adults encounter in daily activities such as transportation and leisure; more specifically, determining the degree to which such problems are potentially remediable by human factors solutions. Applications of this research also include understanding the types of systems, products, and technologies that older adults interact with currently, or are interested in learning to use.