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Abstract
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Background
Aging goes along with cognitive and non-cognitive changes leading to impaired driving skills in a relevant proportion of older people. However, it is unclear which driving dimensions are affected in unfit older drivers and how performance in these dimensions is related to driving-relevant cognitive and non-cognitive factors.
Methods
In a prospective cross-sectional study, 110 healthy older drivers completed a standardized 50-minute on-road driving assessment being accompanied by a driving instructor and a driving expert. The driving expert evaluated practical driving skills with the TRIP protocol (TRIP total score) and determined fitness to drive (fit versus unfit). We used repeated-measures analysis of variance to compare fit (n = 89) and unfit (n = 21) older drivers with respect to their practical driving performance in the 12 dimensions of the TRIP. Moreover, we explored how driving performance in the different TRIP dimensions is related to driving-relevant cognitive and non-cognitive factors.
Results
Results revealed performance differences between the different TRIP dimensions across all drivers (main effect of TRIP dimension) with the poorest overall performances in speed adaptation. Unfit older drivers showed poorer practical driving performances than fit older drivers across all TRIP dimensions (main effect of group). The most pronounced group differences were observed at traffic signs and signals, complex intersections and left turns (TRIP dimension × group interaction). Driving performance in these dimensions was associated with different driving-relevant cognitive and non-cognitive factors.
Conclusions
The results of the current on-road study show that impaired driving skills of unfit older drivers can be observed in multiple driving dimensions, but particularly involve traffic signs and signals, complex intersections and left turns. The findings provide both high diagnostic and therapeutic relevance.
Why does this paper matter?
This paper matters, because the current study identified those dimensions of practical driving behavior that best distinguish between fit and unfit older drivers. In a standardized on-road driving assessment, we identified traffic signs and signals, complex intersections and left turns as being those driving dimensions that involve the greatest difficulties for unfit compared to fit older drivers. In a diagnostic context, the results show which driving dimensions deserve a closer look when evaluating fitness to drive. In a therapeutical context, they show which driving dimensions need more intense training. Finally, in a practical context, the results imply that traffic signs and signals need to be optimized to facilitate and accelerate their perception.
Language: en |