Assessing the driving performance of older adult drivers: on-road versus simulated driving

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Abstract

To validate a laboratory-based driving simulator in measuring on-road driving performance, 129 older adult drivers were assessed with both the simulator and an on-road test. The driving performance of the participants was gauged by appropriate and reliable age-specific assessment criteria, which were found to be negatively correlated with age. Using principal component analysis, two performance indices were developed from the criteria to represent the overall performance in simulated driving and the on-road assessment. There was significant positive association between the two indices, with the simulated driving performance index explaining over two-thirds of the variability of the on-road driving performance index, after adjustment for age and gender of the drivers. The results supported the validity of the driving simulator and it is a safer and more economical method than the on-road testing to assess the driving performance of older adult drivers.

Introduction

In Western countries, driving has become a symbol of freedom and independence. Losing their driving license may limit older drivers’ perceived roles in relation to family and fulfilling obligations and expectations (Crane, 1996, Cobb and Coughin, 1998). It has been established that driving ability gradually deteriorates with age (Carr et al., 1994), prompting concerns on appropriate methods to evaluate the driving ability of the aging population (Reuben, 1993).

Studies have shown that older drivers may be disadvantaged during driving assessments because of their chronological age or their medical conditions (Wiseman and Souder, 1996). Existing licensing procedures for older drivers typically contain certain elements that will screen “age” related deficits. In particular, the assessment criteria have a high percentage of psychometric measures requiring good visual acuity and quick reaction time to perform successfully. However, Summala (1988) concluded that such measures are confounded by age, therefore, fail to reflect the actual cognitive and/or physical deficits of older drivers. Since there is little evidence of a direct relationship between driving competence and medical conditions (McGwin et al., 2000a, McGwin et al., 2000b), revocation of driving privilege based on medical diagnosis alone is unfair and unjustified (Rocca et al., 1990, Odenheimer et al., 1994).

It has been established that age-related declines in cognitive, mental and physical ability are associated with an increase in accident risk (Korteling, 1994). In particular, it has been identified that important attributes to automobile crashes included cognitive decrements in memory and visual perceptual skills (Lundberg et al., 1998, McGwin et al., 1998), visual impairment in acuity and useful field of view deficits (Hu et al., 1998; McGwin et al., 2000a, McGwin et al., 2000b) and difficulty in judging and response to traffic flow (McGwin et al., 1998). Medical impairments have also been associated with driving difficulties (Lyman et al., 2001). Moreover, the behaviour and crash incidents at intersections (Clarke et al., 1998a, Clarke et al., 1998b; Preusser et al., 1998), and overtaking road accidents (Clarke et al., 1998a, Clarke et al., 1998b) have been studied with respect to older adult drivers. The effects of risk factors on individuals vary considerably, therefore, it is unlikely that a single or a combination of risk measures can adequately identify unsafe or problematic older drivers (Abdel-Aty and Radwan, 2000).

Conventional road tests are costly and ineffective. They are also impractical and stressful to older drivers (Waller, 1991, Carr, 2000). The development of a reliable off-road screening component in the license renewal procedure could reduce the need for expensive and time-consuming on-road assessment without compromising the quality of the procedure (Janke and Eberhand, 1998). Rapidly evolving electronic and computer technology have made available relatively low-cost, laboratory-based driving simulators. It is a safe and economical means of testing driving performance. The driving simulator also allows testing of the driver’s unsafe and risky driving behaviour, which can have potentially dangerous consequences (Allen et al., 1990, Carsten et al., 1997). Many studies have concluded that driving simulators can provide accurate observations on drivers’ behaviours and functions (Alicandri, 1994, Fraser et al., 1994, Van der Winsum, 1996, Desmond and Matthews, 1997, Ellingrod et al., 1997, Van der Winsum and Brouwer, 1997). Simulators have recently been used to study the driving behaviour of Alzheimer patients (Rizzo et al., 2001).

To the best of the authors’ knowledge, previous studies on older adult drivers have never compared simulated driving performance with actual on-road driving performance. The purpose of this study is to validate a driving simulator using an on-road driving test of a prescribed route.

Section snippets

Participants

One hundred and twenty-nine community-dwelling older adult drivers in Perth (capital city of Western Australia), with valid driving license and not having incurred five or more demerit points in the past 2 years, volunteered to take part in the study. The sample age ranged from 60 to 88 years (mean=72.9, S.D.=7.1) and 78% of sample were male. Recruitment was accomplished with the assistance of the Royal Automobile Club of Western Australia and Council on the Aging, and through advertisements in

Driving information

Of the 129 participants, 70% wore spectacles during the assessment. Eight percent of the participants reported that modifications have been made to their vehicle. These included fish-eye mirrors, back support cushions, and enlarged liquid crystal display on the dashboard. Approximately 12% of the participants had been employed in occupations which involved driving a vehicle regularly, such as courier workers, taxi or truck drivers, prior to retirement. The estimated driving time per week ranged

Discussion

This study directly compared simulated driving performance with on-road driving performance for elderly drivers. The high positive relationship between the two overall index measures has validated the development of the driving simulator as a screening tool, which can lead to a cost-effective alternative to the on-road driving test. To a certain extent, its success also depends on the acceptability of the machine by the older population. Participants of this study were observed to have taken

Acknowledgements

The authors are indebted to Dr. A. Woods (Lead Psychogeriatrician, Western Australia), Mr. D. Poole (senior engineer, Royal Automobile Club of Western Australia) and Mr. N. Barker (executive director, Council on the Aging) for their valuable assistance in recruiting the study participants. Thanks are also due to two anonymous reviewers for their constructive comments.

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