Objective This study aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and predict older driver performance given functioning in visual, motor, and cognitive domains. Background Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. Methods Two hundred and three drivers, 120 healthy older (61 men and 59 women, ages 65 years or greater) and 83 middle-aged drivers (38 men and 45 women, ages 40–64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Results Older drivers identified fewer landmarks and drove slower but committed more safety errors than middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers. Visual cognition predicted both traffic sign identification and safety errors while executive function predicted traffic sign identification over and above vision. Conclusion Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older driver management of driving tasks at multiple levels, and can help inform the design of on-road tests and interventions for older drivers.

As a result of cognitive impairment, impaired DRF plays a critical role in the pathway from cognitive impairment to oral health decline. Therefore, DRF assessment should be a standard component of geriatric dental assessment. A functionally-tailored oral hygiene intervention is essential to improve oral health for persons with cognitive impairment.

Introduction The aim of the study was to describe the oral health status of persons with different cognition and dental‐related functions (DRFs). Methods The present study was a secondary analysis of data collected for a cross‐sectional study of residents in three assisted living facilities in North Carolina. The participants were aged 50 years or older, had normal to severely impaired cognition and spoke English. Upon obtaining informed consent, an oral assessment was completed by a trained geriatric dentist. A research team member who was blind to the oral examination outcomes then used the Minimum Data Set Cognition Scale to assess participants’ cognition and the dental activities test to evaluate oral self‐care and other DRFs. Descriptive statistics were used to describe the demographic, cognitive, functional and oral health status of the study participants. The impacts of cognitive and functional status on oral health measures were examined using simple linear regression models, negative binomial and zero‐inflated negative binomial models. Results A total of 91 long‐term residents from three long‐term care facilities participated in the study. Oral hygiene and gingival health were significantly associated with cognition (P = 0.056 and P = 0.017, respectively) and DRFs (P = 0.013 and P = 0.008, respectively). Residents with poor cognitive and dental‐related function also presented with poor oral hygiene and gingival health. Conclusion The study results suggest that oral hygiene and gingival health were significantly associated with cognition and DRFs.

Summary:Reduced visibility and other environmental factors can impair driver ability to respond to roadway hazards. We examined the effects of reduced visibility on naturalistic driving in 66 drivers, including 45 at-risk drivers with obstructive sleep apnea (OSA) and 21 controls. We analyzed three months of electronic data using "black box" recorder technology and assessed the extent to which driver speed, longitudinal acceleration, and lateral acceleration metrics depend on ambient visibility from web-based environmental data archives. We calculated summary driving metrics within 10-second intervals, and reduced these to within-subject means and tested for associations of interest. OSA drivers did not differ from controls with respect to electronic measures or visibility conditions in which they drove. On average, drivers drove slower when visibility was reduced. After controlling for speed, variations in lateral and longitudinal acceleration were positively associated with high-visibility conditions. These findings suggest that drivers exert greater vehicular control when visibility is limited, and that this association is not just due to slower speeds. Weaker relationships between visibility and driving measures in OSA suggest reduced adaptive strategies. Our methods provide a framework for analyzing the effects of other environmental factors on driving, and we provide an additional example using wind speed.

Summary:In naturalistic studies, it is vital to give appropriate context when analyzing driving behaviors. Such contextualization can help address the hypotheses that explore a) how drivers perform within specific types of environment (e.g., road types, speed limits, etc.), and b) how often drivers are exposed to such specific environments. In order to perform this contextualization in an automated fashion, we are using Global Positioning System (GPS) data obtained at 1 Hz and merging this with Geographic Information Systems (GIS) databases maintained by the Iowa Department of Transportation (DOT). In this paper, we demonstrate our methods of doing this based on data from 43 drivers with obstructive sleep apnea (OSA). We also use maps from GIS software to illustrate how information can be displayed at the individual drive or day level, and we provide examples of some of the challenges that still need to be addressed.