Driving Safety of Cognitively-Impaired Drivers Based on Near Collisions in Naturalistic Driving

Abstract

Background: Controlled naturalistic driving for examining impacts of cognitive impairment on driving safety is rare. Objective: Evaluating the safety among drivers with mild cognitive impairment based on near collision incidents using naturalistic driving, and investigating its correlation with cognitive measures. Methods: Frequency of near collisions of 44 cognitively impaired [Age = 75.1(±6.7), MMSE = 25.5(±2.5)] and 19 control group drivers [Age = 72.5(±7.8), MMSE = 29.3(±0.8)] were obtained from two weeks of recorded driving. Survival time free of predicted collision based on a previously established near-collision to collision estimate ratio of 11 : 1, for 140 hours of driving exposure was calculated. Participants were also tested using Mini-Mental Status Examination (MMSE), Trail A, and Trail B. Spearman correlation and Cox survival analysis were conducted. Results: Near collision frequency per driving hour was correlated with MMSE (r = -0.258, p = 0.041). Survival analyses showed that cognitively impaired drivers might be prone to higher probability of having collision (p = 0.056) with a hazard ratio of 5.78 (p = 0.092). When all participants were combined, there was a significant difference (p < 0.017) in all the three cognitive measures between drivers with and without predicted collision, which were not significant within patient or control group alone (p > 0.186). Cox regression analysis showed MMSE as the only significant factor (p < 0.025) for survival time of predicted collision, but not age, gender, or driving experience. Conclusion:The association between driving critical events and cognitive measures suggests that some drivers with mild cognitive impairment might have an elevated driving collision risk compared to control drivers. Standard clinical cognitive measures may be reasonable predictors.

Evaluation of Naturalistic Driving Behavior Using In-Vehicle Monitoring Technology in Preclinical and Early Alzheimer’s Disease

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The Role of Eye Tracking Technology in Assessing Older Driver Safety

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Evaluation of the Driving Safety of Visually Impaired Bioptic Drivers Based on Critical Events in Naturalistic Driving

“…This study evaluated the safety performance of bioptic drivers based on near-collision incidents in naturalistic driving. This method was used previously to evaluate the driving safety of cognitively impaired drivers 16 who showed a higher probability of near-collision than the same control group. In this study we did not find a significant difference in the survival time to near-collision between bioptic drivers and the control group.…”

“…The control group came from our previous naturalistic driving study on cognitively impaired drivers. 16 Because the two studies shared the same control group, we also included the cognitively impaired drivers and conducted a secondary analysis to investigate the effect of visual impairment on driving safety compared with cognitive impairment. The control and cognitively impaired drivers were recruited from Rhode Island.…”

“…In a secondary analysis, the control and bioptic groups were combined with 44 drivers with mild cognitive impairment (median age 75.1, median driving experience 55 years, IQR 50-63) enrolled in our previous study 16 to further evaluate the effect of vision loss in a larger mixed sample. All of the patients in the cognitive impairment group had normal vision.…”