The Alabama VIP older driver study rationale and design: examining the relationship between vision impairment and driving using naturalistic driving techniques

Owsley, Cynthia; McGwin, Gerald; Antin, Jonathan F.; Wood, Joanne M.; Elgin, Jennifer

doi:10.1186/s12886-018-0686-5

Cited by 9 publications

(11 citation statements)

References 64 publications

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“…Road safety depends on the user’s functional status, vehicle, and road condition [ 17 ]. However, the driver makes the final decisions, so he/she is responsible for the proper development of driving.…”

Section: Discussionmentioning

confidence: 99%

“…Namely, vision is the most important source of perceptual information for the driver [ 1 ]. Driving in a state in which the required skills are endangered may cause injuries to oneself and others [ 6 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The natural aging process causes a reduction in physical and cognitive abilities [ 6 , 20 ]. Specifically, there are gradual changes due to both the optic-ocular system and neuronal factors that affect the visual function [ 17 ]. Some studies have already found that older drivers have diminished VA, low contrast sensitivity, and are also influenced more by glare and halo [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Development of a Method to Potentially Substitute Direct Evaluation of Mesopic Visual Acuity in Drivers

Garcia-Rojo

Bonnin-Arias

Chamorro

et al. 2021

IJERPH

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(1) Background: In mesopic lighting conditions, or under adverse environmental circumstances, visual information is reduced, which increases the risk of traffic accidents. This effect could be reduced with a precise evaluation of the visual function under mesopic conditions, but it is difficult to replicate in clinics. This study aims to develop an easy-to-adopt method to evaluate mesopic visual acuity (VA) in drivers. (2) Methods: Prospective and observational study in drivers. logMAR mesopic VA was compared with photopic VA measured under different combinations of contrast charts and filters to find the combination that responds best to mesopic conditions. (3) Results: Fifty-six drivers were examined. The best correlation was found with an 80% density filter and a Weber contrast chart of 20%. The logMAR VA for this combination was 0.01 ± 0.11, which was close to the mesopic VA values (0.01 ± 0.12). The difference between both logMAR VA was 0.00 ± 0.06 (R = 0.86; p ≤ 0.001; ICC = 0.86). (4) Conclusions: The use of 20% contrast optotypes and the interposition of an 80% filter under photopic conditions provide VA values similar to those measured under mesopic lighting conditions, making this simple system a good predictor of mesopic VA values.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Development of a Method to Potentially Substitute Direct Evaluation of Mesopic Visual Acuity in Drivers

Garcia-Rojo

Bonnin-Arias

Chamorro

et al. 2021

IJERPH

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“…Data were collected in the Alabama VIP Older Driver study, a 6-month prospective cohort study on adults aged ≥70 years of age utilizing naturalistic driving methods. The details of the study design have been published elsewhere ( 28 , 29 ). Briefly, participants were recruited due to a recent visit at the Callahan Eye Hospital’s clinics at the University of Alabama at Birmingham (UAB) and the electronic health record.…”

Section: Methodsmentioning

confidence: 99%

“…A previous study using naturalistic driving methods focused on older drivers’ intersection behaviors including turning; however, only 10 drivers were studied for 2 weeks, all of whom had good vision ( 27 ). By naturalistic methods, we mean measurement methods in which participant drivers have a data acquisition system (DAS) with multichannel synchronized video and sensors installed in their own vehicles ( 28 ). Older drivers in our study then drove as they normally would for 6 months.…”

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confidence: 99%

Left Turns by Older Drivers With Vision Impairment: A Naturalistic Driving Study

Swain

McGwin

Antin

et al. 2021

Innovation in Aging

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Background and Objectives Older drivers are over-represented in collisions at intersections while making left turns across oncoming traffic. Using naturalistic driving methods, we evaluated the association between vision impairment and their left turn characteristics. Research Design and Methods In this prospective, observational study, vision impairment as defined by visual acuity, contrast sensitivity, visual processing speed, visual field sensitivity and motion perception was assessed in drivers ≥70 years old. Data acquisition systems were installed in their personal vehicles recording video and vehicle kinematics. Driving during everyday life was recorded for six months. Data analysts evaluated a temporal data window surrounding randomly selected left turns at four-way intersections. Left turn traversals and turning behavior were evaluated in terms of age-adjusted associations with vision impairment. Results The sample consisted of 151 older drivers. The number of turns studied was 473; 265 turns were rated as unsafe traversals, and 201 as problematic turning behavior. Drivers with slowed visual processing speed and visual field impairment were less likely to exhibit unsafe traversals (p< 0.05); those with worse contrast sensitivity, slowed visual processing speed, and visual field impairment were less likely to exhibit problematic turning behavior (p <0.05). Discussion and Implications Using naturalistic driving, our study suggests older drivers with vision impairment exhibit better performance in making left turns than those without deficits, which contradicts older driver studies on left turns using driving simulators and on-road driving evaluations. Our findings suggest more cautious and self-regulatory behavior which are consistent with older visually impaired drivers’ commonly expressed concerns about their driving difficulties. Translational Significance In contrast to previous older driver studies using driving simulators and on-road driving evaluations, our study suggests that in everyday life older visually-impaired drivers exercise caution in left-turn behavior across oncoming traffic as compared to those who are normally sighted.

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Naturalistic Driving Techniques and Association of Visual Risk Factors With At-Fault Crashes and Near Crashes by Older Drivers With Vision Impairment

et al. 2021

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IMPORTANCE Government motor vehicle crash reports used in the study of driver safety can be biased and incomplete. Naturalistic driving methods using in-vehicle instrumentation have been developed in recent years to objectively measure crashes and near crashes as they occur on the road using video and vehicle kinematic data.OBJECTIVE To examine visual risk factors associated with at-fault crashes and near crashes among older drivers, most of whom have age-related eye conditions associated with vision impairment. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study was conducted at an academic ophthalmology clinic from January 1, 2015, to November 10, 2018, among 154 adults 70 years of age or older who were legally licensed in Alabama and who reported currently driving at least 4 days per week; 137 of 151 participants (90.7%) had an age-related eye condition in at least 1 eye. Drivers participated in a baseline visual function assessment followed by installation of a data acquisition system recording multichannel synchronized video and vehicle kinematics in their personal vehicle. Drivers were instructed to drive for 6 months as they normally would during everyday life. Statistical analysis was performed from June 15 to September 15, 2020. MAIN OUTCOMES AND MEASURESThe rate of combined incident at-fault crashes and near crashes, defined by the number of events and the number of miles driven. RESULTSThe sample consisted of 154 drivers (85 men [55.2%]; mean [SD] age, 79.3 [5.1] years). Visual functions associated with crash and near-crash involvement included impaired contrast sensitivity (rate ratio [RR], 2.7; 95% CI, 1.3-5.5), moderate (RR, 2.3; 95% CI, 1.1-4.9) and severe (RR, 5.0; 95% CI, 2.2-11.7) slowing in visual processing speed, and elevated motion perception thresholds for a drifting grating (RR, 1.9; 95% CI, 1.1-3.5). Those with impaired peripheral visual field sensitivity had increased rates of crashes and near crashes (RR, 1.8; 95% CI, 1.0-3.3); however, this finding was not statistically significant (P = .07). CONCLUSIONS AND RELEVANCEWith the use of naturalistic driving methods in which crashes and near crashes involving older drivers are objectively measured as they occur on the road, associations have been identified between impaired contrast sensitivity, slowed visual processing speed, and impaired motion perception and an increased rate of a combined total of at-fault crashes and near crashes.

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The Alabama VIP older driver study rationale and design: examining the relationship between vision impairment and driving using naturalistic driving techniques

Cited by 9 publications

References 64 publications

Development of a Method to Potentially Substitute Direct Evaluation of Mesopic Visual Acuity in Drivers

Development of a Method to Potentially Substitute Direct Evaluation of Mesopic Visual Acuity in Drivers

Left Turns by Older Drivers With Vision Impairment: A Naturalistic Driving Study

Naturalistic Driving Techniques and Association of Visual Risk Factors With At-Fault Crashes and Near Crashes by Older Drivers With Vision Impairment

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