Abstract
Older adults represent a rapidly growing segment of the driving population. Although most older drivers are safe, research has shown that this group has more crashes per mile driven than most other age groups. The purpose of the present investigation was to examine the utility of a set of commonly used neuropsychological/cognitive tests in comparison to a newer measure of visual attention (Useful Field of View; UFOV®) in predicting state-recorded, at-fault crashes over the previous five years in a group of older adult drivers. Participants (N = 239) completed tests of mental status, visual attention, memory, and UFOV®. Results show that among all cognitive tests administered, UFOV® was most strongly related to crash involvement, with high levels of sensitivity (86.3%) and specificity (84.3%) at the standard cutoff score of 40% reduction. Practical implications for the assessment of crash risk are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Ball, K., Beard, B., Roenker, D., Miller, R., & Griggs, D. (1988). Age and visual search: Expanding the useful field of view. Journal of the Optical Society A, 5, 2210–2219.
Ball, K., & Owsley, C. (1991). Identifying correlates of accident involvement for the older driver. Human Factors, 33, 583–595.
Ball, K., Owsley, C., Sloane, M. E., Roenker, D. L., & Bruni, J. R. (1993). Visual attention problems as a predictor of vehicle crashes in older drivers. Investigative Ophthalmology and Visual Science, 34, 3110–3123.
Ball, K., Owsley, C., Stalvey, B., Roenker, D. L., Sloane, M. E., & Graves, M. (1997). Driving avoidance and functional impairment in older drivers. Manuscript submitted for publication.
Ball, K., Roenker, D. L., & Bruni, J. R. (1990). Developmental changes in attention and visual search throughout adulthood. In J. Enns (Ed.), Advances in psychology (Vol. 69, pp. 489–508). North Holland: Elsevier.
Barr, R. A. (1991). Recent changes in driving among older adults. Human Factors, 33, 597–600.
Branch, L. G., & Meyers, A. R. (1987). Assessing physical function in the elderly. Clinical Geriatric Medicine, 3, 29–51.
Branch, L. G., Katz, S., Kniepmann, K., & Papsidero, J. A. (1984). A prospective study of functional status among community elders. American Journal of Public Health, 74, 266–268.
Bronfenbrenner, U., McClelland, P., Wethington, E., Moen, P., & Ceci, S. J. (1996). The state of Americans: This generation and the next. New York: Free Press.
Brouwer, W. H., & Ponds, R. W. H. M. (1994). Driving competence in older persons. Disability and Rehabilitation, 16, 149–161.
Burg, A. (1967). The relationship between test scores and driving record: General findings (Report No. 67-24). Los Angeles: Department of Engineering, University of California, Los Angeles.
Burg, A. (1968). Vision test scores and driving record: Additional findings (Report No. 6827). Los Angeles: Department of Engineering, University of California, Los Angeles.
Carr, D. B. (1993). Assessing older drivers for physical and cognitive impairment. Geriatrics, 48, 46–51.
Cooper, P. J., Tallman, K., Tuokko, H., & Beattie, B. L. (1993). Vehicle crash involvement and cognitive deficit in older drivers. Journal of Safety Research, 24, 9–17.
Donaldson, L. J., Clayton, D. G., & Clarke, M. (1980). The elderly in residential care: Mortality in relation to functional capacity. Journal of Epidemiology Community Health, 34, 96–101.
Evans, L. (1988a). Older driver involvement in fatal and severe traffic crashes. Journal of Gerontology, 43, S186–S193.
Evans, L. (1988b). Risk of fatality from physical trauma versus sex and age. The Journal of Trauma, 28, 368–378.
Evans, L. (1991). Traffic safety and the driver. New York: Van Nostrand Reinhold.
Fitten, L. J., Perryman, K. M., Wilkinson, C. J., Little, R. J., Burns, M. M., Pachana, N., Mervis, R., Malmgren, R., Siembieda, D. W., & Ganzell, S. (1995). Alzheimer and vascular dementias and driving. Journal of the American Medical Association, 273, 1360–1365.
Galski, T., Ehle, H. T., & Williams, J. B. (1996). Off-road driving evaluations for persons with cerebral injury: A factor analytic study of predriver and simulator testing. American Journal of Occupational Therapy, 51, 352–359.
Hennessy, D. E. (1995). Vision testing of renewal applicants: Crashes predicted when compensation for impairment is inadequate. Research and Development Section, California Department of Motor Vehicles.
Hofstetter, H. W. (1976). Visual acuity and highway accidents. Journal of the American Optometric Association, 47, 887–893.
Hurt, L., Morris, J. C., Edwards, D., & Wilson, B. S. (1993). Driving performance in persons with mild senile dementia of the Alzheimer type. Journal of the American Geriatrics Society, 41, 747–753.
Jette, A., & Branch, L. A. (1992). A 10-year follow-up of driving patterns among the community-dwelling elderly. Human Factors, 34, 25–31.
Johansson, K., Bronge, L., Lundberg, C., Persson, A., Seideman, M., & Viitanen, M. (1996). Can a physician recognize an older driver with increased crash risk potential? Journal of the American Geriatrics Society, 44, 1198–1204.
Johnson, C., & Keltner, J. (1986). Incidence of visual field loss in 20,000 eyes and its relationship to driving performance. Archives of Ophthalmology, 101, 371–375.
Koepsell, T. D., Wolf, M. E., McCloskey, L., Buchner, D. M., Louie, D., Wagner, E. H., & Thompson, R. S. (1994). Medical conditions and motor vehicle collision injuries in older adults. Journal of the American Geriatrics Society, 42, 695–700.
Korteling, J. E., & Kaptein, N. A. (1996). Neuropsychological driving fitness tests for brain-damaged subjects. Archives of Physical Medicine Rehabilitation, 77, 138–146.
Lezak, M. D. (1983). Neuropsychological assessment (2nd ed.). New York: Oxford University Press.
Lundberg, C., Johansson, K., Ball, K., Bjerre, B., Blomquist, C., Braekhus, A., Brouwer, W. H., Bylsma, F. W., Carr, D. B., Englund, L., Friedland, R. P., Hakamies-Blomquist, L., Kelmetz, G., O'Neill, D., Odenheimer, G., Rizzo, M., Schelin, M., Seideman, M., Tallman, K., Viitanen, M., Waller, P. F., & Winblad, B., (1997). Dementia and driving: An attempt at consensus. Alzheimer Disease and Associated Disorders, 11, 28–37.
Malfetti, J. (Ed.). (1985). Drivers fifty-five plus. Fall Church, VA: AAA Foundation for Traffic Safety.
Manton, K. G. (1988). A longitudinal study of functional change and mortality in the United States. Journal of Gerontology: Medical Sciences, 43, 5153–5161.
Marottoli, R. A., Cooney, L. M., Wagner, D. R., Doucette, J., & Tinetti, M. E. (1994). Predictors of automobile crashes and moving violations among elderly drivers. Annals of Internal Medicine, 121, 842–846.
Marottoli, R. A., Mendes de Leon, C. F., Glass, T. A., Williams, C. S., Cooney, L. M., Berkman, L. F., & Tinetti, M. E. (1997). Driving cessation and increased depressive symptoms: Prospective evidence from the New Haven EPESE. Journal of the American Geriatric Society, 45, 202–206.
Martinez, R. (1995). Older drivers and physicians. Journal of the American Medical Association, 274, 1060.
Mattis, S. (1976). Mental status examination for organic mental syndrome in the elderly patient. In L. Bella & T. B. Karasu (Eds.) Geriatric psychiatry (2nd ed.). New York: Oxford University Press.
Morgan, R., & King, D. (1995). The older driver — a review. Medicine in the Elderly, 71, 525–528.
National Safety Council. (1989). Accident facts, 1989 edition. Chicago: Author.
Odenheimer, G. L., Beaudet, M., Jette, A. M., Albert, M. S., Grande, L., & Minaker, K. (1994). Performance-based driving evaluation of the elderly driver: Safety, reliability, and validity. Journal of Gerontology, 49, M153–M159.
Owsley, C. (1997). Clinical and research issues on older drivers: Future directions. Alzheimer Disease and Associated Disorders, 11, 3–7.
Owsley, C., Ball, K. K., & Keeton, D. M. (1995). Relationship between visual sensitivity and target localization in older adults. Vision Research, 35, 579–587.
Owsley, C., Ball, K., McGwin, G., Sloane, M. E., Roenker, D. L., White, M. F. & Overley, E. T. (1997). Visual processing impairment and risk of motor vehicle crash among older adults. Journal of the American Medical Association, 279, 1083–1088.
Owsley, C., Ball, K., Sloane, M., Roenker, D. L., & Bruni, J. R. (1991). Visual/cognitive correlates of vehicle accidents in older drivers. Psychology and Aging, 6, 403–415.
Parasuraman, R., & Nestor, P. (1993). Attention and driving. Clinics in Geriatric Medicine, 9, 377–387.
Planek, T. W., Condon, M. E., & Fowler, R. C. (1968). An investigation of the problems and opinions of aged drivers. Chicago, IL: National Safety Council.
Ray, W. A., Fought, R. L., & Decker, M. D. (1992). Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. American Journal of Epidemiology, 136, 873–883.
Roenker, D. L., Cissell, G. M., & Ball, K. K. (1997). Training. Manuscript submitted for publication.
Reuben, D. B. (1993). Assessment of Older Drivers. Clinics in Geriatric Medicine, 9, 449–459.
Spreen, O., & Strauss, E. (1991). A compendium of neuropsychological tests. New York: Oxford University Press.
Transportation Research Board. (1988). Transportation in an aging society (Vol. 1). Washington, DC: National Research Council.
U.S. Department of Commerce, Bureau of the Census. (1990). Statistical abstract of the United States. Washington, DC: U.S. Government Printing Office.
Wechsler, D. (1945). A standardized memory scale for clinical use. Journal of Psychology, 19, 87–95.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Goode, K.T., Ball, K.K., Sloane, M. et al. Useful Field of View and Other Neurocognitive Indicators of Crash Risk in Older Adults. Journal of Clinical Psychology in Medical Settings 5, 425–440 (1998). https://doi.org/10.1023/A:1026206927686
Issue Date:
DOI: https://doi.org/10.1023/A:1026206927686