Introduction: Veterans are at heightened risk of being in a motor-vehicle crash and many fail on-road driving evaluations, particularly as they age. This may be due in part to the high prevalence of age-associated conditions impacting cognition in this population, including neurodegenerative diseases (e.g., Alzheimer’s Disease) and acquired neurological conditions (e.g., cerebrovascular accident). However, understanding of the impact of referral diagnosis, age and cognition on Veterans’ on-road driving performance is limited. Methods: 109 Veterans were referred for a driving evaluation (mean age = 72.0, SD = 11.5) at a driving assessment clinic at the Minneapolis Veterans Affairs Healthcare System. Of the 109 Veterans enrolled, 44 were referred due to a neurodegenerative disease, 37 due to an acquired neurological condition, and 28 due to a non-neurological condition (e.g., vision loss). Veterans completed collection of health history information and administration of cognitive tests assessing visual attention, processing speed, and executive functioning, as well as a standardized, on-road driving evaluation. Results: A total of 17.9% of Veterans failed the on-road evaluation. Clinical diagnostic group was not associated with failure rate. Age was not associated with failure rates in the full sample or within diagnostic groups. After controlling for age, poorer processing speed and selective/divided attention were associated with higher failure rates in the full sample. No cognitive tests were associated with failure rates within diagnostic groups. Conclusion: Referral diagnosis and age alone are not reliable predictors of Veterans’ driving performance. Cognitive performance, specifically speed of processing and attention, may be helpful in screening Veterans’ driving safety. Practical Applications: Clinicians tasked with assessing Veterans’ driving safety should take into account cognitive performance, particularly processing speed and attention, when making decisions regarding driving safety. Age and referral diagnosis, while helpful information, are insufficient to predict outcomes on driving evaluations. 相似文献
Objective: Maintaining a lower speed is recommended for curve negotiation and it has been shown that cognitive distraction may impair driving performance. This study examines the effects of different levels of cognitive distraction on the speed control of drivers negotiating a curve.
Methods: Experiments were conducted on a 6 degrees of freedom driving simulator with 28 participants. A comparison of the speed and acceleration from 300 m before to 100 m after the curve was performed for baseline driving (without distraction) and 3 levels of cognitive distractions using n-back tasks.
Results: The speed was significantly higher at the highest level of cognitive distraction (8%) than in baseline driving from the beginning of the curve to 50 m after it and the ratio of the highest level to the baseline was even greater throughout the range. The average acceleration was significantly higher than the baseline at the highest and the medium levels (80 and 70%, respectively) from 250 m before the curve to the one-quarter curve and from 250 to 150 m before the curve, respectively. It was also found that the point of deceleration was significantly delayed at the highest level of cognitive distraction and occurred only after the middle of the curve, whereas deceleration in baseline driving occurred just before entering the curve.
Conclusions: The impairment due to cognitive distraction was confirmed in this study but was only significant at a high level of cognitive distraction. The highly distracted drivers failed to perceive the curve in advance, resulting in a slower response to changes in the roadway. The findings indicate that acceleration may be an indicator of cognitive distraction while negotiating curves. A driver is prone to cognitive distraction and the driving performance is affected when driving requires excessive attention such as curve negotiation. 相似文献
