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Older people’s driving habits, visual abilities, and subjective assessment of daily visual functioning

Professor: LiuStudent: Ruby

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Objective

To find the relationship between the different situations of daily visual functions. Visual functions that are related to driving. The tendency of older people to drive in different visual

conditions. The older people were given for limiting their driving

under different conditions.


References

The number of people in the world above the age of 60 will have increased from 376million in 1980, to 1.1billions in 2025. (Aging America, 1986)

In 1996, people 65+ years old had 10% of the total Israeli population , and constituted 5% of the driving population. (Brookdale Institute, 1997)


References

The older people have following visual problem: Decreases in eye movements. (visual search) Poorer dark adjustment. Reduced visual acuity. Reduced contrast sensitivity. Increased glare reaction. Reduced visual fields.

(Sivak et al., 1994)


References

Older drivers sense a decrease in visual acuity stop or reduce their driving of their own activity by :

Driving shorter distances. Using familiar routes. Avoid driving in darkness and difficult weather conditions. Avoiding high speed highways.

(Foley et al., 1990; Colsher and Wallace, 1993; Shinar et al., 1994; Eberhard, 1997)


Method

Subjects 80 adults ranging in age from 64-85 years old.

(mean age 73) There were 29 female and 51 male. 40 people lived in communities, 23 in urban areas, and 17

in a kibbutz.


Method-study tools and procedure

All subjects were respond to question on their driving activities and every day visual activities. Activities of Daily Vision Scale (ADVS).

21questions about the five everyday visual functions. Provide an overall ADVS score and five sub-scale scores

relating to far vision, near vision, glare disability, night driving, and daytime driving.

Established Population for the Epidemiological Studies of the Elderly (EPESE).

The questions here were about the driving functions in different environmental conditions.

Including driving and the reasons for stop of driving at night, at dusk, on long trips, on unfamiliar roads, in the rain, and on highways.


Method-study tools and procedure

After completion of the questionnaire, three vision tests were required.

The Snellen Visual Acuity (VA) test. Measure the resolution of the subject for target letters 6 m away.

The Ginsburg Contrast Sensitivity Test (CS). Subject to find the slanted lines and measures the minimum lines c

ontrast in which a person can detect the direction of the lines. Timed visual search (VS) Test.

A picture of a traffic scene on which numbers from 1 to 14. Subject is given 10 s to identify as many numbers as possible movi

ng from one to the next.


Results and discussion –correlation between age, vision test and the ADVS


Results and discussion –correlation between age, vision test and the ADVS

There were significant correlations between age and the ADVS subscale scores of night driving, near vision and far vision (r 27).≧

Responses to the AVS also significantly with the objective vision tests. r 0.28 between VS and the ADVS sub-scores.≧ r 0.26 between ADVS sub-cores and VA..≧ r 0.33 between the night driving sub-score and the middle ≧

frequencies of the CS. r 24 between the far vision sub-score and middle high ≧

frequencies of the CS test.


Results and discussion –predicting ADVS from age and vision tests


Results and discussion –predicting ADVS from age and vision tests

Age has little influence on the night driving and far vision sub-scales, and no significant effect at all on the other sub-scores of the ADVS.

Deletion of the visual search score form the statistical test only had a marginal effect on the total variance explained.


Results and discussion –ADVS scores as a function of self-imposed driving limitations


Results and discussion –ADVS scores as a function of self-imposed driving limitations

The decision to drive or stop driving at night is highly associated with four ADVS sub-scores and with visual acuity.

The driver who still drove at night had: High ADVS scores. Higher scores on the night driving sub-scores. Higher scores on the far vision subscale. Higher scores on the glare disability sub-scale. Higher visual acuity.


Results and discussion –reason given by older drivers for stopping to drive under different conditions


Results and discussion –reason given by older drivers for stopping to drive under different conditions

The drivers who reduced night driving because of glare had lower scores on all but one of the ADVS measures and the objective measures of visual performance.

People did not give glare as a reason to reduce night driving, they had lower ADVS, lower far vision ADVS, and a lower night driving ADVS.

People who reduced their night driving because of glare had lower VSS, lower visual acuity, and lower contrast sensitivity in the higher three frequencies(CS3, CS4, and CS5)


Results and discussion –cumulative relative frequencies of those who continue to drive and those who quit driving under different condition as a function of ADVS

50% stopped driving at night had a score of 0 on this sub-scale.

50% continued to drive at night was 92.


Results and discussion –cumulative relative frequencies of those who continue to drive and those who quit driving under different condition as a function of ADVS

The driver who quit driving at night, 75% scored less than 85 on the sub-scale.

The driver who still driving at night, 28% scored less than 85 on the sub-scale.


Results and discussion –the associations among different self- imposed driving restrictions

Older driver rarely drove at dusk also rarely drove at night.

Most of the elderly that avoided long trips also avoided driving at night and avoided driving on the highways.

Driving on unfamiliar roads was not significantly.


Conclusions

The ADVS can be very useful for self-assessment of driving for older people.

Visual acuity alone is not a good predictor of the limitations drivers assume relative to different driving conditions and environments.

The extent of continued night driving was significantly associated with reductions in both objective measures of visual performance and the ADVS scores.


Conclusions

The night driving sub-scale is most closely associated with impaired in objective visual measure.

The self-imposed restrictions may relate more to cognitive impairments and physical weak than to visual impairments.