Adaptation to simulator sickness in older drivers following multiple sessions in a driving simulator

There is a large proportion of individuals experiencing simulator sickness symptoms (headaches, nausea, paleness, etc.). Previous studies have reported that driving in a simulator, compared to on-road driving, can alter braking responses while stopping at intersections. Here we evaluated whether altered braking responses observed in fixed-base simulators could be linked to the presence of sickness symptoms in older drivers. Older individuals participated in a 5-session training study that included a pre-test, three training sessions and a post-test. We evaluated adaptation to simulator sickness through repeated exposure (5 simulator sessions). Furthermore, we assessed whether head postural instability accounted for the presence of sickness symptoms. Sickness symptoms were measured with the Simulator Sickness Questionnaire (SSQ) and a Visual Analog Scale (VAS). After the first session, half of the participants reported mild symptoms (MS, VAS score>5), and another half reported light symptoms (LS, VAS score<5). We compared sickness symptoms, braking responses and head postural stability between the two groups for the first (pre-test) and last (post-test) driving sessions. During the pre-test, participants of the MS group braked earlier, showed longer time of deceleration, a greater number of pedal activations and showed increased irregularities in their deceleration profile. Participants from the MS group adapted in that, sickness symptoms reduced through exposure. During the post-test, we observed a larger decrease in variability for the MS than the LS group, but we did not find any difference regarding the braking responses per se or the head postural stability. We interpreted these results as evidence that adaptation is accompanied with a reduction of variability. Finally, we propose that a more gradual exposure to simulated environment might be required before evaluating the driving performance of individuals prone to simulator sickness

Exploring the relationship between perceptual-cognitive function and driver safety : prediction and transfer

La conduite automobile continue d'être le mode de transport dominant dans le monde et le nombre de véhicules sur la route ne devrait qu’augmenter au cours des prochaines décennies. Dans un même temps, l'évolution démographique qui se produit actuellement dans le monde industrialisé implique que la proportion de conducteurs âgés sur la route devrait augmenter considérablement. L'âge s'accompagne de changements de grande envergure dans les systèmes physiques, sensoriels et cognitifs, entraînant des changements fonctionnels qui peuvent être subtils ou profonds. Nous commençons seulement à comprendre comment la variabilité normale et pathologique de ces mesures fonctionnelles affecte les performances de conduite et la sécurité. Le développement d'un outil fiable et fondé sur des données probantes pour distinguer les conducteurs prudents des conducteurs dangereux continue d'être une préoccupation majeure pour les chercheurs en gérontologie, en accidentologie et en clinique. L'accumulation de preuves suggère maintenant qu'il existe un lien important entre des capacités cognitives spécifiques telles que la vitesse de traitement de l’information et l'attention, et les performances de conduite. Continuer à explorer cette relation pour peut-être un jour développer un tel outil est une entreprise importante. Une autre implication de la relation entre les capacités cognitives et les performances de conduite est que les interventions conçues pour les améliorer ou les maintenir pourraient éventuellement améliorer ou maintenir la sécurité et le confort de conduite des individus à court et à long terme. L'objectif de cette thèse est triple. Premièrement, il développe et valide une nouvelle méthodologie pour évaluer les performances de conduite des jeunes adultes et des adultes plus âgés à l'aide de scénarios de simulation de conduite personnalisés. Deuxièmement, elle pousse l'état de nos connaissances sur la façon dont les capacités cognitives sont liées à la performance de conduite en démontrant que la performance sur un test intégratif d'attention dynamique et de vitesse de traitement - c'est-à-dire le suivi d'objets multiples en 3D (3D-MOT) - prédit les performances des conducteurs de différents groupes d'âge. Enfin, elle offre des preuves suggérant que la formation 3D-MOT améliore réellement la fonction attentionnelle et la vitesse de traitement en transférant la performance sur un test indépendant de ces capacités et, finalement, que cette amélioration pourrait se traduire par une amélioration des performances de conduite.Driving continues to be the world’s dominant form of transportation and the number of vehicles on the road is only projected to increase in the coming decades. At the same time, the demographic shift currently occurring in the industrialized world implies that the proportion of older adult drivers on the road is set to increase substantially. With age comes wide-ranging changes in physical, sensory and cognitive systems resulting in functional changes that can be subtle or profound. We are only beginning to understand how both normal and pathological variability in these functional measures affect driving performance and safety. Developing a reliable, evidence-based tool to distinguish safe from unsafe drivers continues to be a major preoccupation for gerontology, accidentology, and clinical researchers alike. Accumulating evidence now suggests that there is an important link between specific cognitive abilities such as speed-of-processing, attention, and driving performance. Continuing to explore this relationship in order to perhaps one day develop such a tool is an important endeavour. Another implication of the relationship between cognitive abilities and driving performance is that interventions designed to improve or sustain these might conceivably enhance or maintain individuals’ driving safety and comfort in the short- and long-term. The purpose of this thesis is threefold. First, it develops and validates a novel methodology for assessing both young adult and older adult driving performance using custom driving simulator scenarios. Second, it pushes the state of our knowledge of how cognitive abilities relate to driving performance by demonstrating that performance on an integrative test of dynamic attention and speed-of-processing—i.e., 3-dimensional multiple object tracking (3D-MOT)— predicts how drivers of different age groups perform. Finally, it offers evidence to suggest that training 3D-MOT actually enhances attentional function and speed-of-processing by transferring to performance on an unrelated test of these abilities and, ultimately, that this improvement might translate to improved driving performance

Older adults with mild cognitive impairments show less driving errors after a multiple sessions simulator training program but do not exhibit long term retention

The driving performance of individuals with mild cognitive impairment (MCI) is suboptimal when compared to healthy older adults. It is expected that the driving will worsen with the progression of the cognitive decline and thus, whether or not these individuals should continue to drive is a matter of debate. The aim of the study was to provide support to the claim that individuals with MCI can benefit from a training program and improve their overall driving performance in a driving simulator. Fifteen older drivers with MCI participated in five training sessions in a simulator (over a 21-day period) and in a 6-month recall session. During training, they received automated auditory feedback on their performance when an error was noted about various maneuvers known to be suboptimal in MCI individuals (for instance, weaving, omitting to indicate a lane change, to verify a blind spot, or to engage in a visual search before crossing an intersection). The number of errors was compiled for eight different maneuvers for all sessions. For the initial five sessions, a gradual and significant decrease in the number of errors was observed, indicating learning and safer driving. The level of performance, however, was not maintained at the 6-month recall session. Nevertheless, the initial learning observed opens up possibilities to undertake more regular interventions to maintain driving skills and safe driving in MCI individuals

Are interventions effective at improving driving in older drivers?: A systematic review

Background With the aging of the population, the number of older drivers is on the rise. This poses significant challenges for public health initiatives, as older drivers have a relatively higher risk for collisions. While many studies focus on developing screening tools to identify medically at-risk drivers, little research has been done to develop training programs or interventions to promote, maintain or enhance driving-related abilities among healthy individuals. The purpose of this systematic review is to synopsize the current literature on interventions that are tailored to improve driving in older healthy individuals by working on components of safe driving such as: self-awareness, knowledge, behaviour, skills and/or reducing crash/collision rates in healthy older drivers. Methods Relevant databases such as Scopus and PubMed databases were selected and searched for primary articles published in between January 2007 and December 2017. Articles were identified using MeSH search terms: ("safety" OR "education" OR "training" OR "driving" OR "simulator" OR "program" OR "countermeasures") AND ("older drivers" OR "senior drivers" OR "aged drivers" OR "elderly drivers"). All retrieved abstracts were reviewed, and full texts printed if deemed relevant. Results Twenty-five (25) articles were classified according to: 1) Classroom settings; 2) Computer-based training for cognitive or visual processing; 3) Physical training; 4) In-simulator training; 5) On-road training; and 6) Mixed interventions. Results show that different types of approaches have been successful in improving specific driving skills and/or behaviours. However, there are clear discrepancies on how driving performance/behaviours are evaluated between studies, both in terms of methods or dependent variables, it is therefore difficult to make direct comparisons between these studies. Conclusions This review identified strong study projects, effective at improving older drivers' performance and thus allowed to highlight potential interventions that can b- (undefined

A Randomized Trial of a Comprehensive Training Process to Enhance Safe Driving in Older Adults

In Canada, older adult driving exposure is increasing quite drastically. However, older adult drivers have a higher motor vehicle collision fatality risk compared to younger age groups. Therefore, older adult driver safety is an area requiring considerable attention. Using a randomized controlled trial study design, the present study investigated the effectiveness of a comprehensive training process to enhance safe driving in older adults. Based on their age and sex, participants (n=78), aged 65 years and above, were block randomized to one of three driving training intervention groups: 1) in-class training (control); 2) in-class plus on-road training (with individualized feedback); and 3) in-class plus on-road plus simulator training (with individualized feedback). The main outcome measure was the number of unsafe-driving actions committed before and after receiving designated driving training interventions on a standardized on-road driving evaluation, captured by video and GPS technology, and scored by a blinded, independent rater. Driving knowledge and driving comfort data were also collected for all participants before and after receiving their designated interventions. Mean baseline total on-road driving scores were similar for intervention groups, averaging 129.78 (SD=29.87) for the control group, 128.48 (SD=20.15) for the in-class plus on-road training group, and 127.73 (SD=24.24) for the in-class plus on-road plus simulator training group. The control group achieved an average reduction of 7.18 (95% CI [0.11, 14.26]) unsafe-driving actions; the in-class plus on-road training group and the in-class plus on-road plus simulator-training group achieved an average reduction of 41.64 (95% CI [26.21, 53.29]) and 38.69 (95% CI [22.20, 52.16]) unsafe-driving actions, respectively, especially regarding vehicle control and observation errors. Driving knowledge also significantly improved from 74.4% to 83.2% of questions answered correctly before receiving the in-class training component to after receiving the in-class training component; however, there were no significant differences between intervention groups in post- intervention driving comfort levels. The findings demonstrate that achieving considerable improvements in older adults’ driving relies on on-road training, and that individualized feedback supplementation should be the focus of more inquiry. Limitations and future research directions are also discussed

ADVANCED VIRTUAL REALITY HEADSET BASED TRAINING TO IMPROVE YOUNG DRIVERS’ LATENT HAZARD ANTICIPATION ABILITY

Driving safety among young novice driver is one of the largest concern in the transportation domain. Many Paper-based or PC- based training program have been developed over the years to train the young novice driver to improve their driving skills (Hazard Anticipation). This training programs does help young novice driver to improve their situational awareness and so the hazard anticipation skills. But, there is one common problem with most of the currently available training programs. They are not very immersive, because such training program mostly provide plain view of the training scenario’s along with some description about the scenario and the subject trained in such training method needs to translate the provided knowledge in the plain view into the real-world driving. An Advanced training program on risk awareness and perception was developed and evaluated in Oculus rift platform. The primary objective is to train the young novice driver in the Virtual reality headset based risk awareness and perception training program and evaluate the trained driver in the driving simulator against the placebo trained young novice driver. The Virtual reality headset based risk awareness and perception training program (V-RAPT) is based on 3M Error-based Training approach where the driver will have 80 horizontal degrees’ and 90 vertical degrees’ field of view. Thirty-six drivers will receive training in the respective training methods- V-RAPT (Virtual reality headset based risk awareness and perception training), RAPT (PC- based risk awareness and perception training) and placebo training. Twelve young novice driver trained in the V-RAPT group will served as experimental group. Twenty-four other young novice will receive training in the RAPT and Placebo training respective will serve as control group. After training all three-group trained driver will be evaluated in the advanced driving simulator and the eye movement of the all thirty-six participants are recorded and measured. Vehicle measures such as acceleration, velocity and brake position is also recorded. The drivers’ score will based on whether or not their eye-fixations indicated recognition of potential risks in different high risk driving situations. The evaluation driver included six scenarios used in the V-RAPT training (near transfer scenarios) and four scenarios that were not used in the V-RAPT training (far transfer scenarios). Drivers who received the V-RAPT training are expected to drive more safely than the drivers who received either training. The V-RAPT trained drivers are expected to glance on regions (Hazard anticipation) where potential risks might appear than the drivers’ trained in the RAPT and Placebo training method. Further, The V-RAPT trained drivers are expected have slower average velocity and better brake position (Hazard mitigation) are compared to the driver trained in the other two training method

RESIDUAL NEXT-DAY EFFECTS OF ALPRAZOLAM ON PSYCHOMOTOR PERFORMANCE AND SIMULATED DRIVING IN HEALTHY NORMAL VOLUNTEERS

The prevalence of drugged driving has increased in the United States, and some prescription medications (e.g., zolpidem) cause impairment after the predicted duration of therapeutic action has elapsed. The aim of this study is to determine if bedtime administration of alprazolam similarly impacts driving performance the following day. Volunteers were 14 healthy adults (6 males) who completed a double-blind, double-dummy within-subjects design study examining the effects of alprazolam (0.5, 1, & 2mg), zolpidem (10mg), and placebo administered at bedtime on driving performance the following day. The positive control condition was alprazolam (1mg) administered on the test morning. Driving simulator measures, cognitive and psychomotor tasks, and questionnaires querying drug effects were collected the afternoon before drug administration and for 5.5 hours the next day and analyzed using symmetry and mixed-model approaches. The positive control was robustly impairing. Driving impairment equivalent to that seen with alcohol at the legal limit was observed up to 12.5hr after bedtime alprazolam 2mg and for 8.5hr after bedtime zolpidem 10mg. Volunteers were not fully aware of their own level of impairment. These results suggest that alprazolam used before bed may pose an as yet unrecognized public safety risk in the form of next-day drugged-driving