Driving performance in older adults: Current measures, findings, and implications for roadway safety

BACKGROUND AND OBJECTIVES: Over 10,000 people a day turn 65 in the United States. For many older adults, driving represents an essential component of independence and is one of the most important factors in overall mobility. Recent survey studies in older adults suggest that up to 60% of older adult drivers with mild cognitive impairment, and up to 30% with dementia, continue to drive. The purpose of this review is to provide a comprehensive and detailed resource on the topics of cognition and driving for clinicians, researchers, and policymakers working on efforts related to older adult drivers. RESEARCH DESIGN AND METHODS: Publications on PubMed and Medline and discussions with experts working in geriatrics, technology, driving policy, psychology, and diverse aspects of driving performance were utilized to inform the current review. RESULTS: Research indicates that there is a complex and inverse correlation between multiple cognitive measures, driving performance, and risky driving behaviors. The fragmented nature of available peer-reviewed literature, and a reliance on correlative data, do not currently allow for the identification of the temporal and reciprocal nature of the interplay between cognition and driving endpoints. DISCUSSION AND IMPLICATIONS: There are currently no widely accepted definitions, conceptual models, or uniform set of analyses for conducting geriatric research that is focused on driving. Establishing conventions for conducting research that harmonizes the fields of geriatrics, cognition, and driving research is critical for the development of the evidence base that will inform clinical practice and road safety policy

Empirical Evidence on the Use of Credit Scoring for Predicting Insurance Losses with Psycho-social and Biochemical Explanations

An important development in personal lines of insurance in the United States is the use of credit history data for insurance risk classification to predict losses. This research presents the results of collaboration with industry conducted by a university at the request of its state legislature. The purpose was to see the viability and validity of the use of credit scoring to predict insurance losses given its controversial nature and criticism as redundant of other predictive variables currently used. Working with industry and government, this study analyzed more than 175,000 policyholders’ information for the relationship between credit score and claims. Credit scores were significantly related to incurred losses, evidencing both statistical and practical significance. We investigate whether the revealed relationship between credit score and incurred losses was explainable by overlap with existing underwriting variables or whether the credit score adds new information about losses not contained in existing underwriting variables. The results show that credit scores contain significant information not already incorporated into other traditional rating variables (e.g., age, sex, driving history). We discuss how sensation seeking and self-control theory provide a partial explanation of why credit scoring works (the psycho-social perspective). This article also presents an overview of biological and chemical correlates of risk taking that helps explain why knowing risk-taking behavior in one realm (e.g., risky financial behavior and poor credit history) transits to predicting risk-taking behavior in other realms (e.g., automobile insurance incurred losses). Additional research is needed to advance new nontraditional loss prediction variables from social media consumer information to using information provided by technological advances. The evolving and dynamic nature of the insurance marketplace makes it imperative that professionals continue to evolve predictive variables and for academics to assist with understanding the whys of the relationships through theory development.IC2 Institut

Mobility and Aging: Older Drivers’ Visual Searching, Lane Keeping and Coordination

This thesis examined older drivers’ mobility and behaviour through comprehensive measurements of driver-vehicle-environment interaction and investigated the associations between driving behaviour and cognitive functions. Data were collected and analysed for 50 older drivers using eye tracking, GNSS tracking, and GIS. Results showed that poor selective attention, spatial ability and executive function in older drivers adversely affect lane keeping, visual search and coordination. Visual-motor coordination measure is sensitive and effective for driving assessment in older drivers

Cognition, Emotion and Behaviour: Addressing the Relationship Between Executive Functions and Decision-Making

Executive functions are a complex and heterogeneous group of concepts that refer to a set of diverse cognitive abilitiessuch as working memory, cognitive flexibility, planification, reasoning, problem-solving and inhibition. Moreover, decision-making maybe described as a pattern that a person uses when he or she is facing a situation where they must lean towards an option: people tendto choose one or another option considering the risks and benefits these options offer. There is evidence supporting that executivefunctions are associated with the way people make their decisions. The main aim of the present study is to review and update theseconcepts reporting evidence from the literature on the association between the cognitive, emotional, and behavioral aspects of decisionmaking.Fil: Gonzalez Aguilar, Maria Josefina. Universidad Austral. Facultad de Ciencias Biomédicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Rodriguez Lopez, Sofia. Universidad Austral. Facultad de Ciencias Biomédicas; ArgentinaFil: Lynch, Sofia. Universidad Austral. Facultad de Ciencias Biomédicas; ArgentinaFil: Mennella, Paula. Universidad Austral. Facultad de Ciencias Biomédicas; ArgentinaFil: Alba Ferrara, Lucia M. Universidad Austral. Facultad de Ciencias Biomédicas; Argentina. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; Argentin

IDENTIFYING COMPONENT-PROCESSES OF EXECUTIVE FUNCTIONING THAT SERVE AS RISK FACTORS FOR ALCOHOL-RELATED AGGRESSION

The present investigation determined how different component-processes of executive functioning (EF) acted as risk factors for intoxicated aggression. Participants were 512 (246 men and 266 women) healthy social drinkers between 21 and 35 years of age. EF was measured using the Behavior Rating Inventory of Executive Functioning – Adult Version (BRIEF-A; Roth, Isquith, & Gioia, 2005) that assesses nine EF components. Following the consumption of either an alcohol or a placebo beverage, participants were tested on a modified version of the Taylor Aggression Paradigm (Taylor, 1967) in which mild electric shocks were received from, and administered to, a fictitious opponent. Aggressive behavior was operationalized as the shock intensities and durations administered to the fictitious opponent

Cognitive Neuropsychology of HIV-Associated Neurocognitive Disorders

Advances in the treatment of the human immunodeficiency virus (HIV) have dramatically improved survival rates over the past 10 years, but HIV-associated neurocognitive disorders (HAND) remain highly prevalent and continue to represent a significant public health problem. This review provides an update on the nature, extent, and diagnosis of HAND. Particular emphasis is placed on critically evaluating research within the realm of cognitive neuropsychology that aims to elucidate the component processes of HAND across the domains of executive functions, motor skills, speeded information processing, episodic memory, attention/working memory, language, and visuoperception. In addition to clarifying the cognitive mechanisms of HAND (e.g., impaired cognitive control), the cognitive neuropsychology approach may enhance the ecological validity of neuroAIDS research and inform the development of much needed novel, targeted cognitive and behavioral therapies

Exploring Predictors of Older Adults\u27 Performance on a Novel Driving Simulator Task

On a per-mile driven basis, older adults are at increased risk of being involved in an automobile accident. The development and implementation of driving assessment tools is necessary to inform decisions about driving reduction and cessation. Driving simulators are one method of assessing driving performance and safety, however many simulators are cost-prohibitive for most researchers and clinicians. Additionally, while driving performance has been previously explored with respect to clinical populations (e.g., Alzheimer’s Disease), less work has evaluated this topic in a cognitively healthy sample. The present study sought to determine whether a novel, cost-effective driving simulator (Assetto Corsa (AC)) might be useful in the evaluation of driving performance in a sample of cognitively healthy older adults. A total of 53 participants completed a battery of paper-and-pencil and computerized cognitive performance measures and self-reports regarding their driving safety and behaviors, and a subset of participants (n = 35) completed the driving simulator task. Hierarchical regressions revealed that paper-and-pencil measures of simple attention and executive functioning and a computerized measure of processing speed were associated with aspects of driving simulator performance. Pearson correlation coefficients revealed that lower self-rated driving was associated with slower completion of the simulator task, and decrements in several cognitive domains were associated with greater self-reported difficulty driving in various conditions, greater aberrant driving behaviors, and higher likelihood of having legal difficulties as a result of driving (e.g., traffic tickets). Implications for future work are discussed

Driving in Early-Stage Alzheimer’s Disease: An Integrative Review of the Literature

One of the most difficult decisions for individuals with Alzheimer’s disease (AD) is when to stop driving. Because driving is a fundamental activity linked to socialization, independent functioning, and wellbeing, making the decision to stop driving is not easy. Cognitive decline in older adults can lead to getting lost while driving, difficulty detecting and avoiding hazards, as well as increased errors while driving due to compromised judgment and difficulty in making decisions. The purpose of the current literature review was to synthesize evidence regarding how individuals with early-stage AD, their families, and providers make determinations about driving safety, interventions to increase driving safety, and methods to assist cessation and coping for individuals with early-stage AD. The evidence shows that changes in driving ability start early and progress throughout the trajectory of AD. Some individuals with mild cognitive impairment or early-stage AD may be safe to drive for a period of time. Support groups aimed at helping with the transition have been shown to be helpful for individuals who stop driving. Research and practice must support interventions to help individuals maintain safety while driving, as well as cope with driving cessation