Driver self-regulation and depressive symptoms in cataract patients awaiting surgery: a cross-sectional study

Background: Cataract is an extremely common visual condition of ageing. Evidence suggests that visual impairment influences driving patterns and self-regulatory behavior among older drivers. However, little is known about the psychological effects of driver self-regulation among older drivers. Therefore, this study aimed to describe driver self-regulation practices among older bilateral cataract patients and to determine the association between self-regulation and depressive symptoms. Methods: Ninety-nine older drivers with bilateral cataract were assessed the week before first eye cataract surgery. Driver self-regulation was measured via the Driving Habits Questionnaire. Depressive symptoms were assessed using the 20-item Center for Epidemiological Studies Depression Scale. Visual, demographic and cognitive data were also collected. Differences between self-regulators and non self-regulators were described and linear regression modeling used to determine the association between driver self-regulation and depressive symptoms score. Results: Among cataract patients, 48% reported self-regulating their driving to avoid at least one challenging situation. The situations most commonly avoided were driving at night (40%), on the freeway (12%), in the rain (9%) and parallel parking (8%). Self-regulators had significantly poorer contrast sensitivity in their worse eye than non self-regulators (p = 0.027). Driver self-regulation was significantly associated with increased depressive symptoms after controlling for potential confounding factors (p = 0.002).Conclusions: Driver self-regulation was associated with increased depressive symptoms among cataract patients. Further research should investigate this association among the general older population. Self-regulation programs aimed at older drivers may need to incorporate mental health elements to counteract unintended psychological effects

Prefrontal cortex activation and young driver behaviour: a fNIRS study

Road traffic accidents consistently show a significant over-representation for young, novice and particularly male drivers. This research examines the prefrontal cortex activation of young drivers and the changes in activation associated with manipulations of mental workload and inhibitory control. It also considers the explanation that a lack of prefrontal cortex maturation is a contributing factor to the higher accident risk in this young driver population. The prefrontal cortex is associated with a number of factors including mental workload and inhibitory control, both of which are also related to road traffic accidents. This experiment used functional near infrared spectroscopy to measure prefrontal cortex activity during five simulated driving tasks: one following task and four overtaking tasks at varying traffic densities which aimed to dissociate workload and inhibitory control. Age, experience and gender were controlled for throughout the experiment. The results showed that younger drivers had reduced prefrontal cortex activity compared to older drivers. When both mental workload and inhibitory control increased prefrontal cortex activity also increased, however when inhibitory control alone increased there were no changes in activity. Along with an increase in activity during overtaking manoeuvres, these results suggest that prefrontal cortex activation is more indicative of workload in the current task. There were no differences in the number of overtakes completed by younger and older drivers but males overtook significantly more than females. We conclude that prefrontal cortex activity is associated with the mental workload required for overtaking. We additionally suggest that the reduced activation in younger drivers may be related to a lack of prefrontal maturation which could contribute to the increased crash risk seen in this population

Does automatic transmission improve driving behavior in older drivers?

Background: Most older drivers continue to drive as they age. To maintain safe and independent transport, mobility is important for all individuals, but especially for older drivers. Objective: The objective of this study was to investigate whether automatic transmission, compared with manual transmission, may improve the driving behavior of older drivers. Method: In total, 31 older drivers (mean age 75.2 years) and 32 younger drivers – used as a control group (mean age 39.2 years) – were assessed twice on the same fixed route; once in a car with manual transmission and once in a car with automatic transmission. The cars were otherwise identical. The driving behavior was assessed with the Ryd On-Road Assessment driving protocol. Time to completion of left turns (right-hand side driving) and the impact of a distraction task were measured. Results: The older group had more driving errors than the younger group, in both the manual and the automatic transmission car. However, and contrary to the younger drivers, automatic transmission improved the older participants’ driving behavior as demonstrated by safer speed adjustment in urban areas, greater maneuvering skills, safer lane position and driving in accordance with the speed regulations. Conclusion: Switching to automatic transmission may be recommended for older drivers as a means to maintain safe driving and thereby the quality of their transport mobility

Mobility in Later Life and Wellbeing

Transport is more important to older people than ever before. We live in, what is termed by academics in the transport field, as a “hypermobile” society. One where high levels of mobility are needed in order to stay connected to communities, friends and family and to access shops and services. The car has been central to this hyper-connectivity. Being mobile is linked to quality of life. In particular, giving up driving in later life has repeatedly been shown to related to a decrease in wellbeing and an increase in depression and related health problems, including feelings of stress and isolation and also increased mortality. Recent figures from Great Britain suggest around 342,000 over 75뭱year olds ‘feel trapped’ in their own homes through lack of suitable transport after giving-up driving. In previous work, myself and my colleague examined why mobility is important to older people. We placed the need for mobility around three main motivational domains, utility (mobility as a need to get from A to B), psychosocial (mobility that effects independence, identity and roles) and aesthetic needs (mobility for its own sake) in a hierarchical manner. This chapter will examine case studies of life beyond the car in three main areas (older people as pedestrians, older people using public transport and older people receiving lifts from friends and family) as well as examining a group of older drivers identifying to what extent the three levels of need, utility, psychosocial and aesthetic are met. Driving a car satisfies all three levels of mobility need. Results suggest that transport provision beyond the car neglects psychosocial needs of mobility and sporadically meets practical and aesthetic needs depending upon the wider social context