title: Association between unsafe driving performance and cognitive-perceptual dysfunction in older drivers.
abstract: OBJECTIVE
  To find an association between cognitive-perceptual problems of older drivers and unsafe driving performance during simulated automobile driving in a virtual environment.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A driver evaluation clinic in a rehabilitation hospital.
  
  
  METHODS
  Fifty-five drivers aged 65 years or older and 48 drivers in their late twenties to early forties.
  
  
  METHODS
  All participants underwent evaluation of cognitive-perceptual function and driving performance, and the results were compared between older and younger drivers. The association between cognitive-perceptual function and driving performance was analyzed.
  
  
  METHODS
  Cognitive-perceptual function was evaluated with the Cognitive Perceptual Assessment for Driving (CPAD), a computer-based assessment tool consisting of depth perception, sustained attention, divided attention, the Stroop test, the digit span test, field dependency, and trail-making test A and B. Driving performance was evaluated with use of a virtual reality-based driving simulator. During simulated driving, car crashes were recorded, and an occupational therapist observed unsafe performances in controlling speed, braking, steering, vehicle positioning, making lane changes, and making turns.
  
  
  RESULTS
  Thirty-five older drivers did not pass the CPAD test, whereas all of the younger drivers passed the test. When using the driving simulator, a significantly greater number of older drivers experienced car crashes and demonstrated unsafe performance in controlling speed, steering, and making lane changes. CPAD results were associated with car crashes, steering, vehicle positioning, and making lane changes. Older drivers who did not pass the CPAD test are 4 times more likely to experience a car crash, 3.5 times more likely to make errors in steering, 2.8 times more likely to make errors in vehicle positioning, and 6.5 times more likely to make errors in lane changes than are drivers who passed the CPAD test.
  
  
  CONCLUSIONS
  Unsafe driving performance and car crashes during simulated driving were more prevalent in older drivers than in younger drivers. Unsafe performance in steering, vehicle positioning, making lane changes, and car crashes were associated with cognitive-perceptual dysfunction.
authors.affiliation: Department of Rehabilitation Medicine, National Rehabilitation Center, 111 Gaori-gil, Gangbuk-Gu, Seoul, Korea 142-884. seanpark05@yahoo.co.kr
authors.forename: Si-Woon
authors.initials: SW
authors.lastname: Park
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Choi
authors.forename: Mun Hee
authors.initials: MH
authors.lastname: Lim
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Kim
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Hwang
authors.forename: Kyung-In
authors.initials: KI
authors.lastname: Choi
authors.forename: Hyun-Chul
authors.initials: HC
authors.lastname: Yoo
authors.forename: Kuem Ju
authors.initials: KJ
authors.lastname: Lee
authors.forename: Hi-Eun
authors.initials: HE
authors.lastname: Jung
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D001334:Automobile Driving; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis*; D003198:Computer Simulation; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012449:Safety; D014584:User-Computer Interface