title: Cognitive functioning predicts driver safety on road tests 1 and 2 years later.
abstract: OBJECTIVE
  To describe longitudinal changes in mean level and evaluate rank-order stability in potential predictors of driving safety (visual sensory, motor, visual attention, and cognitive functioning) and safety errors during an 18-mile on-road driving test in older adults and to evaluate the relative predictive power of earlier visual sensory, motor, visual attention, and cognitive functioning on future safety errors, controlling for earlier driving capacity.
  
  
  METHODS
  Three-year longitudinal observational study.
  
  
  METHODS
  Large teaching hospital in the Midwest.
  
  
  METHODS
  One hundred eleven neurologically normal older adults (60-89 at baseline).
  
  
  METHODS
  Safety errors based on video review of a standard 18-mile on-road driving test served as the outcome measure. A comprehensive battery of tests on the predictor side included visual sensory functioning, motor functioning, cognitive functioning, and a measure of useful field of view.
  
  
  RESULTS
  Longitudinal changes in mean levels of safety errors and cognitive functioning were small from year to year. Relative rank-order stability between consecutive assessments was moderate in overall safety errors and moderate to strong in visual attention and cognitive functioning. Although prospective bivariate correlations between safety errors and predictors ranged from fair to moderate, only functioning in the cognitive domain predicted future driver performance 1 and 2 years later in multivariate analyses.
  
  
  CONCLUSIONS
  Normative aging-related declines in driver performance as assessed using on-road tests emerge slowly. Even in the presence of conservative controls, such as previous driving ability, age, and visual sensory and motor functioning, cognitive functioning predicted future on-road driving performance 1 and 2 years later.
authors.affiliation: Division of Neuroergonomics, Department of Neurology, University of Iowa, Iowa City, IA 52242, USA. nazan-aksan@uiowa.edu
authors.forename: Nazan
authors.initials: N
authors.lastname: Aksan
authors.forename: Steven W
authors.initials: SW
authors.lastname: Anderson
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Dawson
authors.forename: Amy M
authors.initials: AM
authors.lastname: Johnson
authors.forename: Ergun Y
authors.initials: EY
authors.lastname: Uc
authors.forename: Matthew
authors.initials: M
authors.lastname: Rizzo
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001288:Attention / Q000502:physiology*; D001334:Automobile Driving / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011597:Psychomotor Performance; D012449:Safety; D013997:Time Factors
references.citation: Neurology. 2011 May 31;76(22):1894-902
references.pmid: 21624988
references.citation: J Clin Exp Neuropsychol. 2005 Jul;27(5):529-43
references.pmid: 16019630
references.citation: Inj Prev. 2002 Jun;8(2):116-20
references.pmid: 12120829
references.citation: J Int Neuropsychol Soc. 2010 Jul;16(4):679-86
references.pmid: 20441682
references.citation: Traffic Inj Prev. 2009 Mar;10(1):84-90
references.pmid: 19214882
references.citation: Optom Vis Sci. 2005 Aug;82(8):724-31
references.pmid: 16127338
references.citation: J Gerontol A Biol Sci Med Sci. 2000 Jan;55(1):M22-7
references.pmid: 10719769
references.citation: J Am Geriatr Soc. 2010 Jun;58(6):1090-6
references.pmid: 20487082
references.citation: J Am Geriatr Soc. 2006 Jan;54(1):77-84
references.pmid: 16420201
references.citation: Accid Anal Prev. 2001 Nov;33(6):809-19
references.pmid: 11579983
references.citation: Am J Ophthalmol. 1982 Jul;94(1):91-6
references.pmid: 7091289
references.citation: JAMA. 1995 Oct 4;274(13):1026-30
references.pmid: 7563452
references.citation: Clin Psychol Rev. 2005 Jan;25(1):45-65
references.pmid: 15596080
references.citation: Psychol Aging. 2010 Jun;25(2):464-9
references.pmid: 20545430
references.citation: Int J Epidemiol. 2000 Apr;29(2):315-22
references.pmid: 10817131
references.citation: Traffic Inj Prev. 2004 Jun;5(2):112-6
references.pmid: 15203945
references.citation: Invest Ophthalmol Vis Sci. 1993 Oct;34(11):3110-23
references.pmid: 8407219
references.citation: Neurology. 2010 Apr 20;74(16):1316-24
references.pmid: 20385882
references.citation: Neurology. 2009 Feb 10;72(6):521-7
references.pmid: 19204261
references.citation: JAMA. 1998 Apr 8;279(14):1083-8
references.pmid: 9546567
references.citation: J Am Geriatr Soc. 1994 Jan;42(1):93-108
references.pmid: 8277123
references.citation: J Neurol Neurosurg Psychiatry. 1998 Mar;64(3):325-30
references.pmid: 9527142
references.citation: Traffic Inj Prev. 2008 Aug;9(4):336-41
references.pmid: 18696390
references.citation: Neurology. 2009 Dec 15;73(24):2112-9
references.pmid: 20018639
references.citation: JAMA. 2011 Mar 9;305(10):1018-26
references.pmid: 21364126