title: The role of navigation instruction at intersections for older drivers and those with early Alzheimer's disease.
abstract: OBJECTIVE
  Our purpose was to explore the effect of navigation instruction on older drivers' driving performance at left turn intersections. Left turns at intersections are particularly complex because they require many perceptive and cognitive abilities under considerable time pressure.
  
  
  METHODS
  Fifty-four participants were recruited: 18 drivers with early-stage Alzheimer's disease (AD), 18 neurologically healthy older drivers and 18 younger individuals. Various cognitive processes were measured, and 9 left turn maneuvers with or without navigation instruction were evaluated during an in-traffic road test. The psychomotor, planning and decision-making components involved in left turn were also analyzed closely.
  
  
  RESULTS
  Only older drivers (both healthy drivers and those with AD) were negatively affected by navigation instruction during the maneuver. The planning and decision-making components were more likely to be affected by the navigation instruction.
  
  
  CONCLUSIONS
  This finding highlights the importance of carefully considering the use of navigation instructions when developing navigation systems. Adapting this instruction is necessary to simplify our understanding of the real-world driving environment and to avoid increasing the cognitive load of older drivers.
authors.affiliation: Ifsttar-TS2-Lescot, Bron, France. Electronic address: laurence.paire-ficout@ifsttar.fr.
authors.forename: Laurence
authors.initials: L
authors.lastname: Paire-Ficout
authors.affiliation: Ifsttar-TS2-Lescot, Bron, France. Electronic address: claude.marin-lamellet@ifsttar.fr.
authors.forename: Claude
authors.initials: C
authors.lastname: Marin-Lamellet
authors.affiliation: Ifsttar-TS2-Umrestte, Bron, France. Electronic address: sylviane.lafont@ifsttar.fr.
authors.forename: Sylviane
authors.initials: S
authors.lastname: Lafont
authors.affiliation: Laboratoire d'Étude des Mécanismes Cognitifs (EMC), EA3082, Université Lyon 2, Bron, France,. Electronic address: c.thomas-anterion@orange.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Thomas-Antérion
authors.affiliation: Service de neurologie, Hôpital nord, Saint-Etienne, France. Electronic address: bernard.laurent@chu-st-etienne.fr.
authors.forename: Bernard
authors.initials: B
authors.lastname: Laurent
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000523:psychology*; D001334:Automobile Driving / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D013647:Task Performance and Analysis
keywords: Aging; Alzheimer’s disease; Cognitive decline; Left turn maneuver; Navigation instruction