Abstract and Introduction
Abstract
In 129 community-dwelling older adults, feedback regarding qualification for an insurance discount (based on a visual speed of processing test; Useful Field of View) was examined as a prospective predictor of change in self-reported driving ability, driving avoidance, and driving exposure over 3 months, along with physical, visual, health, and cognitive variables. Multiple regression models indicated that after controlling for baseline scores on the outcome measures, failure to qualify was a significant predictor of increased avoidance over 3 months (p = .02) but not change in self-rated driving ability or exposure. Female gender (p = .03) was a significant predictor of subsequent lower self-rated driving ability. Overall, the findings of this study provide support for the role of feedback in the self-monitoring of older adults' driving behavior through avoidance of challenging driving situations but not through driving exposure or self-rated driving ability.
Introduction
Research suggests that many drivers adjust their driving behavior as they age due to a variety of factors, including health indicators, and cognitive and sensory declines (Ball et al., 1998; Holland & Rabbitt, 1992; Tuokko, McGee, Gabriel, & Rhodes, 2007). Several interrelated components of driving behavior have been examined in this literature, including driving avoidance, perceived driving difficulty, days driven per week, and total miles driven over a given time period. For example, older adults may limit their driving to times and places where they feel safe or competent, and may avoid specific driving situations in which they do not feel confident (i.e., driving at night), or which require little effort to avoid (i.e., driving during peak traffic hours; Baldock, Mathias, McLean, & Berndt, 2006a; Ball et al., 1998). Characteristics associated with greater levels of driving self-regulation include being female, of older age, not being the principal driver in the household, crash involvement in the previous 2 years, fewer years of education, vision problems, poor health status, and low driving confidence ratings (Charlton et al., 2006; Owsley, Stalvey, Wells, & Sloane, 1999; West et al., 2003). Additionally, although self-regulation tends to increase with age, this trend becomes much more pronounced as health status declines (Donorfio, D'Ambrosio, Coughlin, & Mohyde, 2008).
Older drivers' lower self-rated driving ability has been associated with several components of driving behavior, including fewer days per week driven (Lyman, McGwin, & Sims, 2001), greater avoidance of difficult driving situations (Baldock, Mathias, McLean, & Berndt, 2006b), and restrictions in driving behavior among cognitively unimpaired older adults—and to a lesser degree for those with poor cognitive functioning (Dobbs, 1999). Regardless, the preponderance of evidence indicates that some older adults tend to overrate their own driving abilities and driving safety (Cooper, 1990; Freund, Colgrove, Burke, & McLeod, 2005).
Poor cognitive functioning has also been associated with decreased driving exposure and increased avoidance of difficult driving situations (Baldock et al., 2006a; Stutts, 1998; Vance et al., 2006). Reduced performance on one measure of visual attention and speed of information processing, Useful Field of View as measured by the Useful Field of View (UFOV) test, has been associated with driving avoidance (Ball et al., 1998). Drivers at higher risk for crashes, as indicated by poorer UFOV performance, have been found to report greater avoidance of challenging driving situations than lower risk drivers (Okonkwo, Crowe, Wadley, & Ball, 2008).
Some question remains as to whether older drivers self-regulate their behavior in a manner consistent with driving skill and safety. As noted by Man-Son-Hing, Marshall, Molnar, and Wilson (2007), the relationship between self-regulation and prospective crash risk is unclear. Baldock and colleagues (2006b) reported that poorer performance on an on-road driving test was related to self-reported avoidance of specific driving situations but not to global avoidance across all situations examined, whereas another study (Holland & Rabbitt, 1992) found that older adults who reported compensatory restrictions in driving behavior also reported fewer recent crashes than those who did not report such restrictions. A recent 5-year longitudinal study (Ross et al. 2009) indicated that older drivers at higher risk of crash (determined by the UFOV test) reported reduced driving distance and frequency, and increased driving avoidance over time compared with their lower risk counterparts. However, taken in combination with prior research from the same study sample that found that drivers with poor UFOV scores were twice as likely to incur an at-fault crash over 5 years (Ball et al., 2006), there are questions of whether such increased self-regulation is sufficient to compensate for speed of processing impairment.
Although the previous studies examined only self-reported driving behavior, one recent study examined objective measures of driving behaviors in relation to self-reported driving behaviors. Blanchard and Myers (2010) examined driving behaviors using in-vehicle devices among 61 drivers aged 65–84 years. They then compared participants' recorded driving behavior over the course of 1 week with participants' self-reported usual driving practices. Results suggested that poorer perceived driving abilities and driving comfort (particularly for night driving) were significantly related to recorded driving behavior, including reduced driving exposure (in general and at night), average and maximum distance traveled from home, and driving in challenging situations. Age and gender were not associated with any of the driving indicators.