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Purpose To explore differences in driving performance of older adults with age-related macular degeneration (AMD) and age-matched controls, and to identify the visual determinants of driving performance in this population. Methods Participants included 33 older drivers with AMD (mean age [M] = 76.6 ± 6.1 years; better eye Age-Related Eye Disease Study grades: early [61%] and intermediate [39%]) and 50 age-matched controls (M = 74.6 ± 5.0 years). Visual tests included visual acuity, contrast sensitivity, visual fields, and motion sensitivity. On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist (masked to drivers' visual status). Outcome measures included driving safety ratings (scale of 1–10, where higher values represented safer driving), types of driving behavior errors, locations at which errors were made, and number of critical errors (CE) requiring an instructor intervention. Results Drivers with AMD were rated as less safe than controls (4.8 vs. 6.2; P = 0.012); safety ratings were associated with AMD severity (early: 5.5 versus intermediate: 3.7), even after adjusting for age. Drivers with AMD had higher CE rates than controls (1.42 vs. 0.36, respectively; rate ratio 3.05, 95% confidence interval 1.47–6.36, P = 0.003) and exhibited more observation, lane keeping, and gap selection errors and made more errors at traffic light–controlled intersections (P < 0.05). Only motion sensitivity was significantly associated with driving safety in the AMD drivers (P = 0.005). Conclusions Drivers with early and intermediate AMD can exhibit impairments in their driving performance, particularly during complex driving situations; motion sensitivity was most strongly associated with driving performance. These findings have important implications for assessing the driving ability of older drivers with visual impairment.

OBJECTIVES: To quantify the driving difficulties of older adults using a detailed assessment of driving performance and to link this with self-reported retrospective and prospective crashes. DESIGN: Prospective cohort study. SETTING: On-road driving assessment. PARTICIPANTS: Two hundred sixty-seven community-living adults aged 70 to 88 randomly recruited through the electoral roll. MEASUREMENTS: Performance on a standardized measure of driving performance. RESULTS: Lane positioning, approach, and blind spot monitoring were the most common error types, and errors occurred most frequently in situations involving merging and maneuvering. Drivers reporting more retrospective or prospective crashes made significantly more driving errors. Driver instructor interventions during self-navigation (where the instructor had to brake or take control of the steering to avoid an accident) were significantly associated with higher retrospective and prospective crashes; every instructor intervention almost doubled prospective crash risk. CONCLUSION: These findings suggest that on-road driving assessment provides useful information on older driver difficulties, with the self-directed component providing the most valuable information.

To quantify the driving difficulties of older adults using a detailed assessment of driving performance and to link this with self-reported retrospective and prospective crashes.Prospective cohort study.On-road driving assessment.Two hundred sixty-seven community-living adults aged 70 to 88 randomly recruited through the electoral roll.Performance on a standardized measure of driving performance.Lane positioning, approach, and blind spot monitoring were the most common error types, and errors occurred most frequently in situations involving merging and maneuvering. Drivers reporting more retrospective or prospective crashes made significantly more driving errors. Driver instructor interventions during self-navigation (where the instructor had to brake or take control of the steering to avoid an accident) were significantly associated with higher retrospective and prospective crashes; every instructor intervention almost doubled prospective crash risk.These findings suggest that on-road driving assessment provides useful information on older driver difficulties, with the self-directed component providing the most valuable information.

Wood J M, Worringham C, Kerr G, et al. Quantitative assessment of driving performance in Parkinson’s disease (J Neurol Neurosurg Psychiatry 2005;76:176–80). SD instead of SE was inadvertently inserted during the publication process in tables 2, 3, and 4. The p values are unaffected.

OBJECTIVES: The primary aim of this study was to determine how Parkinson's disease (PD) affects driving performance. It also examined whether changes in driver safety were related to specific clinical disease markers or an individual's self rating of driving ability. METHODS: The driving performance of 25 patients with idiopathic PD and 21 age matched controls was assessed on a standardised open road route by an occupational therapist and driving instructor, to provide overall safety ratings and specific driving error scores. RESULTS: The drivers with PD were rated as significantly less safe (p

OBJECTIVE. The purpose of this study was to validate an assessment tool used by occupational therapists to evaluate on-road driving performance. METHODS. The driving assessment was conducted over a 15-km route that consisted of a range of traffic situations and contained both directed and self-directed navigational instruction. The driving performance of four groups of drivers of different ages and visual characteristics was assessed independently by an occupational therapist and driving instructor using a range of scoring criteria. RESULTS. The occupational therapist scores were significantly affected by the drivers’ age and visual characteristics (directed navigation, F(3,133) = 6.05, p = 0.001; self-directed navigation, F(3,133) = 5.04, p < 0.002), and these group differences were greater for self-directed navigational instruction. The occupational therapist scores were highly correlated with the driving instructor’s global driver safety rating (r = 0.76, p < 0.001). DISCUSSION. The driving assessment instrument was a valid measure of on-road driving performance relative to an independent global driving safety evaluation. The instrument provided detailed information regarding driving performance and highlighted areas of difficulty, particularly when drivers followed self-navigational instruction.

PURPOSE: The aim of this study was to determine whether visual impairment and age affected driver performance and safety rated during in-traffic driving conditions. METHODS: Participants included 30 younger, 25 middle-aged, and 35 older subjects with normal vision and 47 older subjects with visual impairment. All subjects were legally eligible to drive. Driving performance was assessed during in-traffic conditions by a professional driving instructor and an occupational therapist using specific scoring criteria. RESULTS: Group allocation significantly affected driving performance as assessed by the driving instructor and occupational therapist (p < 0.05). The driving instructor and occupational therapist scores were highly correlated (r = 0.76). Of the drivers who were scored as being unsafe, all were older and the majority (75%) had visual impairment. DISCUSSION: Older drivers with or without visual impairment were rated as being less safe than the younger and middle-aged drivers with normal vision.