Falls risk and simulated driving performance in older adults

Abstract

Declines in executive function and dual-task performance have been related to falls in older adults, and recent research suggests that older adults at risk for falls also show impairments on real-world tasks, such as crossing a street. The present study examined whether falls risk was associated with driving performance in a high-fidelity simulator. Participants were classified as high or low falls risk using the Physiological Profile Assessment and completed a number of challenging simulated driving assessments in which they responded quickly to unexpected events. High falls risk drivers had slower response times (~2.1 seconds) to unexpected events compared to low falls risk drivers (~1.7 seconds). Furthermore, when asked to perform a concurrent cognitive task while driving, high falls risk drivers showed greater costs to secondary task performance than did low falls risk drivers, and low falls risk older adults also outperformed high falls risk older adults on a computer-based measure of dual-task performance. Our results suggest that attentional differences between high and low falls risk older adults extend to simulated driving performance.

Figure 1

Examples of potential hazards in the hazard driving task. In (a), a pedestrian crosses the street in front of the driver. In (b), a parked vehicle starts to pull out in front of the driver.

Figure 2

Brake response times. Mean brake response time in seconds for the high and low falls risk driver groups in drive-only and drive + 1-Back task conditions in the hazard response and car following paradigms. Error bars represent one standard error of the mean. *P < .05.

Figure 3

Driving response times and dual-task performance. Response time in seconds in the hazard (a) and (c) and following (b) and (d) driving tasks plotted against single-task and dual-task reaction time in milliseconds on the computer dual-task paradigm. *P < .05.

Figure 4

1-Back accuracy. Accuracy on the 1-Back task in critical and noncritical segments of the hazard and following drives and in the single-task (1-Back only) condition. Error bars represent one standard error of the mean. *P < .05.