Useful Field of View and Other Neurocognitive Indicators of Crash Risk in Older Adults

  • Kathryn T. Goode
  • Karlene K. Ball
  • Michael Sloane
  • Daniel L. Roenker
  • David L. Roth
  • Renee S. Myers
  • Cynthia Owsley


Older adults represent a rapidly growing segment of the driving population. Although most older drivers are safe, research has shown that this group has more crashes per mile driven than most other age groups. The purpose of the present investigation was to examine the utility of a set of commonly used neuropsychological/cognitive tests in comparison to a newer measure of visual attention (Useful Field of View; UFOV®) in predicting state-recorded, at-fault crashes over the previous five years in a group of older adult drivers. Participants (N = 239) completed tests of mental status, visual attention, memory, and UFOV®. Results show that among all cognitive tests administered, UFOV® was most strongly related to crash involvement, with high levels of sensitivity (86.3%) and specificity (84.3%) at the standard cutoff score of 40% reduction. Practical implications for the assessment of crash risk are discussed.

driving older adults visual attention neuropsychology 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ball, K., Beard, B., Roenker, D., Miller, R., & Griggs, D. (1988). Age and visual search: Expanding the useful field of view. Journal of the Optical Society A, 5, 2210–2219.Google Scholar
  2. Ball, K., & Owsley, C. (1991). Identifying correlates of accident involvement for the older driver. Human Factors, 33, 583–595.Google Scholar
  3. Ball, K., Owsley, C., Sloane, M. E., Roenker, D. L., & Bruni, J. R. (1993). Visual attention problems as a predictor of vehicle crashes in older drivers. Investigative Ophthalmology and Visual Science, 34, 3110–3123.Google Scholar
  4. Ball, K., Owsley, C., Stalvey, B., Roenker, D. L., Sloane, M. E., & Graves, M. (1997). Driving avoidance and functional impairment in older drivers. Manuscript submitted for publication.Google Scholar
  5. Ball, K., Roenker, D. L., & Bruni, J. R. (1990). Developmental changes in attention and visual search throughout adulthood. In J. Enns (Ed.), Advances in psychology (Vol. 69, pp. 489–508). North Holland: Elsevier.Google Scholar
  6. Barr, R. A. (1991). Recent changes in driving among older adults. Human Factors, 33, 597–600.Google Scholar
  7. Branch, L. G., & Meyers, A. R. (1987). Assessing physical function in the elderly. Clinical Geriatric Medicine, 3, 29–51.Google Scholar
  8. Branch, L. G., Katz, S., Kniepmann, K., & Papsidero, J. A. (1984). A prospective study of functional status among community elders. American Journal of Public Health, 74, 266–268.Google Scholar
  9. Bronfenbrenner, U., McClelland, P., Wethington, E., Moen, P., & Ceci, S. J. (1996). The state of Americans: This generation and the next. New York: Free Press.Google Scholar
  10. Brouwer, W. H., & Ponds, R. W. H. M. (1994). Driving competence in older persons. Disability and Rehabilitation, 16, 149–161.Google Scholar
  11. Burg, A. (1967). The relationship between test scores and driving record: General findings (Report No. 67-24). Los Angeles: Department of Engineering, University of California, Los Angeles.Google Scholar
  12. Burg, A. (1968). Vision test scores and driving record: Additional findings (Report No. 6827). Los Angeles: Department of Engineering, University of California, Los Angeles.Google Scholar
  13. Carr, D. B. (1993). Assessing older drivers for physical and cognitive impairment. Geriatrics, 48, 46–51.Google Scholar
  14. Cooper, P. J., Tallman, K., Tuokko, H., & Beattie, B. L. (1993). Vehicle crash involvement and cognitive deficit in older drivers. Journal of Safety Research, 24, 9–17.Google Scholar
  15. Donaldson, L. J., Clayton, D. G., & Clarke, M. (1980). The elderly in residential care: Mortality in relation to functional capacity. Journal of Epidemiology Community Health, 34, 96–101.Google Scholar
  16. Evans, L. (1988a). Older driver involvement in fatal and severe traffic crashes. Journal of Gerontology, 43, S186–S193.Google Scholar
  17. Evans, L. (1988b). Risk of fatality from physical trauma versus sex and age. The Journal of Trauma, 28, 368–378.Google Scholar
  18. Evans, L. (1991). Traffic safety and the driver. New York: Van Nostrand Reinhold.Google Scholar
  19. Fitten, L. J., Perryman, K. M., Wilkinson, C. J., Little, R. J., Burns, M. M., Pachana, N., Mervis, R., Malmgren, R., Siembieda, D. W., & Ganzell, S. (1995). Alzheimer and vascular dementias and driving. Journal of the American Medical Association, 273, 1360–1365.Google Scholar
  20. Galski, T., Ehle, H. T., & Williams, J. B. (1996). Off-road driving evaluations for persons with cerebral injury: A factor analytic study of predriver and simulator testing. American Journal of Occupational Therapy, 51, 352–359.Google Scholar
  21. Hennessy, D. E. (1995). Vision testing of renewal applicants: Crashes predicted when compensation for impairment is inadequate. Research and Development Section, California Department of Motor Vehicles.Google Scholar
  22. Hofstetter, H. W. (1976). Visual acuity and highway accidents. Journal of the American Optometric Association, 47, 887–893.Google Scholar
  23. Hurt, L., Morris, J. C., Edwards, D., & Wilson, B. S. (1993). Driving performance in persons with mild senile dementia of the Alzheimer type. Journal of the American Geriatrics Society, 41, 747–753.Google Scholar
  24. Jette, A., & Branch, L. A. (1992). A 10-year follow-up of driving patterns among the community-dwelling elderly. Human Factors, 34, 25–31.Google Scholar
  25. Johansson, K., Bronge, L., Lundberg, C., Persson, A., Seideman, M., & Viitanen, M. (1996). Can a physician recognize an older driver with increased crash risk potential? Journal of the American Geriatrics Society, 44, 1198–1204.Google Scholar
  26. Johnson, C., & Keltner, J. (1986). Incidence of visual field loss in 20,000 eyes and its relationship to driving performance. Archives of Ophthalmology, 101, 371–375.Google Scholar
  27. Koepsell, T. D., Wolf, M. E., McCloskey, L., Buchner, D. M., Louie, D., Wagner, E. H., & Thompson, R. S. (1994). Medical conditions and motor vehicle collision injuries in older adults. Journal of the American Geriatrics Society, 42, 695–700.Google Scholar
  28. Korteling, J. E., & Kaptein, N. A. (1996). Neuropsychological driving fitness tests for brain-damaged subjects. Archives of Physical Medicine Rehabilitation, 77, 138–146.Google Scholar
  29. Lezak, M. D. (1983). Neuropsychological assessment (2nd ed.). New York: Oxford University Press.Google Scholar
  30. Lundberg, C., Johansson, K., Ball, K., Bjerre, B., Blomquist, C., Braekhus, A., Brouwer, W. H., Bylsma, F. W., Carr, D. B., Englund, L., Friedland, R. P., Hakamies-Blomquist, L., Kelmetz, G., O'Neill, D., Odenheimer, G., Rizzo, M., Schelin, M., Seideman, M., Tallman, K., Viitanen, M., Waller, P. F., & Winblad, B., (1997). Dementia and driving: An attempt at consensus. Alzheimer Disease and Associated Disorders, 11, 28–37.Google Scholar
  31. Malfetti, J. (Ed.). (1985). Drivers fifty-five plus. Fall Church, VA: AAA Foundation for Traffic Safety.Google Scholar
  32. Manton, K. G. (1988). A longitudinal study of functional change and mortality in the United States. Journal of Gerontology: Medical Sciences, 43, 5153–5161.Google Scholar
  33. Marottoli, R. A., Cooney, L. M., Wagner, D. R., Doucette, J., & Tinetti, M. E. (1994). Predictors of automobile crashes and moving violations among elderly drivers. Annals of Internal Medicine, 121, 842–846.Google Scholar
  34. Marottoli, R. A., Mendes de Leon, C. F., Glass, T. A., Williams, C. S., Cooney, L. M., Berkman, L. F., & Tinetti, M. E. (1997). Driving cessation and increased depressive symptoms: Prospective evidence from the New Haven EPESE. Journal of the American Geriatric Society, 45, 202–206.Google Scholar
  35. Martinez, R. (1995). Older drivers and physicians. Journal of the American Medical Association, 274, 1060.Google Scholar
  36. Mattis, S. (1976). Mental status examination for organic mental syndrome in the elderly patient. In L. Bella & T. B. Karasu (Eds.) Geriatric psychiatry (2nd ed.). New York: Oxford University Press.Google Scholar
  37. Morgan, R., & King, D. (1995). The older driver — a review. Medicine in the Elderly, 71, 525–528.Google Scholar
  38. National Safety Council. (1989). Accident facts, 1989 edition. Chicago: Author.Google Scholar
  39. Odenheimer, G. L., Beaudet, M., Jette, A. M., Albert, M. S., Grande, L., & Minaker, K. (1994). Performance-based driving evaluation of the elderly driver: Safety, reliability, and validity. Journal of Gerontology, 49, M153–M159.Google Scholar
  40. Owsley, C. (1997). Clinical and research issues on older drivers: Future directions. Alzheimer Disease and Associated Disorders, 11, 3–7.Google Scholar
  41. Owsley, C., Ball, K. K., & Keeton, D. M. (1995). Relationship between visual sensitivity and target localization in older adults. Vision Research, 35, 579–587.Google Scholar
  42. Owsley, C., Ball, K., McGwin, G., Sloane, M. E., Roenker, D. L., White, M. F. & Overley, E. T. (1997). Visual processing impairment and risk of motor vehicle crash among older adults. Journal of the American Medical Association, 279, 1083–1088.Google Scholar
  43. Owsley, C., Ball, K., Sloane, M., Roenker, D. L., & Bruni, J. R. (1991). Visual/cognitive correlates of vehicle accidents in older drivers. Psychology and Aging, 6, 403–415.Google Scholar
  44. Parasuraman, R., & Nestor, P. (1993). Attention and driving. Clinics in Geriatric Medicine, 9, 377–387.Google Scholar
  45. Planek, T. W., Condon, M. E., & Fowler, R. C. (1968). An investigation of the problems and opinions of aged drivers. Chicago, IL: National Safety Council.Google Scholar
  46. Ray, W. A., Fought, R. L., & Decker, M. D. (1992). Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. American Journal of Epidemiology, 136, 873–883.Google Scholar
  47. Roenker, D. L., Cissell, G. M., & Ball, K. K. (1997). Training. Manuscript submitted for publication.Google Scholar
  48. Reuben, D. B. (1993). Assessment of Older Drivers. Clinics in Geriatric Medicine, 9, 449–459.Google Scholar
  49. Spreen, O., & Strauss, E. (1991). A compendium of neuropsychological tests. New York: Oxford University Press.Google Scholar
  50. Transportation Research Board. (1988). Transportation in an aging society (Vol. 1). Washington, DC: National Research Council.Google Scholar
  51. U.S. Department of Commerce, Bureau of the Census. (1990). Statistical abstract of the United States. Washington, DC: U.S. Government Printing Office.Google Scholar
  52. Wechsler, D. (1945). A standardized memory scale for clinical use. Journal of Psychology, 19, 87–95.Google Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • Kathryn T. Goode
    • 1
  • Karlene K. Ball
    • 1
  • Michael Sloane
    • 1
  • Daniel L. Roenker
    • 2
  • David L. Roth
    • 1
  • Renee S. Myers
    • 1
  • Cynthia Owsley
    • 3
  1. 1.Department of PsychologyUniversity of Alabama at BirminghamBirmingham
  2. 2.Western Kentucky UniversityBowling GreenKentucky
  3. 3.Department of OphthalmologyUniversity of Alabama at BirminghamBirmingham

Personalised recommendations