Date Presented 04/05/19
Visual, physical, or cognitive declines may impact older drivers, increasing their risk for motor vehicle crashes, injury, or death. Vehicle automation has the potential to reduce crash risk and promote independence. We conducted a scoping review to determine the impact of vehicle automation on older adults’ driving in regard to convenience, comfort, and safety. While vehicle automation improved aspects of driving, new technologies also presented challenges, such as increased cognitive workload.
Primary Author and Speaker: Sherrilene Classen
Additional Authors and Speakers: Mary Jeghers, Jane Morgan-Daniel, Sandra Winter, Luther King, Linda Struckmeyer
PURPOSE: By 2020, an estimated 40 million licensed drivers will be over age 65 (Murdock et al., 2015). Older drivers are vulnerable to motor vehicle crashes, with approximately 20 fatalities and 712 persons injured every day (CDC, 2017). Age-related declines in visual, physical, and cognitive function contribute to crash risk (Owsley, 2004). However, continuation of driving, when safe, is important. Driving is associated with life satisfaction, quality of life, and autonomy for older adults (Dickerson et al., 2017). Therefore, strategies to keep individuals driving safer and longer are needed. Availability of In-vehicle Information Systems (IVIS) and Advanced Driver Assistance Systems (ADAS) may extend driving safety, comfort and ability for older drivers, while increasing participation in society.
Through our scoping review we aimed to understand: 1) the impact of IVIS; and 2) the impact of ADAS within levels 1 and 2 vehicle automation with older drivers. Our research question assessed the impact – comfort, convenience, safety – of IVIS and/or ADAS on the task of driving in adults 65 years and older.
DESIGN: Due to the exploratory nature of the research question, we conducted a scoping review. PICOS criteria guided our literature search and article inclusion criteria: 1) Population – drivers 65 years and older; 2) Intervention – real-world driving or high-fidelity simulator driving using IVIS and/or ADAS; 3) Comparators – N/A; 4) Outcomes – driving performance related to comfort, convenience, function, and/or safety; and, 5) Study design – experimental studies, systematic reviews, and meta-analyses that addressed the efficacy or effectiveness of IVIS and/or ADAS on driving performance.
METHODS: Our systematic search strategy, implemented by a health sciences librarian, encompassed 16 bibliographic databases. Articles were exported into Endnote and imported into a screening document. A two-phase iterative process included: 1) title and abstract screening, and 2) full-text screening and extraction. To reduce random or systematic error, we blinded reviewers and randomly assigned articles. We used Cohen’s Kappa coefficient to test inter-rater reliability. Included articles were reviewed to evaluate each study’s outcome measure – comfortable/ uncomfortable, convenient/inconvenient, and safe/unsafe – with older drivers using IVIS and/or ADAS. Additionally, reviewers wrote a qualitative narrative highlighting the implications of these technologies regarding research, practice, and policy.
RESULTS: Results from our database search included 748 articles. After de-duplication and title and abstract screening, 61 articles met inclusion criteria for the full-text screening. Twenty-two articles were excluded at full-text screening. Thirty-nine articles underwent data extraction and were included in data analysis for our scoping review.
Initial Cohen’s Kappa percentage agreement ratings ranged from 27%-75% for the title and abstract screening, and 67%-100% for the full-text screening and extraction. Reviewers discussed their disagreements until a 100% agreement rating was achieved.
Findings include benefits and challenges with the use of IVIS and/or ADAS for older drivers. Overall, use of IVIS and ADAS were shown to improve driving performance; comfort, convenience, and safety; and assist with age-related declines. Conversely, the use of IVIS and ADAS in some instances had negative effects, such as increased cognitive workload or distraction.
CONCLUSION: Occupational therapists are in an ideal position to address driving limitations through assessment and intervention. Our presentation illustrates the opportunities and challenges of vehicle automation, which stands to revolutionize transportation and community mobility as we understand them.
References
Centers for Disease Control and Prevention (CDC). (2017). Web-based injury statistics query and reporting system (WISQARS). Retrieved from https://www.cdc.gov/injury/wisqars/index.html
Dickerson, A. E., Molnar, L. J., Bedard, M., Eby, D. W., Berg-Weger, M., Choi, M., . . .Meuser, T. (2017). Transportation and aging: An updated research agenda for advancing safe mobility among older adults transitioning from driving to non-driving. The Gerontologist, Advance online publication. doi:10.1093/geront/gnx120
Murdock, S. H., Cline, M. E., Zey, M., Perez, D., & Jeanty, P. W. (2015). Population change in the United States: Socioeconomic challenges and opportunities in the twenty-first century. New York, NY: Springer.
Owsley, C. (2004). Driver Capabilities in Transportation in an Aging Society: A Decade of Experience. Technical Papers and Reports from a Conference. Paper presented at the Transportation in an Aging Society: A Decade of Experience, Bethesda, MD.
