Skip to main content

  • Older Drivers and Accidents

    By Jean Shaw
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
    Add to My Bookmarks

    Journal Highlights

    JAMA Ophthalmology, June 2021

    Download PDF

    Swain et al. set out to examine the visual risk factors associated with at-fault crashes and near crashes among older drivers, using data acquired from sensors placed in the drivers’ cars. They identified three visual factors likely to increase a driver’s risk of accidents and near accidents.

    For this study, the researchers evaluated 154 participants 70 years of age or older who reported driving at least four days a week. An unobtrusive data acquisition system, which cap­tured information on roadway envi­ronment, accelerator position, brake actuation, and speed, was installed in each participant’s car. The partici­pants were instructed to continue their normal driving patterns for six months. The primary outcome was the rate of combined incident at-fault crashes and near crashes, defined by the number of events and the number of miles driven.

    Of the drivers, 85 were in their 70s, 66 were in their 80s, and three were in their 90s. Cognitive status was normal in 152 of the participants. Information was available on the eye health of 151 participants; of these, 14 had no eye disease, while the remainder had such conditions as cataract (n = 63; 41.7%), primary open-angle glaucoma (n = 43; 28.5%), age-related macular degen­eration (n = 28; 18.5%), and diabetic retinopathy or macular edema (n = 10; 6.6%).

    With regard to visual acuity (VA), 151 participants had VA of 20/40 or better, while three had a VA of 20/40 or worse. Seventeen had impaired contrast sensitivity (worse than 1.5 log sensitivity). Visual processing speed was measured in 125 participants; of these, 62 had slowed visual processing speed. Other factors measured included visual field sensitivity and motion perception.

    A total of 26 at-fault crashes and 55 at-fault near crashes occurred during the six-month study period. Of these, 55 (67.9%) involved other vehicles. Participants who had deficits in their visual processing speed, contrast sen­sitivity, and motion perception were more likely to be involved in an at-fault collision or near collision. (Also see related commentary by Sheila K. West, PhD, in the same issue.)

    The original article can be found here.