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Iconic Sign Comprehension in Older Adults: The Role of Cognitive Impairment and Text Enhancement*

Published online by Cambridge University Press:  31 March 2010

Charles Scialfa*
Affiliation:
University of Calgary
Pat Spadafora
Affiliation:
Sheridan Institute of Technology and Advanced Learning
Marianne Klein
Affiliation:
Sheridan Institute of Technology and Advanced Learning
Agata Lesnik
Affiliation:
Sheridan Institute of Technology and Advanced Learning
Lindsay Dial
Affiliation:
University of Calgary
Antje Heinrich
Affiliation:
University of Toronto at Mississauga
*
Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: C.T. Scialfa, Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, (scialfa@ucalgary.ca)

Abstract

Sign comprehension is critical for effective driving, responses to warnings, and way-finding. Signs that are poorly comprehended by older people increase accident risk and may compromise independence. This study sought to determine whether iconic sign comprehension suffers in healthy aging and in the presence of cognitive impairment. Additionally, we examined whether the addition of text to iconic signage would increase comprehension in older adults. In Experiment 1, young adults, healthy older adults, and older adults with varying levels of cognitive impairment were asked the meaning of 65 signs used for driving, warnings, and way-finding. Healthy older adults were generally good at sign comprehension but had difficulty with way-finding signs. Older adults with cognitive impairment had poorer sign comprehension overall and particular difficulty with way-finding icons and signs that had icons only. In Experiment 2, healthy older adults were asked the meaning of signs containing icons only, or icons and text. A significant improvement in comprehension was found when text was added. An important implication of this work is that the assessment of sign comprehension needs to involve a broad and heterogeneous sample of older adults reflecting the range of perceptual and cognitive abilities represented in the population.

Résumé

Bien comprendre les panneaux de signalisation est critique pour bien conduire aun véhicule, réagir aux avertissements, et s'orienter. Les aînés qui comprennent mal un panneau routier risquent davantage de subir un accident et de voir leur indépendance compromise. La présente étude visait à déterminer le degré de compréhension des pictogrammes par des aînés en bonne santé et des aînés souffrant de déficience. De plus, nous nous sommes demandé si l'ajout de texte aux pictogrammes permettrait aux aînés de les mieux comprendre. Lors de l'Expérience 1, nous avons demandé à des jeunes adultes, à des adultes plus âgés en bonne santé et aussi à des aînés souffrant de déficience cognitive à divers degrés, la signification de 65 panneaux routiers visant la conduite, les avertissements, et l'orientation. Les adultes plus âgés en bonne santé comprenaient bien la signalisation en général, mais avaient de la difficulté à déterminer ce que signifiait le panneau d'orientation. Les aînés souffrant de déficience cognitive comprenaient en général moins bien les panneaux routiers et en particulier les icônes d'orientation et les panneaux avec seulement un pictogramme. Au cours de l'Expérience 2, nous avons demandé à des aînés en bonne santé la signification de panneaux comportant seulement des icônes ou des icônes avec du texte. La compréhension était améliorée de façon importante lorsque le panneau comportait du texte. Ce travail a démontré que l'évaluation de la compréhension des panneaux de signalisation doit porter sur un vaste échantillon hétérogène d'adultes plus âgés dans l'échelle de capacités perceptuelles et cognitives représentées dans la population.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2008

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Footnotes

*

This work was supported by grants from the Natural Science and Engineering Research Council of Canada and the University of Calgary and by a Canadian Institutes for Health Research Strategic Training Grant on Communication and Social Interaction in Healthy Aging. Experiment 2 was completed in partial fulfillment of the degree requirements for Lindsay Dial.

References

Al-Madani, H., & Al-Janahi, A-R (2002). Assessment of drivers' comprehensions of traffic signs based on their traffic, personal and social characteristics. Transportation Research Record, Part F, 5, 6376.CrossRefGoogle Scholar
American National Standards Institute (1998). Accredited standard on safety colors, signs, symbols, labels and tags. Z535.1–5 (rev.). Washington, DC: National Electrical Manufacturers Association.Google Scholar
Baltes, P., & Lindenberger, U. (1997). Emergence of a powerful connection between sensory and cognitive functions across the adult life span: A new window to the study of cognitive aging?. Psychology and Aging, 12, 1221.CrossRefGoogle Scholar
Brashear, A., Unverzagt, F., Kuhn, E., Glazier, B., Farlow, M., Perkins, A., & Hui, S. (1998). Impaired traffic sign recognition in drivers with dementia. American Journal of Alzheimer's Disease, 13, 131137.CrossRefGoogle Scholar
Candida, C., & Horberry, T. (Eds.). (2004). The human factors of transport signs. New York: CRC.Google Scholar
Carr, D., LaBarge, E., Dunnigan, K., & Storandt, M. (1998). Differentiating drivers with dementia of the Alzheimer type from healthy older persons with a traffic sign naming test. Journals of Gerontology: Series A: Biological Sciences and Medical Sciences, 53A, M135M139.CrossRefGoogle Scholar
Craik, F.I.M. (1977). Human memory. In Birren, J., & Schaie, K.W. (Eds.), Handbook of the psychology of aging (pp. 384420). New York: van Nostrand Reinhold.Google Scholar
Crowell, T.A., Luis, C.A., Vanderploeg, R.D., Schinka, J.A., & Mullan, M. (2002). Memory patterns and executive functioning in mild cognitive impairment and Alzheimer's disease. Aging, Neuropsychology and Cognition, 9, 288297.CrossRefGoogle Scholar
Dewar, R., Kline, D., & Swanson, A. (1996). Age differences in comprehension of traffic sign devices. Transportation Research Record, 1456, 110.Google Scholar
Federal Highway Administration (1988). Manual on uniform traffic control devices for streets and highways. Washington, DC: U.S. Department of Transportation.Google Scholar
Flood, J., Morley, J. (2000). Age-related memory changes in learning, memory and memory processing. In Morley, J., Vellas, B.J., Armbrecht, H., Vellas, B., & Coe, R. (Eds.), The science of geriatrics (pp. 503513). New York: Springer.Google Scholar
Hale, S., & Myerson, J. (1996). Experimental evidence for differential slowing in the lexical and nonlexical domains. Aging, Neuropsychology, and Cognition, 3, 112.CrossRefGoogle Scholar
Halpern, D.F. (1984). Age differences in response time to verbal and symbolic traffic signs. Experimental Aging Research, 10, 201204.CrossRefGoogle ScholarPubMed
Hancock, H., Fisk, A., & Rogers, W. (2005). Comprehending product warning information: Age related effects and the roles of memory, inferencing and knowledge. Human Factors, 4, 219234.CrossRefGoogle Scholar
Hancock, H., Rogers, W., Schroeder, D., & Fisk, A. (2004). Safety symbol comprehension: Effects of symbol type, familiarity and age. Human Factors, 46, 183195.CrossRefGoogle ScholarPubMed
Hebert, L., Scherr, P., Bienias, J., Bennett, D., & Evans, D. (2003). Alzheimer disease in the US population: Prevalence estimates using the 2000 Census. Archives of Neurology, 60, 11101122.CrossRefGoogle ScholarPubMed
Higgins, K., Wood, J., & Tait, A. (1998). Vision and driving: Selective effect of optical blur on different driving tasks. Human Factors, 40, 224232.CrossRefGoogle ScholarPubMed
Hough, M. (2004). Naming and category concept generation in older adults with and without dementia. Aphasiology, 18, 589597.CrossRefGoogle Scholar
Hulbert, S., Beers, J., & Fowler, P. (1979). Motorists' understanding of traffic control devices. Falls Church, VA: AAA Foundation for Traffic Safety.Google Scholar
International Organization for Standardization (1988). General principles for the creation of graphical symbols. Geneva: International Organization for Standardization ISO 3461-1.Google Scholar
Joshi, S., & Morley, J. (2006). Cognitive impairment. Medical Clinics of North America, 90, 769787.CrossRefGoogle ScholarPubMed
Kline, D., Scialfa, C. (1997). Sensory and perceptual functioning: Basic research and human factors applications. In Fisk, A.D., & Rogers, W.A. (Eds.), Handbook of human factors and the older adult (pp. 2754). San Diego: Academic.Google Scholar
Kline, D.W., & Fuchs, P. (1993). The visibility of symbolic highway signs can be increased among drivers of all ages. Human Factors, 35, 2534.CrossRefGoogle ScholarPubMed
Kline, T.J.B., Ghali, L.M., Kline, D.W., & Brown, S. (1990). Visibility distance of highway signs among young, middle-aged, and older observers: Icons are better than text. Human Factors, 32, 606619.CrossRefGoogle Scholar
Lawton, M.P., & Brody, E.M. (1969). Assessment of older people: Self-monitoring and instrumental activities of daily living. Gerontologist, 9, 179186.CrossRefGoogle Scholar
Light, L.L. (1996). Memory and aging. In Bjork, E.L., & Bjork, R.A. (Eds.), Memory (pp. 443490). San Diego, CA: Academic.CrossRefGoogle Scholar
Maxwell, S.E., & Delaney, H.D. (2004). Designing experiments and analyzing data: A model comparisons perspective. (2nd ed.). Mahwah, NJ: Earlbaum.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services task force on Alzheimer's disease. Neurology, 34, 939943.CrossRefGoogle ScholarPubMed
Mitchell, R., Castleden, C., & Fanthome, Y. (1995). Driving, Alzheimer's disease and ageing: A potential cognitive screening device for all elderly drivers. International Journal of Geriatric Psychiatry, 10, 865869.CrossRefGoogle Scholar
Moeur, R.C. (2006). Manual of traffic signs. Retrieved July 26, 2008, from http://www.trafficsign.us.Google Scholar
Molloy, W. (1999). The standardized mini mental status exam. Troy, ON: New Grange.Google Scholar
Morrell, R., Park, D.C., & Poon, L.W. (1990). Effects of labeling techniques on memory and comprehension of prescription information in young and old adults. Journal of Gerontology: Psychological Sciences, 45, 166172.CrossRefGoogle ScholarPubMed
Morrrow, D.G., Leirer, V.O., & Andrassy, J.M. (1996). Using icons to convey medication schedule information. Applied Ergonomics, 27, 267275.CrossRefGoogle Scholar
Morrow, D., Ridolfo, H., Menard, W., Sanborn, A., Stine-Morrow, E., Magnor, C., Herman, L., Teller, T., & Bryant, D. (2003). Environmental support promotes expertise-based mitigation of age differences on pilot communication tasks. Psychology and Aging, 18, 268284.CrossRefGoogle ScholarPubMed
Morrow, D.G., Leirer, V.O., Andrassy, J.M., Tanke, E.D., & Stine-Morrow, E.A. (1996). Medication instruction design: Younger and older adult schemas for taking medication. Human Factors, 38, 556573.CrossRefGoogle ScholarPubMed
Nickel, K., Lahmann, C., Muehlbacher, C., Gil, F., Buschmann, N., Fartacek, R., Leiberich, P., Tritt, K., Miterlehner, F., Kettler, C., Egger, C., Rother, W., & Loew, T. (2006). Change in instrumental activities of daily living disability in female senior patients with musculoskeletal pain: A prospective, randomized, controlled trial. Archives of Gerontology and Geriatrics, 42, 247255.CrossRefGoogle ScholarPubMed
Ringseis, E., & Caird, J. (1995). The comprehensibility and legibility of twenty pharmaceutical pictograms. Proceedings of the Human factors and Ergonomics Society 38th Annual Meeting. (pp. 974978). San Francisco: Human Factors and Ergonomics Society.Google Scholar
Schneider, B.A., Pichora-Fuller, M.K. (2000). Implications of perceptual deterioration for cognitive aging research. In Craik, F.I.M., & Salthouse, T.A. (Eds.), The handbook of aging and cognition (2nd ed.), (pp. 155219), Mahwah, NJ: Erlbaum.Google Scholar
Scialfa, C., Laberge, J., & Ho, G. (2004). Design of a way-finding system for geriatric long-term care: Using human factors to make living environments more accessible. Ergonomics in Design, 12, 511.CrossRefGoogle Scholar
Shinar, D., Dewar, R., Summala, H., & Zakowska, L. (2003). Traffic sign symbol comprehension: A cross-cultural study. Ergonomics, 46, 15491565.CrossRefGoogle ScholarPubMed
Sivak, M., & Olson, P. (1982). Nighttime legibility of traffic signs: Conditions eliminating the effects of driver age and disability glare. Accident Analysis & Prevention, 14, 8793.CrossRefGoogle Scholar
Sojourner, R., & Wogalter, M. (1997). The influence of pictorials on evaluations of prescription medication instructions. Drug Information Journal, 31, 963972.CrossRefGoogle Scholar
Sojourner, R., & Wogalter, M. (1998). The influence of pictorials on the comprehension and recall of pharmaceutical safety and warning information. International Journal of Cognitive Ergonomics, 2, 93106.Google Scholar
Stephens, E.C., Carswell, C.M., & Schumacher, M.M. (2006). Evidence for an elders' advantage in the naïve product usability judgments of older and younger adults. Human Factors, 48, 422433.CrossRefGoogle ScholarPubMed
Stutts, J.C., Stewart, R., & Martell, C. (1998). Cognitive test performance and crash risk in an older driver population. Accident Analysis & Prevention, 30, 337346.CrossRefGoogle Scholar
Uc, E., Rizzo, M., Anderson, S., Shi, Q., & Dawson, J. (2005). Driver landmark and sign identification in early Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 76, 764768.CrossRefGoogle ScholarPubMed
U.S. Department of Transportation (1998). Older driver highway design handbook. Washington, DC: U.S. Department of Transportation.Google Scholar
Vittengl, J.R., White, C.N., McGovern, R.J., & Morton, B.J. (2006). Comparative validity of seven scoring systems for the instrumental activities of daily living scale in rural elders. Aging & Mental Health, 10, 4047.CrossRefGoogle ScholarPubMed
White, N., Scott, A., Woods, R.T., Wenger, C.G., Keady, J.D., & Devakumar, M. (2002). The limited utility of the Mini-Mental State Examination in screening people over the age of 75 years for dementia in primary care. British Journal of General Practice, 52, 10021003.Google ScholarPubMed
Wild, K., & Cotrell, V. (2003). Identifying driving impairment in Alzheimer disease: A comparison of self and observer reports versus driving evaluation. Alzheimer Disease & Associated Disorders, 17, 2734.CrossRefGoogle ScholarPubMed
Willis, S. (2004). Technology and learning in current and future older cohorts. In Pew, R., & Van Hemel, S. (Eds.), Steering committee for the workshop on technology for adaptive aging (pp. 209229). Washington, DC: National Research Council.Google Scholar
Wogalter, M., Dejoy, D., & Laughery, K. (1999). Warnings and risk communication. London: Taylor and Francis.CrossRefGoogle Scholar
Wolff, J., & Wogalter, M. (1993). Test and development of pharmaceutical pictorials. Interface, 93, 187192.Google Scholar
Wolff, J., & Wogalter, M. (1998). Comprehension of pictorial symbols: Effects of context and test method. Human Factors, 40, 173186.CrossRefGoogle Scholar