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Neuropsychological Correlates of Hazard Perception in Older Adults

Published online by Cambridge University Press:  28 December 2015

Katalina McInerney
Ohio University, Athens, Ohio
Julie Suhr
Ohio University, Athens, Ohio
E-mail address:


Objectives: Hazard perception, the ability to identify and react to hazards while driving, is of growing importance in driving research, given its strong relationship to real word driving variables. Furthermore, although poor hazard perception is associated with novice drivers, recent research suggests that it declines with advanced age. In the present study, we examined the neuropsychological correlates of hazard perception in a healthy older adult sample. Methods: A total of 68 adults age 60 and older who showed no signs of dementia and were active drivers completed a battery of neuropsychological tests as well as a hazard perception task. Tests included the Repeatable Battery for the Assessment of Neuropsychological Status, Wechsler Test of Adult Reading, Trail Making Test, Block Design, Useful Field of View, and the Delis-Kaplan Executive Function System Color Word Interference Test. Results: Hazard perception errors were related to visuospatial/constructional skills, processing speed, memory, and executive functioning skills, with a battery of tests across these domains accounting for 36.7% of the variance in hazard perception errors. Executive functioning, particularly Trail Making Test part B, emerged as a strong predictor of hazard perception ability. Conclusions: Consistent with prior work showing the relationship of neuropsychological performance to other measures of driving ability, neuropsychological performance was associated with hazard perception skill. Future studies should examine the relationship of neuropsychological changes in adults who are showing driving impairment and/or cognitive changes associated with Mild Cognitive Impairment or dementia. (JINS, 2015, 21, 332–340)

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Copyright © The International Neuropsychological Society 2015 

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Anderson, S.W., Rizzo, M., Shi, Q., Uc, E.Y., & Dawson, J.D. (2005). Cognitive abilities related to driving performance in a simulator and crashing on the road. Proceedings of the Third International Driving Symposium on Human Factors in Driver Assessment, Training and Vehicle Design. Iowa City: University of Iowa; 286–292.Google Scholar
Anstey, K.J., Horswill, M.S., Wood, J.M., & Hatherly, C. (2012). The role of cognitive and visual abilities as predictors in the Multifactorial Model of Driving Safety. Accident Analysis & Prevention, 45, 766774. doi:10.1016/j.aap.2011.10.006 CrossRefGoogle ScholarPubMed
Anstey, K., Wood, J., Lord, S., & Walker, J. (2005). Cognitive, sensory and physical factors enabling driving safety in older adults. Clinical Psychology Review, 25(1), 4565. doi:10.1016/j.cpr.2004.07.008 CrossRefGoogle ScholarPubMed
Apolinario, D., Magaldi, R.M., Busse, A.L., da Costa Lopes, L., Kasai, J.Y.T., & Satomi, E. (2009). Cognitive impairment and driving: A review of the literature. Dementia & Neuropsychologia, 3(4), 283290.CrossRefGoogle ScholarPubMed
Baldock, M.R.J., Mathias, J., McLean, J., & Berndt, A. (2007). Visual attention as a predictor of on-road driving performance of older drivers. Australian Journal of Psychology, 59(3), 159168. doi:10.1080/00049530701458035 Google Scholar
Barrash, J., Stillman, A., Anderson, S.W., Uc, E.Y., Dawson, J.D., & Rizzo, M. (2010). Prediction of driving ability with neuropsychological tests: Demographic adjustments diminish accuracy. Journal of the International Neuropsychological Society, 16, 679686. doi:10.1017/S1355617710000470 CrossRefGoogle ScholarPubMed
Beanland, V., Goode, N., Salmon, P.M., & Lenne, M.G. (2013). Is there a case for driver training? A review of the efficacy of pre-and post-licence driver training. Safety Science, 51(1), 127137. doi:10.1016/j.ssci.2012.06.021 CrossRefGoogle Scholar
Bédard, M., Leonard, E., McAuliffe, J., Weaver, B., Gibbons, C., & Dubois, S. (2006). Visual attention and older drivers: The contribution of inhibition of return to safe driving. Experimental Aging Research, 32(2), 119135. doi:10.1080/03610730500511918 CrossRefGoogle ScholarPubMed
Bieliauskas, L.A., Roper, B.R., Trobe, J., & Lacy, M. (1998). Cognitive measures, driving safety, and Alzheimer’s disease. The Clinical Neuropsychologist (Neuropsychology, Development and Cognition: Section D), 12(2), 206212. doi:10.1076/clin. CrossRefGoogle Scholar
Chaparro, A., Wood, J., & Carberry, T. (2005). Effects of age and auditory and visual dual tasks on closed-road driving performance. Optometry and Vision Science, 82(8), 747. doi:10.1097/01.opx.0000174724.74957.45 CrossRefGoogle ScholarPubMed
Clay, O.J., Wadley, V.G., Edwards, J.D., Roth, D.L., Roenker, D.L., & Ball, K.K. (2005). Cumulative meta-analysis of the relationship between useful field of view and driving performance in older adults: Current and future implications. Optometry & Vision Science, 82(8), 724731. doi:1040-5488/05/8208-0724/0 CrossRefGoogle ScholarPubMed
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(1), 917. doi:10.1016/002-4375(93)90047-Q CrossRefGoogle Scholar
Daigneault, G., Joly, P., & Frigon, J.Y. (2002). Executive functions in the evaluation of accident risk of older drivers. Journal of Clinical and Experimental Neuropsychology, 24(2), 221238. doi:1380-3395/02/2402-221 Google ScholarPubMed
de Raedt, R., & Ponjaert-Kristoffersen, I. (2000). The relationship between cognitive/neuropsychological factors and car driving performance in older adults. Journal of the American Geriatrics Society, 48(12), 16641668. PMid:11129759CrossRefGoogle ScholarPubMed
de Raedt, R., & Ponjaert-Kristoffersen, I. (2001). Predicting at-fault car accidents of older drivers. Accident Analysis & Prevention, 33(6), 809. CrossRefGoogle ScholarPubMed
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). Delis-Kaplan executive function system technical manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Hirth, V.A., Davis, B., Fridriksson, J., Rorden, C., & Bonilha, L. (2007). Cognitive performance and neural correlates of detecting driving hazards in healthy older adults. Dementia and Geriatric Cognitive Disorders, 24(5), 335342. doi:10.1159/000108606 CrossRefGoogle ScholarPubMed
Hoffman, L., McDowd, J.M., Atchley, P., & Dubinsky, R.A. (2005). The role of visual attention in predicting driving impairment in older adults. Psychology and Aging, 20(4), 610622. doi:10.1037/0882-7974.20.4.610 CrossRefGoogle ScholarPubMed
Horswill, M.S., Anstey, K.J., Hatherly, C.G., & Wood, J.M. (2010). The crash involvement of older drivers is associated with their hazard perception latencies. Journal of the International Neuropsychological Society, 16, 939944. doi:10.1017/S135561771000055X CrossRefGoogle ScholarPubMed
Horswill, M.S., Falconer, E.K., Pachana, N.A., Wetton, M., & Hill, A. (2015). The long-term effects of a brief hazard perception training intervention in older drivers. Psychology and Aging, 30(1), 6267. doi:10.1037/a0038671 CrossRefGoogle ScholarPubMed
Horswill, M.S., Kemala, C.N., Wetton, M., Scialfa, C.T., & Pachana, N.A. (2010). Improving older drivers’ hazard perception ability. Psychology and Aging, 25(2), 464469. doi:10.1037/a0017306 CrossRefGoogle ScholarPubMed
Horswill, M.S., Marrington, S.A., McCullough, C.M., Wood, J., Pachana, N.A., McWilliam, J., &Raikos, M.K. (2008). The hazard perception ability of older drivers. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63(4), 212218. Retrieved from at Ohio University Libraries.CrossRefGoogle ScholarPubMed
Horswill, M.S., & McKenna, F.P. (2004). Drivers’ hazard perception ability: Situation awareness on the road. In S. Banbury & S. Tremblay (Eds.), A cognitive approach to situation awareness: Theory and application (pp. 155175). Burlington, VT: Ashgate Publishing Company.Google Scholar
Horswill, M.S., Pachana, N.A., Wood, J., Marrington, S.A., McWilliam, J., & McCullough, C.M. (2009). A comparison of the hazard perception ability of matched groups of healthy drivers aged 35 to 55, 65 to 74, and 75 to 84 years. Journal of the International Neuropsychological Society, 15, 799802. doi:10.1017/S1355617709990312 CrossRefGoogle ScholarPubMed
Horswill, M.S., Taylor, K., Newnam, S., Wetton, M., & Hill, A. (2013). Even highly experienced drivers benefit from a brief hazard perception training intervention. Accident Analysis & Prevention, 52, 100110. doi:10.1016/j.aap.2012.12.014 CrossRefGoogle ScholarPubMed
Hunt, L.A., & Arbesman, M. (2008). Evidence-based and occupational perspective of effective interventions for older clients that remediate or support improved driving performance. The American Journal of Occupational Therapy, 62(2), 136148.CrossRefGoogle ScholarPubMed
Huestegge, L., Skottke, E-M., Anders, S., Musseler, J., & Debus, G. (2010). The development of hazard perception: Dissociation of visual orientation and hazard processing. Transportation Research Part F, 13, 18. doi:10.1016/j.trf.2009.09.005 CrossRefGoogle Scholar
Iverson, D.J., Gronseth, G.S., Reger, M.A., Classen, S., & Dubinsky, R.M. (2010). Practice parameters update: Evaluation and management of driving risks in dementia. Neurology, 74, 13161324. doi:10.1212/WNL.0b013e3181da3b0f CrossRefGoogle Scholar
Jackson, L., Chapman, P., & Crundall, D. (2009). What happens next? Predicting other road users’ behaviour as a function of driving experience and processing time. Ergonomics, 52(2), 154164. doi:10.1080/00140130802030714 CrossRefGoogle ScholarPubMed
Lade, D.C. (2001 September 01) Older drivers could face skill, brain function tests. SunSentinel. Retrieved from Google Scholar
Lee, J.D. (2008). Fifty years of driving safety research. Human Factors: The Journal of the Human Factors and Ergonomics Society, 50(3), 521528. doi:10.1518/001872008X288376 CrossRefGoogle ScholarPubMed
Mans-Son-Hing, M., Marshall, S.C., Molnar, F.J., & Wilson, K.G. (2007). Systematic review of driving risk and the efficacy of compensatory strategies in persons with dementia. Journal of the American Geriatrics Society, 55(6), 878884. doi:10.1111/j.1532-5415.2007.01177.x CrossRefGoogle Scholar
Mathias, J., & Lucas, K. (2009). Cognitive predictors of unsafe driving in older drivers: A meta-analysis. International Psychogeriatrics, 21(4), 637653. doi:10.1017/S1041610209009119 CrossRefGoogle ScholarPubMed
McKenna, F.P., & Horswill, M.S. (1999). Hazard perception and its relevance for driver licensing. International Association of Traffic Safety Science Research, 23, 3641.Google Scholar
Owsley, C., Ball, K., & Keeton, D.M. (1995). Relationship between visual sensitivity and target localization in older adults. Vision Research, 35(4), 579587. doi:10.1016/0042-6989(94)00166-J CrossRefGoogle ScholarPubMed
Parasuraman, R., & Nestor, P. (1993). Attention and driving. Assessment in elderly individuals with dementia. Clinics in Geriatric Medicine, 9(2), 377. PMID:8504386Google ScholarPubMed
Pelz, D.C., & Krupat, E. (1974). Caution profile and driving record of undergraduate males. Accident Analysis & Prevention, 6(1), 4558. doi:10.1016/0001-4575(74)90015-3 CrossRefGoogle Scholar
Pollatsek, A., Narayanaan, V., Pradhan, A., & Fisher, D.L. (2006). Using eye movements to evaluate a PC-based risk awareness and perception training program on a driving simulator. Human Factors: The Journal of the Human Factors and Ergonomics Society, 48(3), 447464. doi:10.1518/001872006778606787 CrossRefGoogle ScholarPubMed
Quimby, A.R., Maycock, G., Carter, I.D., Dixon, R., & Wall, J.G. (1986). Perceptual abilities of accident-involved drivers (Research report 27). Crowthorne, UK: Transport and Road Research Laboratory.Google Scholar
Randolph, C. (2012). Repeatable battery for the assessment of neuropsychological status manual. San Antonio, TX: Psychological Corporation.Google Scholar
Reitan, R.M., & Wolfson, D. (1985). Neuroanatomy and neuropathology: A clinical guide for neuropsychologists. Middletown, MD: Neuro Psychology Press.Google Scholar
Richardson, E.D., & Marottoli, R.A. (2003). Visual attention and driving behaviors among community-living older persons. The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences, 58A(9), 832836. Retrieved from at Ohio University Libraries.CrossRefGoogle Scholar
Rizzo, M., Reinach, S., McGhee, D., & Dawson, J. (1997). Simulated car crashes and crash predictors in drivers with Alzheimer disease. Archives of Neurology, 54(5), 545551. PMid:9152111CrossRefGoogle ScholarPubMed
Salthouse, T. (2010). Selective review of cognitive aging. Journal of the International Neuropsychological Society, 16, 754760.CrossRefGoogle ScholarPubMed
Scialfa, C.T., Borkenhagen, D., Lyon, J., & Deschênes, M. (2013). A comparison of static and dynamic hazard perception tests. Accident Analysis & Prevention, 51, 268273. doi:10.1016/j.aap.2012.12.006 CrossRefGoogle ScholarPubMed
Scialfa, C.T., Borkenhagen, D., Lyon, J., Deschênes, M., Horswill, M., & Wetton, M. (2012). The effects of driving experience on responses to a static hazard perception test. Accident Analysis & Prevention, 45, 547553. doi:10.1016/j.aap.2011.09.005 CrossRefGoogle ScholarPubMed
Scialfa, C.T., Deschênes, M.C., Ference, J.D., Boone, J., Horswill, M.S., & Wetton, M. (2012). Hazard perception in older drivers. International Journal of Human Factors and Ergonomics, 1(3), 221233. doi:10.1504/IJHFE.2012.050869 CrossRefGoogle Scholar
Scialfa, C.T., Deschênes, M.C., Ference, J., Boone, J., Horswill, M.S., & Wetton, M. (2011). A hazard perception test for novice drivers. Accident Analysis & Prevention, 43(1), 204208. doi:10.1016/j.aap.2010.08.010 CrossRefGoogle ScholarPubMed
Scialfa, C.T., Pereversev, R.S., & Borkenhagen, D. (2014). Short-term reliability of a brief hazard perception test. Accident Analysis & Prevention, 73, 4146. doi:10.1016/j.aap.2014.08.007 CrossRefGoogle ScholarPubMed
Shanmugaratnam, S., Kass, S.J., & Arruda, J.E. (2010). Age differences in cognitive and psychomotor abilities and simulated driving. Accident Analysis and Prevention, 42(3), 802808. doi:10.1016/j.aap.2009.10.002 CrossRefGoogle ScholarPubMed
Sims, R.V., McGwin, G. Jr., Allman, R.M., Ball, K., & Owsley, C. (2000). Exploratory study of incident vehicle crashes among older drivers. Journals of Gerontology . Series A: Biological Sciences and Medical Sciences, 55(1), M22M27. doi:10.1093/gerona/55.1.M22 Google Scholar
Smith, S.S., Horswill, M., Chambers, B., & Wetton, M. (2009). Sleepiness and hazard perception while driving. (Road Safety Grant Report, 2009-001). Australian Transport Safety Bureau. Retrieved from publications/2009/pdf/RSRG_2009001.pdf.Google Scholar
Stav, W.B., Justiss, M.D., McCarthy, D.P., Mann, W.C., & Lanford, D.N. (2008). Predictability of clinical assessments for driving performance. Journal of Safety Research, 39(1), 17. doi:10.1016/j.jsr.2007.10.004 CrossRefGoogle ScholarPubMed
Stroop, J.R. (1935). Studies of interference in serial verbal reaction. Journal of Experimental Psychology, 18, 643662.CrossRefGoogle Scholar
Stutts, J.C., Stewart, J.R., & Martell, C. (1998). Cognitive test performance and crash risk in an older driver population. Accident Analysis & Prevention, 30(3), 337346. doi:10.1016/S0001-4575(97)00108-5 CrossRefGoogle Scholar
Szlyk, J.P., Myers, L., Zhang, Y., Wetzel, L., & Shapiro, R. (2002). Development and Assessment of a neuropsychological battery to aid in predicting driving performance. Journal of Rehabilitation Research and Development, 39(4), 483496. doi:10.3758/brm.41.2.284 Google ScholarPubMed
Viamonte, S., Vance, D., Wadley, V., Roenker, D., & Ball, K. (2010). Driving-related cognitive performance in older adults with pharmacologically treated cardiovascular disease. Clinical Gerontologist, 33(2), 109123. doi:10.1080/07317110903552180 CrossRefGoogle ScholarPubMed
Visual Awareness Research Group, Inc. (2009). Useful Field of View user’s guide. Punta Gorda, FL: Visual Awareness Research Group, Inc.Google Scholar
Wallis, T.S., & Horswill, M.S. (2007). Using fuzzy signal detection theory to determine why experienced and trained drivers respond faster than novices in a hazard perception test. Accident Analysis & Prevention, 39(6), 11771185. doi:10.1016/j.aap.207.03.003 CrossRefGoogle Scholar
Wechsler, D. (2001). Wechsler Test of Adult Reading. San Antonio, TX: Harcourt Assessment/The Psychological Corporation.Google Scholar
Wechsler, D. (2008). Wechsler Adult Intelligence Scale—Fourth Edition: Technical and interpretive manual. San Antonio, TX: Pearson Assessment.Google Scholar
Wetton, M.A., Horswill, M.S., Hatherly, C., Wood, J.M., Pachana, N.A., & Anstey, K.J. (2010). The development and validation of two complementary measures of drivers’ hazard perception ability. Accident Analysis & Prevention, 42(4), 12321239. doi:10.1016/j.aap.2010.01.017 CrossRefGoogle ScholarPubMed
Whelihan, W., DiCarlo, M.A., & Paul, R.H. (2005). The relationship of neuropsychological functioning to driving competence in older persons with early cognitive decline. Archives of Clinical Neuropsychology, 20(2), 217228. doi:10.1016/j.acn.2004.07.002 CrossRefGoogle ScholarPubMed
Wood, J.M., Horswill, M.S., Lacherez, P.F., & Anstey, K.J. (2013). Evaluation of screening tests for predicting older driver performance. Accident Analysis and Prevention, 50, 11611168. doi:10.1016/j.aap.2012.09.009 CrossRefGoogle ScholarPubMed
Zook, N.A., Bennett, T.L., & Lane, M. (2009). Identifying at-risk older adult community-dwelling drivers through neuropsychological evaluation. Applied Neuropsychology, 16(4), 281287. doi:10.1080/09084280903297826 CrossRefGoogle ScholarPubMed
Zuin, D., Ortiz, H., Boromei, D., & Lopez, O.L. (2002). Motor vehicle crashes and abnormal driving behaviours in patients with dementia in Mendoza, Argentina. European Journal of Neurology, 9(1), 2934. doi:10.1046/j.1468-1331.2002.00296.x CrossRefGoogle ScholarPubMed

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