Skip to main content Accessibility help

Neuropsychological Correlates of Hazard Perception in Older Adults

  • Katalina McInerney (a1) and Julie Suhr (a1)


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)


Corresponding author

Correspondence and reprint requests to: Julie Suhr, Department of Psychology, Ohio University, Athens, OH 45701. E-mail


Hide All
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.
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
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
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.
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
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
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
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
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.
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
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
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
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
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:11129759
de Raedt, R., & Ponjaert-Kristoffersen, I. (2001). Predicting at-fault car accidents of older drivers. Accident Analysis & Prevention, 33(6), 809.
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). Delis-Kaplan executive function system technical manual. San Antonio, TX: The Psychological Corporation.
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
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
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
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
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
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.
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.
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
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
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.
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
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
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
Lade, D.C. (2001 September 01) Older drivers could face skill, brain function tests. SunSentinel. Retrieved from
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
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
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
McKenna, F.P., & Horswill, M.S. (1999). Hazard perception and its relevance for driver licensing. International Association of Traffic Safety Science Research, 23, 3641.
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
Parasuraman, R., & Nestor, P. (1993). Attention and driving. Assessment in elderly individuals with dementia. Clinics in Geriatric Medicine, 9(2), 377. PMID:8504386
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
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
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.
Randolph, C. (2012). Repeatable battery for the assessment of neuropsychological status manual. San Antonio, TX: Psychological Corporation.
Reitan, R.M., & Wolfson, D. (1985). Neuroanatomy and neuropathology: A clinical guide for neuropsychologists. Middletown, MD: Neuro Psychology Press.
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.
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:9152111
Salthouse, T. (2010). Selective review of cognitive aging. Journal of the International Neuropsychological Society, 16, 754760.
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
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
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
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
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
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
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
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.
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
Stroop, J.R. (1935). Studies of interference in serial verbal reaction. Journal of Experimental Psychology, 18, 643662.
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
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
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
Visual Awareness Research Group, Inc. (2009). Useful Field of View user’s guide. Punta Gorda, FL: Visual Awareness Research Group, Inc.
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
Wechsler, D. (2001). Wechsler Test of Adult Reading. San Antonio, TX: Harcourt Assessment/The Psychological Corporation.
Wechsler, D. (2008). Wechsler Adult Intelligence Scale—Fourth Edition: Technical and interpretive manual. San Antonio, TX: Pearson Assessment.
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
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
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
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
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



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed