Abstract
BACKGROUND: Despite sensational news reports, few studies have quantified the rates of poor driving performance among older drivers and the predictors of poor performance. We determined the rate of running red traffic lights among older drivers and the relationship of failure to stop to measures of vision and cognition. METHODS: Multiple measures of vision and cognition were collected at the baseline examination of a population of 1,425 drivers aged 67-87 years in greater Salisbury, Maryland. Each driver had real-time data collected on 5 days of driving performance at baseline and again at 1 year. Failure to stop at a red traffic light was the primary outcome. RESULTS: Overall, 3.8% of older drivers failed to stop at red traffic lights, with 15% of those who ran the light having failed 10% or more of the traffic lights they encountered. A narrowing of the attentional visual field (AVF; the extent of peripheral vision in which objects are detected while attention is also centrally fixated) was associated with failure to stop at traffic lights at baseline and predictive 1 year later (incidence rate ratio = 1.09 per degree lost, 95% confidence interval = 1.01-1.16). Persons with smaller vertical AVF were more likely to fail to stop. No demographic or vision variable was related to failure to stop. CONCLUSIONS: Failure to stop at red lights was a relatively uncommon event in older drivers and associated with reduced ability to pay attention to visual events in the vertical field of vision.