PURPOSE. To identify visual factors that are significantly associated with increased vehicle crashes in older drivers. METHODS. Several aspects of vision and visual information processing were assessed in 294 drivers aged 55 to 90 years. The sample was stratified with respect to age and crash frequency during the 5-year period before the test date. Variables assessed included eye health status, visual sensory function, the size of the useful field of view, and cognitive status. Crash data were obtained from state records. RESULTS. The size of the useful field of view, a test of visual attention, had high sensitivity (89%) and specificity (81%) in predicting which older drivers had a history of crash problems. This level of predictability is unprecedented in research on crash risk in older drivers. Older adults with substantial shrinkage in the useful field of view were six times more likely to have incurred one or more crashes in the previous 5-year period. Eye health status, visual sensory function, cognitive status, and chronological age were significantly correlated with crashes, but were relatively poor at discriminating between crash-involved versus crash-free drivers. CONCLUSIONS. This study suggests that policies that restrict driving privileges based solely on age or on common stereotypes of age-related declines in vision and cognition are scientifically unfounded. With the identification of a visual attention measure highly predictive of crash problems in the elderly, this study points to a way in which the suitability of licensure in the older adult population could be based on objective, performance-based criteria. Keywords: Driver distraction;

Visual attention problems as a predictor of vehicle crashes in older drivers.

Over the past two decades, “active aging” has emerged in Europe as the foremost policy response to the challenges of population aging. This article examines the concept of active aging and how it differs from that of “successful aging.” In particular, it shows how active aging presents a more holistic, life course–oriented approach than successful aging. We provide a critical perspective on active aging too by, first, tracing its emergence in Europe and then showing how, in practice, it has been dominated by a narrow economic or productivist perspective that prioritizes the extension of working life. It has also been gender blind. Nonetheless, it is argued that an active aging approach has the potential to enable countries to respond successfully to the challenges of population aging because of its comprehensive focus and emphasis on societal as well as individual responsibility. Finally, we set out the basic principles that need to be followed if the full potential of active aging is to be achieved.

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Active and Successful Aging: A European Policy Perspective

PurposeThe aims of this study were (a) to explore patients self-reported visual disability resulting from glaucoma by means of a questionnaire developed for this purpose; (b) identify activities strongly associated with a measure of visual field loss, (c) to quantify different psychophysical aspects

Quality of life in glaucoma and its relationship with visual function.

‘Active ageing’ is a topic of increasing attention in scientific and policy discussions on ageing, yet there is no consensus on its actual meaning. The current paper proposes a detailed classification of various definitions that have been used since its introduction. These definitions are subjected to critical investigation, and subtle differences with regard to such terms as ‘healthy ageing’ and ‘productive ageing’ are clarified. Bearing the hazards of previous definitions in mind, a comprehensive strategy is initiated. Given that earlier definitions have tended to exclude frail older adults, this strategy pays particular attention to the translation of the active-ageing concept to situations of dependency by centring on three key principles: fostering adaptability, supporting the maintenance of emotionally close relationships and removing structural barriers related to age or dependency.

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‘Active ageing’: from empty rhetoric to effective policy tool

Most older adults rely on the automobile to maintain their mobility and independence, in spite of the fact that age-related behavioral and biomedical changes may make driving more difficult. Indeed, accident and fatality rates begin to rise after age 55. One research goal, therefore, is to identify functional measures that differentiate older adults who drive safely from those who do not. This paper discusses conceptual and methodological issues involved in addressing this question, considers why earlier research has been largely unsuccessful, presents a working model for approaching the problem, and argues the need for large-sample, prospective research in this area.

Identifying correlates of accident involvement for the older driver

Efforts to assess visual deterioration with increasing age, coupled with new mechanisms proposed to limit the exposure of visually impaired drivers to driving risks, have emerged in response to the increase in older drivers. Visual functions discussed in this context include static acuity (photopic, mesopic, and in the presence of glare), dynamic visual acuity, visual field, contrast sensitivity, and motion perception. Exposure control mechanisms discussed include alternative periodic vision testing strategies, visual training, and environmental and vehicular modifications to accommodate the older driver. Finally, relevant research needs are addressed.

Frank Schieber

Papers

Visual requirements for safety and mobility of older drivers.

Optimizing sensation and perception in older adults