Michael E. Sloane

Bio: Michael E. Sloane is an academic researcher from University of Alabama at Birmingham. The author has contributed to research in topics: Useful field of view & Poison control. The author has an hindex of 19, co-authored 33 publications receiving 5732 citations. Previous affiliations of Michael E. Sloane include Western Kentucky University & Northwestern University.

Visual Processing Impairment and Risk of Motor Vehicle Crash Among Older Adults

Abstract: CONTEXT: Motor vehicle crash risk in older drivers has been associated with visual acuity loss, but only weakly so, suggesting other factors contribute. The useful field of view is a measure that reflects decline in visual sensory function, slowed visual processing speed, and impaired visual attention skills. OBJECTIVE: To identify whether measures of visual processing ability, including the useful field of view test, are associated with crash involvement by older drivers. DESIGN: Prospective cohort study with 3 years of follow-up, 1990-1993. SETTING: Ophthalmology clinic assessment of community-based sample. PATIENTS: A total of 294 drivers aged 55 to 87 years at enrollment. MAIN OUTCOME MEASURE: Motor vehicle crash occurrence. RESULTS: Older drivers with a 40% or greater impairment in the useful field of view were 2.2 times (95% confidence interval, 1.2-4.1) more likely to incur a crash during 3 years of follow-up, after adjusting for age, sex, race, chronic medical conditions, mental status, and days driven per week. This association was primarily mediated by difficulty in dividing attention under brief target durations. CONCLUSION: Reduction in the useful field of view increases crash risk in older drivers. Given the relatively high prevalence of visual processing impairment among the elderly, visual dysfunction and eye disease deserve further examination as causes of motor vehicle crashes and injury.

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

Abstract: 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/cognitive correlates of vehicle accidents in older drivers.

Abstract: Older drivers have more accidents per miles driven than any other age group and tend to have significant impairments in their visual function, which could interfere with driving. Previous research has largely failed to document a link between vision and driving in the elderly. We have taken a comprehensive approach by examining how accident frequency in older drivers relates to the visual/cognitive system at a number of levels: ophthalmological disease, visual function, visual attention, and cognitive function. The best predictor of accident frequency as recorded by the state was a model incorporating measures of early visual attention and mental status, which together accounted for 20% of the variance, a much stronger model than in earlier studies. Those older drivers with a visual attentional disorder or with poor scores on a mental status test had 3-4 times more accidents (of any type) and 15 times more intersection accidents than those without these problems.

Older drivers and cataract: driving habits and crash risk.

Abstract: BACKGROUND: Cataract is a leading cause of vision impairment in older adults, affecting almost half of those over age 75 years. Driving is a highly visual task and, as with other age groups, older adults rely on the personal automobile for travel. The purpose of this study was to examine the role of cataract in driving. METHODS: Older adults (aged 55-85 years) with cataract (n = 279) and those without cataract (n = 105) who were legally licensed to drive were recruited from eye clinics to participate in a driving habits interview to assess driving status, exposure, difficulty, and "space" (the distance of driving excursions from home base). Crash data over the prior 5 years were procured from state records. Visual functional tests documented the severity of vision impairment. RESULTS: Compared to those without cataract, older drivers with cataract were approximately two times more likely to report reductions in days driven and number of destinations per week, driving slower than the general traffic flow, and preferring someone else to drive. Those with cataract were five times more likely to have received advice about limiting their driving. Those with cataract were four times more likely to report difficulty with challenging driving situations, and those reporting driving difficulty were two times more likely to reduce their driving exposure. Drivers with cataract were 2.5 times more likely to have a history of at-fault crash involvement in the prior 5 years (adjusted for miles driven/week and days driven/week). These associations remained even after adjustments for the confounding effects of advanced age, impaired general health, mental status deficit, or depression. CONCLUSIONS: Older drivers with cataract experience a restriction in their driving mobility and a decrease in their safety on the road. These findings serve as a baseline for our ongoing study evaluating whether improvements in vision following cataract surgery expand driving mobility and improve driver safety.

Guided Search 2.0 A revised model of visual search

Abstract: An important component of routine visual behavior is the ability to find one item in a visual world filled with other, distracting items. This ability to performvisual search has been the subject of a large body of research in the past 15 years. This paper reviews the visual search literature and presents a model of human search behavior. Built upon the work of Neisser, Treisman, Julesz, and others, the model distinguishes between a preattentive, massively parallel stage that processes information about basic visual features (color, motion, various depth cues, etc.) across large portions of the visual field and a subsequent limited-capacity stage that performs other, more complex operations (e.g., face recognition, reading, object identification) over a limited portion of the visual field. The spatial deployment of the limited-capacity process is under attentional control. The heart of the guided search model is the idea that attentional deployment of limited resources isguided by the output of the earlier parallel processes. Guided Search 2.0 (GS2) is a revision of the model in which virtually all aspects of the model have been made more explicit and/or revised in light of new data. The paper is organized into four parts: Part 1 presents the model and the details of its computer simulation. Part 2 reviews the visual search literature on preattentive processing of basic features and shows how the GS2 simulation reproduces those results. Part 3 reviews the literature on the attentional deployment of limited-capacity processes in conjunction and serial searches and shows how the simulation handles those conditions. Finally, Part 4 deals with shortcomings of the model and unresolved issues.

Action video game modifies visual selective attention

Abstract: As video-game playing has become a ubiquitous activity in today's society, it is worth considering its potential consequences on perceptual and motor skills. It is well known that exposing an organism to an altered visual environment often results in modification of the visual system of the organism. The field of perceptual learning provides many examples of training-induced increases in performance. But perceptual learning, when it occurs, tends to be specific to the trained task; that is, generalization to new tasks is rarely found. Here we show, by contrast, that action-video-game playing is capable of altering a range of visual skills. Four experiments establish changes in different aspects of visual attention in habitual video-game players as compared with non-video-game players. In a fifth experiment, non-players trained on an action video game show marked improvement from their pre-training abilities, thereby establishing the role of playing in this effect.

Effects of Cognitive training interventions with older adults. A randomized controlled trial

Abstract: ContextCognitive function in older adults is related to independent living and need for care. However, few studies have addressed whether improving cognitive functions might have short- or long-term effects on activities related to living independently.ObjectiveTo evaluate whether 3 cognitive training interventions improve mental abilities and daily functioning in older, independent-living adults.DesignRandomized, controlled, single-blind trial with recruitment conducted from March 1998 to October 1999 and 2-year follow-up through December 2001.Setting and ParticipantsVolunteer sample of 2832 persons aged 65 to 94 years recruited from senior housing, community centers, and hospital/clinics in 6 metropolitan areas in the United States.InterventionsParticipants were randomly assigned to 1 of 4 groups: 10-session group training for memory (verbal episodic memory; n = 711), or reasoning (ability to solve problems that follow a serial pattern; n = 705), or speed of processing (visual search and identification; n = 712); or a no-contact control group (n = 704). For the 3 treatment groups, 4-session booster training was offered to a 60% random sample 11 months later.Main Outcome MeasuresCognitive function and cognitively demanding everyday functioning.ResultsThirty participants were incorrectly randomized and were excluded from the analysis. Each intervention improved the targeted cognitive ability compared with baseline, durable to 2 years (P<.001 for all). Eighty-seven percent of speed-, 74% of reasoning-, and 26% of memory-trained participants demonstrated reliable cognitive improvement immediately after the intervention period. Booster training enhanced training gains in speed (P<.001) and reasoning (P<.001) interventions (speed booster, 92%; no booster, 68%; reasoning booster, 72%; no booster, 49%), which were maintained at 2-year follow-up (P<.001 for both). No training effects on everyday functioning were detected at 2 years.ConclusionsResults support the effectiveness and durability of the cognitive training interventions in improving targeted cognitive abilities. Training effects were of a magnitude equivalent to the amount of decline expected in elderly persons without dementia over 7- to 14-year intervals. Because of minimal functional decline across all groups, longer follow-up is likely required to observe training effects on everyday function.

Investigative Ophthalmology and Visual Science

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Long-term effects of cognitive training on everyday functional outcomes in older adults

Abstract: ContextCognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated.ObjectiveTo determine the effects of cognitive training on daily function and durability of training on cognitive abilities.Design, Setting, and ParticipantsFive-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26% black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67% of the sample.InterventionsTen-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training.Main Outcome MeasuresSelf-reported and performance-based measures of daily function and cognitive abilities.ResultsThe reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99% confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99% CI, −0.002 to 0.51) nor memory training (effect size, 0.20; 99% CI, −0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99% CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99% CI, 0.11-0.35]; reasoning: effect size, 0.26 [99% CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99% CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99% CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99% CI, 0.61-1.09).ConclusionsReasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention.Trial Registrationclinicaltrials.gov Identifier: NCT00298558