Distracted Driving and Driving Patterns in Older Drivers With Glaucoma

Jain, Purva; Unkart, Jonathan; Daga, Fábio B.; Hill, Linda · 2021 · American Journal of Lifestyle Medicine

DOI: 10.1177/15598276211042825

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Summary

This study investigates the relationship between glaucoma, objective visual measures (visual field and visual acuity), and self-perceived driving capabilities in older adults. Motivated by the rising prevalence of glaucoma and the critical role driving plays in maintaining independence among seniors, the research addresses a gap in understanding how visual impairments influence drivers' self-assessment of their safety and distracted driving behaviors. The authors sought to determine if individuals with glaucoma accurately perceive their visual limitations and how these perceptions correlate with actual clinical metrics. The study utilized data from 212 participants: 137 individuals with glaucoma recruited from the Hamilton Glaucoma Center at UC San Diego and 75 healthy controls from the general population. Participants completed a 58-question survey assessing demographics, driving patterns, self-rated vision, self-perceived driving ability, and self-perceived distracted driving. Clinical data, including binocular summation of visual field defects and visual acuity scores, were obtained. Multivariable linear regression models, adjusted for age and sex, were employed to analyze associations between glaucoma status, visual metrics, and survey outcomes. Results indicated that glaucoma status itself was not significantly associated with differences in self-rated vision, self-perceived driving ability, or distracted driving behaviors compared to controls. However, objective visual measures strongly influenced self-rated vision. For every one-degree increase in visual field, participants reported higher quality of corrected vision (RR = 1.06), day vision (RR = 1.05), and night vision (RR = 1.08). Conversely, worse visual acuity scores were associated with lower self-rated vision quality. Crucially, neither visual field nor visual acuity significantly predicted self-perceived driving ability or the frequency of distracted driving. Participants with poorer vision rated their vision lower but did not significantly adjust their perceived ability to drive safely or their engagement in distracted behaviors like cell phone use. The findings suggest a disconnect between objective visual impairment and self-perceived driving competence in older adults with glaucoma. While patients accurately recognize declines in their visual quality, they do not necessarily perceive a corresponding decline in their ability to drive safely or avoid distractions. This lack of correlation implies that visual deficits alone may not prompt behavioral changes in driving habits, potentially increasing crash risk. The authors conclude that clinicians should target interventions to enhance safe driving practices, as patients may overestimate their capabilities despite significant visual loss.

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