Saccadic eye movement performance as an indicator of driving ability in elderly drivers

Schmitt, Kai-Uwe; Seeger, Rolf; Fischer, Hartmut; Lanz, Christian; Muser, Markus; Walz, Felix; Schwarz, Urs · 2015 · DOAJ

DOI: 10.4414/smw.2015.14098

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Summary

This study investigates whether saccadic eye movement performance can serve as an efficient screening tool for assessing the driving fitness of elderly drivers. With aging populations increasing the risk of traffic accidents due to declining cognitive and physical abilities, there is a need for cost-effective methods to identify unfit drivers. While detailed clinical and on-road assessments are considered the gold standard, they are resource-intensive. The authors hypothesized that analyzing specific eye movements, which are linked to frontal cortical function and cognitive status, could provide a sensitive and scalable alternative for detecting early signs of impairment. The research involved 144 participants divided into four groups: 21 elderly drivers referred to authorities for suspected fitness issues (Group LM), 47 elderly control drivers (Group EC), 42 neurology patients with diagnosed brain lesions (Group NP), and 34 young healthy volunteers (Group YC). Participants underwent three saccadic eye movement paradigms using a video-based infrared eye tracker: prosaccades (reflexive), antisaccades (voluntary suppression of reflex), and visuovisual interactive (VVI) saccades (volitional in a disturbed field). Group LM also underwent medical examinations and practical on-road driving tests, which served as the ground truth for driving fitness. Statistical analysis compared the percentage of correctly performed saccades and latency across groups. The results demonstrated a strong correlation between antisaccade performance and driving ability. Group LM exhibited significantly poorer performance in antisaccade tasks compared to both elderly and young control groups, with a mean of only 10.6% correctly performed antisaccades. Performance in the VVI task was also significantly lower in Group LM than in the young comparison group. In contrast, prosaccade performance showed no statistically significant differences between the groups, although Group LM had slightly lower accuracy. Medical examinations revealed that 16 of the 21 drivers in Group LM showed signs of dementia, and most failed the practical road test. The study found that antisaccade and VVI tasks were sensitive indicators of the cognitive deficits associated with poor driving performance, whereas simple reflexive prosaccades were not. The authors conclude that testing saccadic eye movements, particularly antisaccades and VVI tasks, is a promising and efficient method for screening large populations of elderly drivers. The findings suggest that these eye movement metrics can effectively identify individuals with diminished driving capabilities, potentially serving as a preliminary filter before more comprehensive and expensive clinical or on-road assessments. This approach offers a practical solution for traffic medicine, leveraging established neurological diagnostic tools to address public safety concerns related to elderly driving.

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• useful field of view
• eye movements scanning

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• Methodological Resource: measurement protocol