Falls risk and driving performance in older adults

Attention plays an important role in real-world tasks such as driving. Safe driving relies on the ability to allocate attention and perform multiple tasks concurrently. Declines in executive function and dual-task performance have been related to falls in older adults, and recent research suggests that older adults at risk for falls also show impairments on real-world tasks, such as crossing a street (e.g. Nagamatsu et al., 2011). The present study built upon this work by examining the driving performance of older adults at high and low risk for falls. Participants were classified as high or low falls risk based on scores on the Physiological Profile Assessment (Lord et al., 2003) and completed a number of challenging driving assessments in which they responded quickly to unexpected events (e.g. a pedestrian stepping into the road) in a high fidelity driving simulator. High falls risk drivers had slower response times (~2.1 seconds) to unexpected events compared to low falls risk drivers (~1.7 seconds). Furthermore, when asked to perform a concurrent cognitive task while driving, high falls risk drivers sacrificed secondary task performance to a greater extent compared to low falls risk drivers. Low falls risk older adults also outperformed high falls risk older adults on a computer-based measure of dual-task performance and computer-based dual-task performance was correlated with driving response times. Our results suggest attentional differences between high and low falls risk older adults which extend to simulated driving performance with and without secondary task distraction