Anna Devlin

Investigating driving behaviour of older drivers with mild cognitive impairment using a portable driving simulator

While there is a large body of research indicating that individuals with moderate to severe dementia are unfit to drive, relatively little is known about the driving performance of older drivers with mild cognitive impairment (MCI). The aim of the current study was to examine the driving performance of older drivers with MCI on approach to intersections, and to investigate how their healthy counterparts perform on the same driving tasks using a portable driving simulator. Fourteen drivers with MCI and 14 age-matched healthy older drivers (aged 65-87 years) completed a 10-min simulator drive in an urban environment. The simulator drive consisted of stop-sign controlled and signal-controlled intersections. Drivers were required to stop at the stop-sign controlled intersections and to decide whether or not to proceed through a critical light change at the signal-controlled intersections. The specific performance measures included; approach speed, number of brake applications on approach to the intersection (either excessive or minimal), failure to comply with stop signs, and slower braking response times on approach to a critical light change. MCI patients in our sample performed more poorly than controls across a number of variables. However, because the trends failed to reach statistical significance it will be important to replicate the study using a larger sample to qualify whether the results can be generalised to the broader population.

Adult Age Differences in the Ability to Mentally Transform Object and Body Stimuli

ABSTRACT Cognitive neuroscience literature suggests a strong dissociation between the ability to mentally transform object and body stimuli (Hegarty & Waller, 2004 ). However, little is known about how this ability changes with age. This dissociation was explored in 20 younger (19–24 years) and 20 older (65–87 years) adults. Mental rotation of object stimuli was demonstrated for both age groups, suggesting that the neuro-cognitive network involved with performing (object-based) mental transformations is relatively preserved in older age. Compared to young adults, older adults displayed the greatest decline in performance efficiency for the whole-body task. The authors propose that an age-related decline in the integrity of body-schema information may account for this change.

Self-regulation of older drivers with cognitive impairment: a systematic review.

Cognitive decline contributes significantly to the safety risk of older drivers. Some drivers may be able to compensate for the increased crash risk by avoiding complex driving situations or restricting their driving.

Epilepsy and driving: Current status of research

In many parts of the world, licensing guidelines state that drivers with medical conditions such as epilepsy are restricted or prohibited from driving. These guidelines are sometimes subjective and not strongly evidence-based, rendering the task of assessing fitness to drive a complex one. Determining fitness to drive is not only essential for maintaining the safety of individual drivers but has implications for the community at large. It is therefore important to review the current state of knowledge regarding epilepsy and driving in order to aid health professionals required to assess fitness to drive and to guide future research directions. This review outlines the functional impairments related to epilepsy and driving, treatment and management issues, motor vehicle crash risk for drivers with epilepsy, estimates of predicted seizure occurrence and concludes with a discussion of the international licensing guidelines and relevant legal issues. More comprehensive research, including investigation into the effects of antiepileptic medication on driving, could aid in the development of policies and guidelines for assessing fitness to drive.

Co-occurrence of posttraumatic stress symptoms, pain, and disability 12 months after traumatic injury.

Introduction: Chronic pain is common after traumatic injury and frequently co-occurs with posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS). Objectives: This study sought to understand the association between probable PTSD, PTSS, and pain. Methods: Four hundred thirty-three participants were recruited from the Victorian Orthopaedic Trauma Outcomes Registry and Victorian State Trauma Registry and completed outcome measures. Participants were predominantly male (n = 324, 74.8%) and aged 17-75 years at the time of their injury (M = 44.83 years, SD = 14.16). Participants completed the Posttraumatic Stress Disorder Checklist, Brief Pain Inventory, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia, EQ-5D-3L and Roland-Morris Disability Questionnaire 12 months after hospitalization for traumatic injury. Data were linked with injury and hospital admission data from the trauma registries. Results: Those who reported having current problems with pain were 3 times more likely to have probable PTSD than those without pain. Canonical correlation showed that pain outcomes (pain severity, interference, catastrophizing, kinesiophobia, self-efficacy, and disability) were associated with all PTSSs, but especially symptoms of cognition and affect, hyperarousal, and avoidance. Posttraumatic stress disorder symptoms, on the contrary, were predominantly associated with high catastrophizing and low self-efficacy. When controlling for demographics, pain and injury severity, depression, and self-efficacy explained the greatest proportion of the total relationship between PTSS and pain-related disability. Conclusion: Persons with both PTSS and chronic pain after injury may need tailored interventions to overcome fear-related beliefs and to increase their perception that they can engage in everyday activities, despite their pain.