The useful field of view assessment predicts simulated commercial motor vehicle driving safety

Correlation between visuo-cognitive tests and simulator performance of commercial drivers in the United States

BACKGROUND

Driving commercial vehicles requires intact visuo-cognitive skills. Approximately 13% of all fatal motor vehicle crashes in the United States involve commercial drivers. The ability to accurately predict risk factors for unsafe commercial driving is essential for public safety. Accurate prediction tools will advance the field of commercial driver science, provide policy guidance for driver testing and assist healthcare providers during testing. Prior studies have correlated clinical tools to roadway safety; translating these results to commercial drivers has not yet been done.

OBJECTIVE

This study aimed to identify specific demographic, driving history and visuo-cognitive test results that correlate with driving simulator performance. Using the Cumulative Simulator Score (CSS) as a surrogate for driving ability, the objective was to correlate both sets of data (self-reported and visuo-cognitive testing) with the CSS to identify screening tools for unsafe driving in commercial drivers.

PRINCIPAL RESULTS

Baseline assessments of 120 variables were collected from October 2020 to January 2022. Of the 31 participants, 3 were female and 28 were male with a mean age of 53 years. Average BMI was 32, blood pressure 136/84, 32 years of CDL driving experience, 36,500 annual CDL mileage, 11,000 annual personal mileage, 14 years of education, average number of medications: 2, average number of medical conditions: 2, six participants with personal and/or commercial crashes or tickets in past five years, MOCA 27/30, Trails B time 66 s, UFOV Speed of Processing 15 ms, Stroke Disease Severity Assessment pass rate 94 %. The Cumulative Simulator Score (CSS), correlated significantly with education (r = 0.42; p = 0.02), commercial driving experience (r = 0.42; 0 = 0.02), and number of tickets as a commercial driver (Spearman rho = 0.40; p = 0.02). In a stepwise multivariable linear regression analysis, the number of tickets as a CDL driver in the past five years and years of education were retained as significant variables in the multivariable linear regression model, explaining 38 % of the variance of total scores on the CSS.

MAJOR CONCLUSIONS

Descriptive and self-reported driving characteristics correlate better with the Cumulative Simulator Score in CDL drivers than visuo-cognitive tests. Since simulator performance has been shown to be a reliable surrogate for driving performance, the number of tickets as a CDL driver in the past five years and years of education can be considered as additions to annual physicals for policy makers and health care providers to help assess their on-the-road safety.

Driving habits, cognition, and health-related quality of life in middle-aged and older adults with HIV

Cognitive impairment is known to increase with aging in people living with HIV (PLWH). Impairment in cognitive domains required for safe driving may put PLWH at risk for poor driving outcomes, decreased mobility, and health-related quality of life (HRQoL). This study described the driving behaviors of middle-aged and older PLWH and examined correlations between driving behaviors and cognitive functioning (Aim 1), and driving behaviors and HRQoL domains (Aim 2). A sample of 260 PLWH ages 40 and older completed a comprehensive assessment including a battery of cognitive tests, an HRQoL measure, and a measure of self-reported driving habits. Associations between driving habits, cognitive function, and HRQoL domains were examined. While 212 (81.54%) participants reported currently driving, only 166 (63.85%) possessed a driver's license. Several significant correlations emerged between driving habits and both cognitive and HRQoL variables, with a general pattern suggesting that current greater driving exposure was associated with better cognitive functioning and HRQoL. Given consistent associations that emerged between the social functioning HRQoL domain and several driving habits, multivariable regression was conducted to examine the unique association between an index of greater driving exposure (i.e., days driven per week) and social functioning, adjusting for potential confounders (race, income, education, depression, and global cognition). Results showed that more days driven per week was a significant, independent correlate of higher social functioning. Understanding the factors underlying driving behaviors in PLWH may contribute to interventions to promote better mobility and improved access to care.