Gunilla Haegerström-Portnoy

PubMed2005

Night driving self-restriction: vision function and gender differences.

PURPOSE: The purpose of this study was to evaluate gender differences in the relationship between night driving self-restriction and vision function in an older population. METHODS: Night driving self-restriction patterns (assessed by questionnaire) were examined cross-sectionally in relation to age, gender, health and cognitive status, depression, and vision function in a sample of 900 elders (mean age, 76 years) living in Marin County, California. RESULTS: Of the total sample, 91% of men and 77% of women were current drivers. The mean age of the drivers was 73.3 years (range, 58-96 years). Among current drivers, women had slightly better vision function than men on most measures (low-contrast acuity, contrast sensitivity, low-contrast acuity in glare, low-contrast, low-luminance acuity, and glare recovery) but were twice as likely as men to restrict their driving to daytime. Men showed significant associations with avoidance of night driving on four spatial vision measures (high- and low-contrast acuity, low-contrast, low-luminance acuity, and contrast sensitivity). For women, in addition to these measures, a significant association was seen for low-contrast acuity in glare. Neither men nor women showed significant associations between driving restriction and performance on the other vision measures examined (glare recovery time, attentional field integrity, or stereopsis). The vision measures most predictive of self-restriction were contrast sensitivity for men and low-contrast acuity in glare for women. CONCLUSIONS: Including both cessation and self-restriction, men over age 85 years are 6.6 times more likely than women to be driving at night. For both genders, vision plays a significant role in the self-restriction decision. A higher percentage of men than women continue to drive at night with poor vision. Men's night-driving cessation was associated with contrast sensitivity and depression, whereas women's night-driving cessation was associated with low-contrast acuity in glare as well as age.

Accidents, Traffic↗

PubMed2003

Practical assessment of vision in the elderly.

In this article we have demonstrated the significant visual impairments in elders with good vision by standard measures when the viewing conditions are less than ideal--low contrast, low or changing light level, or glare. Much of this impairment can be accounted for by the known age-related changes in the eye. We have emphasized that two people of the same age with the same standard acuity can have dramatically different vision under these nonideal conditions. Because one cannot predict vision under these conditions on the basis of standard acuity, it is important to use these additional measures. These other vision measures are more closely related to task performance (reading, face recognition) than standard acuity. We find that persons who perform poorly on these low-contrast measures are more likely to have significant losses of standard acuity in the future. Hence, these measures help identify persons who should be more closely monitored. Each of the vision functions shows significant decline across age. It is important to recognize that a 60-year-old with 20/30 acuity is different from an 80-year-old with the same acuity. The older person is more likely to be impaired under the conditions of daily life. Measurement and appreciation of visual function should allow better understanding of subjective visual symptoms and allow the clinician to offer appropriate advice for mitigating these impairments. Often simple interventions, such as correcting refractive error, improving lighting, avoiding large changes in light level, increasing contrast, and avoiding glare (perhaps through cataract surgery), can greatly improve not only vision function but quality of life. Many studies have reported that good vision allows for independent living, which is the goal for most elders.

Aged↗