Aging goes along with cognitive and non-cognitive changes leading to impaired driving skills in a relevant proportion of older people. However, it is unclear which driving dimensions are affected in unfit older drivers and how performance in these dimensions is related to driving-relevant cognitive and non-cognitive factors. In a prospective cross-sectional study, 110 healthy older drivers completed a standardized 50-minute on-road driving assessment being accompanied by a driving instructor and a driving expert. The driving expert evaluated practical driving skills with the TRIP protocol (TRIP total score) and determined fitness to drive (fit versus unfit). We used repeated-measures analysis of variance to compare fit (n = 89) and unfit (n = 21) older drivers with respect to their practical driving performance in the 12 dimensions of the TRIP. Moreover, we explored how driving performance in the different TRIP dimensions is related to driving-relevant cognitive and non-cognitive factors. Results revealed performance differences between the different TRIP dimensions across all drivers (main effect of TRIP dimension) with the poorest overall performances in speed adaptation. Unfit older drivers showed poorer practical driving performances than fit older drivers across all TRIP dimensions (main effect of group). The most pronounced group differences were observed at traffic signs and signals, complex intersections and left turns (TRIP dimension × group interaction). Driving performance in these dimensions was associated with different driving-relevant cognitive and non-cognitive factors. The results of the current on-road study show that impaired driving skills of unfit older drivers can be observed in multiple driving dimensions, but particularly involve traffic signs and signals, complex intersections and left turns. The findings provide both high diagnostic and therapeutic relevance. This paper matters, because the current study identified those dimensions of practical driving behavior that best distinguish between fit and unfit older drivers. In a standardized on-road driving assessment, we identified traffic signs and signals, complex intersections and left turns as being those driving dimensions that involve the greatest difficulties for unfit compared to fit older drivers. In a diagnostic context, the results show which driving dimensions deserve a closer look when evaluating fitness to drive. In a therapeutical context, they show which driving dimensions need more intense training. Finally, in a practical context, the results imply that traffic signs and signals need to be optimized to facilitate and accelerate their perception.

中文翻译：

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交通标志和信号灯、复杂交叉路口和左转处的道路驾驶表现可区分老年驾驶员是否适合

衰老伴随着认知和非认知的变化，导致相当一部分老年人的驾驶技能受损。然而，尚不清楚哪些驾驶维度会影响不健康的老年驾驶员，以及这些维度的表现如何与驾驶相关的认知和非认知因素相关。在一项前瞻性横断面研究中，110 名健康的老年驾驶员在驾驶教练和驾驶专家的陪同下完成了 50 分钟的标准化道路驾驶评估。驾驶专家使用 TRIP 协议（​​TRIP 总分）评估实际驾驶技能，并确定驾驶适合性（适合与不适合）。我们使用重复测量方差分析来比较适合 (n = 89) 和不适合 (n = 21) 的老年驾驶员在 TRIP 12 个维度中的实际驾驶表现。此外，我们还探讨了不同 TRIP 维度中的驾驶表现如何与驾驶相关的认知和非认知因素相关。结果显示，所有驾驶员的不同 TRIP 维度之间存在性能差异（TRIP 维度的主要影响），其中速度适应的总体性能最差。在所有 TRIP 维度上，不适合的老年驾驶员的实际驾驶表现都比适合的老年驾驶员差（群体的主效应）。最明显的群体差异出现在交通标志和信号灯、复杂的十字路口和左转处（TRIP 维度 × 群体互动）。这些维度的驾驶表现与不同的驾驶相关认知和非认知因素相关。目前的道路研究结果表明，不合格的老年驾驶员的驾驶技能受损可以在多个驾驶维度上观察到，但特别涉及交通标志和信号、复杂的十字路口和左转。这些发现提供了高度的诊断和治疗相关性。这篇论文很重要，因为当前的研究确定了最能区分健康和不健康的老年驾驶员的实际驾驶行为的维度。在标准化的道路驾驶评估中，我们发现交通标志和信号、复杂的十字路口和左转是与健康的老年驾驶员相比，不健康的驾驶者面临最大困难的驾驶维度。在诊断背景下，结果表明在评估驾驶适应性时哪些驾驶维度值得仔细研究。在治疗背景下，他们展示了哪些驾驶维度需要更密集的训练。最后，在实际环境中，结果表明交通标志和信号需要优化，以促进和加速它们的感知。