Importance: Visual processing speed reaction time is a critical component for fitness-to-drive decisions.
Objective: To examine Vision CoachTM reaction times of medically-at-risk drivers and healthy controls to determine the relationship with outcomes of a comprehensive driving evaluation.
Design: Predictive validity design.
Setting: University research center.
Participants: Of the sample (N = 419), 272 (64.9%) were healthy controls (M age = 49.4 yr, SD = 21.9, range = 21–87) with 196 (72.1%) women, and 147 (35.1%) were medically-at-risk participants (M age = 62.2 yr, SD = 15.7, range = 16–90) with 52 (35.4%) women.
Outcome and Measures: Reaction time was measured in seconds; there was an average of three trials using the full field with 60 random appearing lights.
Results: A significant difference was found between age groups for the healthy controls and the medically-at-risk participants, with no gender main effect or interactions between variables, suggesting that age-related changes and having a medical condition slowed processing speed. The receiver operating characteristic area under the curve scores for the three populations (all medically-at-risk participants, participants 16 to 64 yr old, and participants older than 65 yr) were 0.886, 0.894, and 0.783, respectively, suggesting moderate to good prediction power for fitness to drive.
Conclusions and Relevance: Vision Coach can be used as a screening tool to differentiate between drivers who will likely pass or likely fail a comprehensive driving evaluation and drivers who need further evaluation.
Plain-Language Summary: With the growing number of older adults living longer and with more medical conditions, it is important for occupational therapists to have screening tools to determine fitness to drive. An on-road assessment is the gold standard for determining fitness to drive. However, the number of older adults with cognitive impairment is increasing, which can lead to a decline in processing speed while driving. As processing speed declines, it can take longer for a person to make decisions, which results in increased driving risk. Occupational therapists need a screening tool to assess processing speed, particularly for people with cognitive impairment. In this study we found that the Vision CoachTMdemonstrates good sensitivity and specificity in assessing visual processing speed reaction time as well as determining who will likely pass or fail a comprehensive driving evaluation and who should be referred for further evaluation.
