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Abstract
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OBJECTIVE: To evaluate the epidemiologic association between visual acuity and other measures of visual function and motor vehicle collisions (MVCs) as well as their performance as screening tests for MVCs.
DESIGN: Prospective cohort study. PARTICIPANTS: 2,000 licensed drivers aged 70 years and older who resided in the environs of Jefferson County, Alabama.
METHODS: Visual acuity, contrast sensitivity, Useful Field of View (UFOV), Motor-Free Visual Perception test (MVPT) and visual field sensitivity were measured at a baseline visit. Study participants were followed for up to four years for the occurrence of MVC involvement. Area under the curve (AUC), sensitivity and specificity were calculated to determine the screening performance of each visual function measure with respect to MVC occurrence. Poisson regression was used to estimate rate ratios (RRs) for the association between each visual function measure and MVC occurrence. MAIN OUTCOME MEASURES: Police-reported MVCs.
RESULTS: For all visual function measures, the AUC values were only slightly higher than 0.50; additionally, none of the measures exhibited adequate values for both sensitivity and specificity (i.e., >80%). For all visual function measures except visual acuity, there were statistically significant positive RRs for the association between vision impairment and MVC occurrence, though the magnitude of the associations were weak (i.e., <2.0).
CONCLUSIONS: The negative impact of involuntary driving cessation on mobility and the associated mental health implications likely outweighs the safety benefit of vision screening. Alternative approaches to improving older driver safety should be considered.
Language: en |