In-vehicle navigation systems (IVNS) have the potential to benefit older drivers, reducing stress associated with way-finding and providing on-trip support, especially in unfamiliar locations. However, existing IVNS present challenges to usability, resulting in lack of uptake and over-reliance on pre-trip planning. This paper presents research aimed at identifying features that make IVNS user-friendly and appropriate for older drivers. Studying navigational performance within a simulated driving environment, it focuses on the use of landmarks with route guidance information, and the most appropriate method of information provision (audio only, visual only or a combination of audio and visual). It also assesses potential gender differences that might arise with landmark-based navigational information. Solutions include use of appropriate roadside landmarks, and information delivered through a combination of audio and icon-based visual format. These features result in lower workload and fewer navigational errors. The audio/visual modality reduces the hazard of distraction by landmarks resulting in fewer visual glances and lower glance duration to the roadside compared to other modalities. Design and provision of IVNS tailored to older drivers’ needs can make a considerable contribution to maintaining individual mobility for longer.

This research sought to understand the relationship between licensing policy and the opportunity for the development of a scientifically-based approach to identifying high risk older drivers based on prior driving history. This research focused on five tasks: 1) review of the literature, 2) compilation of information on licensing policy for use by decision-makers, 3) assessment of charges and payer source for older driver crashes using linked crash and hospital data , and 4) the development and 5) validation of an older driver crash prediction model. There is relatively little available in the way of information for policymakers regarding licensing, and there is even less information available on evaluation of licensing practice effectiveness. Emergency department charges for older males were lower than females even though males accounted for a larger percentage of the injured population. Older drivers were no more likely to be covered by public insurance than the comparison group. Crash and citation data used to develop a driver history showed no differences between drivers in injury causing crashes and drivers in non-injury crashes. Logistic regression, Poisson regression, and negative binomial regression models were unable to effectively predict crash involvement based on driver history. This is likely due to self-selection bias for older drivers and truncated distribution of count variable (injury causing crashes). Recommendations resulting from this research include Massachusetts and national policy recommendations and additional research. Massachusetts should expand beyond its referral-based system for reviewing older drivers, consider restriction rather than only revocation, review medical advisory board practices, conduct evaluation of any policies it does implement, and conduct a thorough review of alternative transportation options. Nationally, efforts should focus on developing effective cognitive/functional testing by licensing agents, identification of effective second phase of testing, determination of a mechanism for determining when to retest, and assessment of the differences between older males and females for potential use in training, education, and testing. Research recommendations include continued exploration of the potential for systematic identification of high risk drivers using administrative data and in-depth analyses of the differences between males and females in terms of aging and driver safety.

Les manoeuvres de stationnement représentent une difficulté pour les conducteurs âgés. De ce fait, elles font partie des situations de conduite les plus évitées chez les séniors. L'étude s'intéresse aux difficultés et aux besoins des conducteurs âgés lors des manoeuvres à basses vitesses. Premièrement, une enquête s'intéressant aux différents aspects de l'activité de stationnement sera réalisée auprès des conducteurs âgés du Rhône. Ensuite, la gestion de ressources cognitives chez le conducteur manoeuvrant sera étudiée dans une série d'expériences avec les différents types de manoeuvres de stationnement. Pour ce faire, des places de stationnement de configuration modifiable seront aménagées dans un parking, et les manoeuvres seront effectuées par les participants. L'étude s'intéresse plus particulièrement à la gestion de la ballance saillance-pertinence lors de l'exploration visuelle de l'environnement du parking. Les informations ainsi obtenues devraient contribuer à la conception des systèmes d'aide aux manoeuvres adaptés aux seniors. / One cannot imagine driving without parking manoeuvres since they mark the beginning and the end of each trip. However, physiological and cognitive decline with ageing can increase the difficulty of parking manoeuvring. Our study is organized in two stages. Firstly, a postal survey investigated the parking behaviour among seniors. It provided information about parking habits, needs and difficulties of older drivers. An approach based on Manchester Driving Behaviour Questionnaire lead us to classify four types of parking errors. We also identified factors contributing to the difficulty of parking manoeuvring.Secondly, we studied parking manoeuvring with experimental vehicle and in a driving simulator. In order to examine attentional processes during manoeuvres, we used the MAM model of attention. The salience and the relevance of elements present in the parking were modified. Parking performance was also examined in relation to drivers’ age and their attentional and visual abilities. The salience and the relevance of parking environments interacted with driver’s age and the extent of their total, peripheral and attentional field of view. Drivers with restricted total, peripheral field or attentional field of view can meet more difficulty during manoeuvres when they must share their attention in complex parking environment. A highly salient obstacle can be more easily detected by these drivers. In the presence of a pedestrian, the difficulty of manoeuvring can increase among drivers with restricted total, peripheral field or attentional field of view and decrease among drivers without such restriction. Further research should provide more information on strategies adopted by older drivers during manoeuvring.

Introduction: Multiple studies have shown the symptoms of Parkinson's disease (PD) can impair driving performance. Studies have also found elevated crash rates in drivers with PD, however, none have controlled for exposure or amount of driving. Although a few studies have suggested that drivers with PD may self-regulate (e.g., by reducing exposure or avoiding challenging situations), findings were based on self-report data. Studies with healthy older drivers have shown that objective driving data is more accurate than self-estimates. Purposes: The primary objectives of this study were to examine whether drivers with PD restrict their driving (exposure and patterns) relative to an age-matched control group and explore possible reasons for such restrictions: trip purposes, perceptions of driving comfort and abilities, as well as depression, disease severity and symptoms associated with PD. Methods: A convenience sample of 27 drivers with PD (mean 71.6±6.6, range 57 to 82, 78% men) and 20 age-matched control drivers from the same region (70.6±7.9, range 57 to 84, 80% men) were assessed between October 2009 and August 2010. Driving data was collected for two weeks using two electronic devices (one with GPS) installed in each person‟s vehicle. Participants completed trip logs, questionnaires on background and usual driving habits, and measures of cognitive functioning, depression, quality of life, daytime sleepiness, driving comfort and abilities. Contrast sensitivity and brake response time were also assessed. Severity of PD was assessed using the Unified Parkinson‟s Disease Rating Scale (UPDRS) motor scores. An interview was conducted at the end of the second assessment to examine influence of the devices, driving problems and any departures from usual patterns over the monitoring period. Results: Of the 128 PD patients screened for possible study participation, 35% had already stopped driving. Former drivers were older, more likely to be women and had poorer UPDRS motor scores. Only 48% of those who were eligible for the study agreed to participate. Compared to controls, the PD group had significantly slower brake response times, higher depression and quality of life scores, less comfort driving at night and poorer perceptions of their driving abilities. The PD group also had significantly lower cognitive functioning scores than controls, and a significantly greater proportion (74% versus 45%) were classified as having mild cognitive impairment. Compared to vehicle recordings, both groups mis-estimated the amount they drove over two weeks (measurement error was 94 km for the PD group and 210 km for the controls). The PD group drove significantly less overall (days, trips, distance and duration), at night, on week-ends and in bad weather and for different purposes. Four of the PD drivers had minor accidents over the two weeks, while one lost his license. Conclusions: Self-estimates of exposure were inaccurate warranting the continued use of objective driving data. Overall, the findings suggest that drivers with PD appear to restrict their driving exposure and patterns relative to controls. The PD group were more likely to combine several activities into one trip, possibly due to fatigue. Moreover, they were more likely than controls to drive for medical appointments and less likely to drive for leisure activities and make out of town trips. The findings need to be replicated with larger samples and longer monitoring periods to examine changes in self-regulatory practices associated with disease progression and symptomatology. Other researchers are also likely to have similar difficulty in recruiting drivers with PD as this group may quit driving at an earlier age and those who are still driving are fearful of being reported to licensing authorities. Future studies also need to screen for cognitive impairment which often goes undetected, particularly in otherwise healthy drivers.

Introduction: Multiple studies have shown the symptoms of Parkinson's disease (PD) can impair driving performance. Studies have also found elevated crash rates in drivers with PD, however, none have controlled for exposure or amount of driving. Although a few studies have suggested that drivers with PD may self-regulate (e.g., by reducing exposure or avoiding challenging situations), findings were based on self-report data. Studies with healthy older drivers have shown that objective driving data is more accurate than self-estimates. Purposes: The primary objectives of this study were to examine whether drivers with PD restrict their driving (exposure and patterns) relative to an age-matched control group and explore possible reasons for such restrictions: trip purposes, perceptions of driving comfort and abilities, as well as depression, disease severity and symptoms associated with PD. Methods: A convenience sample of 27 drivers with PD (mean 71.6±6.6, range 57 to 82, 78% men) and 20 age-matched control drivers from the same region (70.6±7.9, range 57 to 84, 80% men) were assessed between October 2009 and August 2010. Driving data was collected for two weeks using two electronic devices (one with GPS) installed in each person‟s vehicle. Participants completed trip logs, questionnaires on background and usual driving habits, and measures of cognitive functioning, depression, quality of life, daytime sleepiness, driving comfort and abilities. Contrast sensitivity and brake response time were also assessed. Severity of PD was assessed using the Unified Parkinson‟s Disease Rating Scale (UPDRS) motor scores. An interview was conducted at the end of the second assessment to examine influence of the devices, driving problems and any departures from usual patterns over the monitoring period. Results: Of the 128 PD patients screened for possible study participation, 35% had already stopped driving. Former drivers were older, more likely to be women and had poorer UPDRS motor scores. Only 48% of those who were eligible for the study agreed to participate. Compared to controls, the PD group had significantly slower brake response times, higher depression and quality of life scores, less comfort driving at night and poorer perceptions of their driving abilities. The PD group also had significantly lower cognitive functioning scores than controls, and a significantly greater proportion (74% versus 45%) were classified as having mild cognitive impairment. Compared to vehicle recordings, both groups mis-estimated the amount they drove over two weeks (measurement error was 94 km for the PD group and 210 km for the controls). The PD group drove significantly less overall (days, trips, distance and duration), at night, on week-ends and in bad weather and for different purposes. Four of the PD drivers had minor accidents over the two weeks, while one lost his license. Conclusions: Self-estimates of exposure were inaccurate warranting the continued use of objective driving data. Overall, the findings suggest that drivers with PD appear to restrict their driving exposure and patterns relative to controls. The PD group were more likely to combine several activities into one trip, possibly due to fatigue. Moreover, they were more likely than controls to drive for medical appointments and less likely to drive for leisure activities and make out of town trips. The findings need to be replicated with larger samples and longer monitoring periods to examine changes in self-regulatory practices associated with disease progression and symptomatology. Other researchers are also likely to have similar difficulty in recruiting drivers with PD as this group may quit driving at an earlier age and those who are still driving are fearful of being reported to licensing authorities. Future studies also need to screen for cognitive impairment which often goes undetected, particularly in otherwise healthy drivers.

Railway level crossing collisions in Australia are a major cause of concern for both rail and road authorities. Despite the fact that the number of railway crash fatalities in Australia has fallen in recent years, level crossing collisions constitute a significant proportion of the national rail toll. Although rail transport is presently one of the safest forms of land transport, collisions at level crossings are three times more likely to involve fatalities as compared to all other types of road crashes (Afxentis, 1994). With many level crossing fatalities and injuries resulting in coronial inquests, litigation and negative media publicity, the actions of rail and road infrastructure providers and the behaviour of motorists, pedestrians and rail users, come under close scrutiny. Historically, research in this area has been plagued by the rail/road interface and the separation of responsibilities between rail and road authorities reflecting the social and political context in which they are contained. With the recent rail reform in Australia, safety at level crossings has become a key priority area. Accordingly, there is a need to better understand the scope and nature of motorist behaviour at level crossings, in order to develop and implement more effective countermeasures for unsafe driving behaviour. However, a number of obstacles have hindered research into the area of level crossing safety. As with many road crashes, the contributing causes and factors are often difficult to determine, however a recent investigation of fatal collisions at level crossings supports the notion that human fault is a major contributor (Australian Transport Safety Bureau, 2002a). Additionally, there is a lack of reliable data available relating to the behavioural characteristics and perceptions of drivers at level crossings. Studies that do exist have lacked a strong theoretical base to guide the interpretation of results. Due to the lack of financial viability of continuing to approach risk management from an engineering perspective, the merits of human factor research need to be examined for suitability. In Australia, there has been considerable recognition regarding the importance of human factor approaches to level crossing safety (Australian Transport Council, 2003). However, little attempt has been made by authorities to scientifically develop and measure the effectiveness of road safety educational interventions. Therefore, there exists a significant need for developing targeted road safety educational interventions to improve current risk management solutions at level crossings. This research program is the first of its kind in investigating motorist behaviour at level crossings and the measuring the effectiveness of educational interventions for improving driving safety. Although other ‘educational’ campaigns exist in this field, no campaign or intervention has been guided by empirical research or theory. This thesis adopted a multidisciplinary approach to theory, reviewing perspectives from psychology, sociology and public health to explain driver behaviour at level crossings. This array of perspectives is necessary due to the variety of behaviours involved in collisions and near-misses at level crossings. The motivation underlying motorist behaviour determines to a large extent how successful behaviour change strategies (e.g. educational interventions) may be. Fishbein’s Integrated Model of Behaviour Change (IM) based largely on the health belief model, theory of reasoned action and theory of planned behaviour (Fishbein, 2000), assisted in the planning and development of a ‘oneoff’ targeted educational intervention specific for three different road user groups and in questionnaire development to ascertain the present context of motorist behaviour at level crossings. As no known research has been conducted that utilizes any psychosocial model to explain or predict level crossing behavior within different road user groups, this research program used this model as an exploratory tool rather than a tool to asses the model’s capacity in explaining such behaviour. The difference between this model and others is the inclusion of two important constructs in driving: skills (or abilities) and environmental factors. Fishbein (2003) suggests that the model recognises the lack of skills (or abilities) and/or environmental constraints may prevent a person from acting on their intentions, in light of the fact that intention is viewed as the primary determinant of behaviour. While the majority of behaviour change theories are limited by a range of conceptual and contextual factors (Parker, 2004), the IM was used to assist this research program as it appeared to be the most applicable model to examining level crossing safety. A variety of data collection methods were used in this research program as much of what is currently known about level crossing collisions is derived from coroner’s findings and statistics. The first study (Study One) was designed to extend this knowledge by undertaking a more thorough examination of contributing factors to level crossing crashes and the road user groups at risk. This study used the method of ‘triangulation’ (i.e. combining research methods to give a range of perspectives) whereby both qualitative (focus groups) and quantitative (modified Delphi technique) research designs were utilised (Barbour, 1999, Bryman, 1992). With the discipline of road safety research requiring methodological strategies that will enhance efforts to conceptualise the multi-faceted nature of motorist behaviour at level crossings, this application provided the robustness required. Results from the Delphi technique indicated that older, younger and heavy vehicle drivers are considered to be three of the highest risk road user groups by experts in the field. For the older driver group, experts agreed that errors in judgment were the most important issue for this group when driving at level crossings. Risk taking by younger drivers, such as trying to beat the train across the crossing, was viewed as the central issue for the younger driver group. Like the younger driver group, a concern by experts with the heavy vehicle group was intentional risk taking at level crossings. However, experts also rated the length of heavy vehicles a major concern due to the possibility of a truck over-hanging a crossing. Results from focus groups with train drivers in Study One indicated that there are unique problems associated with crossings in rural/regional areas compared to urban areas. The metropolitan train drivers generally experienced motorist behaviour at active crossings with flashing lights and boom gates while the regional train drivers experienced behaviours at active crossings with boom gates, crossings with lights only and passive crossings with stationary signs. In the metropolitan train driver group, experiences of motorist behaviour at level crossings included: motorists driving around boom gates, getting stuck under boom gates, queuing over congested crossings and driving through the crossing after the red lights commence flashing. The behaviour of motorists driving around boom gates was noted to occur quite regularly. The majority of metropolitan train drivers reported that it was a common occurrence for motorists to drive through a crossing when the lights are flashing both before and after the booms were activated and some crossings were named as ‘black spots’ (locations where motorists repeatedly violate the road rules). Vehicles protruding into the path of the train and motorists entering congested crossings and then panicking and driving backwards into the boom gates were also mentioned. Regional train drivers indicated that motorists not stopping or giving way to trains is a continual problem at passively controlled crossings (i.e. no boom gates or flashing lights). Regional train drivers generally agreed that the majority of motorists obey protection systems; however some motorists drive through flashing lights or drive around boom gates. Other high risk behaviours included motorists attempting to beat the train across the crossing, speeding up to go through flashing lights, and general risk taking by younger drivers in particular. Motorists not allowing enough time to cross in front of the train or hesitating (stopstarting) at crossings were also noted to be at high risk. There was a general perception by regional train drivers that motorists are unable to judge the speed and distance of an approaching train to determine a safe gap during which to cross. Local motorists were also reported to be a problem at level crossings for regional train drivers. A theme common to regional and metropolitan train drivers was the risk of catastrophic consequence associated with level crossing collisions. The reasons given for this were the threat of derailment, serious property damage, the high risk of a fatality, personal injury and, most earnestly, the potential for enduring psychological consequences. Drivers uniformly spoke about the continual fear they had of being involved in a collision with a heavy vehicle, and many spoke of the effects that such collisions had on train drivers involved. For this reason, train drivers were said to consider any near-miss incident involving trucks particularly serious. The second study undertaken as part of this research program (Study Two), involved formative research as part of the planning, development and delivery of behavioural interventions for each of the three road user groups identified in Study One. This study also used both qualitative and quantitative data collection methods to provide methodological triangulation and ensure reliability of the data. The overall objective of the qualitative data collection was to obtain rich data using a qualitative mode of inquiry, based on the key variables of attitudes, norms, self-efficacy (perceived behavioural control), perceived risk, environmental constraints and the skills/abilities of drivers. The overall objective of the quantitative data collection was to prioritise the issues identified in order to direct and allocate project resources for intervention planning, development and delivery. This combined recruitment strategy was adopted as it was an appropriate and practical data collection strategy within the qualitative and exploration methodology. Information obtained from each of the groups was critical in assisting, guiding, and identifying priority areas for message and material development. The use of focus groups and one-on-one interviews provided insights into why drivers think or do what they do at level crossings. The qualitative component of this study found that for the older driver group, regional drivers hold a greater perception of risk at level crossings than urban older drivers, with many recalling near-misses. Participants from the urban older driver group indicated that level crossings are not as dangerous as other aspects of driving, with many participants being doubtful that motorists are killed while driving at level crossings. Both urban and regional younger drivers tended to hold a low perception of risk for driving at level crossings, however many participants reported having great difficulty in judging the distance a train is from a crossing. Impatience for waiting at level crossings was reported to be the major reason for any risk taking at level crossings in the younger driver group. Complacency and distraction were viewed by heavy vehicle participants as two of the major driver factors that put them at risk at level crossings, while short-stacking (when the trailer of the truck extends onto the crossing), angle of approach (acute or obtuse angle) and lack of advance warning systems were seen as the major engineering problems for driving a truck at level crossings. The quantitative component of this study involving research with train drivers found that at the aggregate train driver level, it is apparent that train drivers consider motorists’ deliberate violations of the road rules and negligently lax approach to hazard detection as the predominant causes of dangerous driving at level crossings. Experts were observed to rank risk taking behaviours slightly lower than train drivers, although they agreed with train drivers that ‘trying to beat the train’ is the single most critical risk taking behaviour observed by motorists. The third study (Study Three) involved three parts. The aim of Part One of this study was to develop targeted interventions specific to each of the three road user groups by using Fishbein’s theoretical model (Integrated Model of Behaviour Change) as a guide. The development of interventions was originally seen as being outside of the scope of this project, however it became intertwined in questionnaire development and thus deemed to be within the realms of the current mode of inquiry. The interventions were designed in the format of a pilot radio road safety advertisement, as this medium was found to be one of the most acceptable to each of the road user groups as identified in the formative research undertaken in Study Two. The interventions were used as a ‘one-off’ awareness raising intervention for each road user group. Part Two involved the investigation of the present context of unsafe driving behaviour at level crossings. This second part involved the examination of the present context of motorist behaviour at level crossings using key constructs from Fishbein’s Integrated Model of Behaviour Change (IM). Part Three involved trialing a pilot road safety radio advertisement using an intervention and control methodology. This part investigated the changes in pre and post-test constructs including intentions, self-reported behaviour, attitudes, norms, selfefficacy/ perceived behaviour control, perceived risks, environment constraints and skills/ability. Results from this third study indicated that younger drivers recognise that level crossings are potentially a highly dangerous intersection yet are still likely to engage in risk taking behaviours. Additionally, their low levels of self-efficacy in driving at level crossings pose challenges for developing interventions with this age group. For the older driver sample, this research confirms the high prevalence of functional impairments such as increasing trouble adjusting to glare and night-time driving, restricted range of motion to their neck and substantial declines in their hearing. While factors contributing to the over-representation of older drivers in collisions at level crossings are likely to be complex and multi-faceted, such functional impairments are expected to play a critical role. The majority of heavy vehicle drivers reported driving safely and intending to drive safely in the future, however, there is a sub-set of drivers that indicate they have in the past and will in the future take risks when traversing crossings. Although this sub-set is relatively small, if generalised to the larger trucking industry it could be problematic for the rail sector and greater public alike. Familiarity was a common factor that was found to play a role in driving intention at level crossings for all three road user groups. This finding supports previous research conducted by Wigglesworth during the 1970’s in Australia (Wigglesworth, 1979). Taken together, the results of the three studies in this research program have a number of implications for level crossing safety in Australia. Although the ultimate goal to improve level crossing safety for all motorists would be to have a combination of engineering, education and enforcement countermeasures, the small number of fatalities in comparison to the national road toll limits this. It must be noted though that the likelihood of creating behavioural change would be increased if risk taking at level crossings by all motorists was detected and penalised, or alternatively, if perceptions of such detection were increased. The instilling of fear in drivers with the threat of punishment via some form of sanction can only be achieved through a combination of a mass media campaign and increasing police presence. Ideally, the aim would be to combine fear of punishment with the guilt associated with the social non-acceptability of disobeying road rules at level crossings. Such findings have direct implications for improving the present context of motorist behaviour at level crossings throughout Australia.

L’insécurité routière chez les conducteurs âgés est attribuable en partie, aux effets délétères du vieillissement normal sur le fonctionnement cognitif. Les méthodes d’évaluation neuropsychologique par les tests ayant montré une certaine efficacité dans le cas du dépistage des habiletés de conduite chez les conducteurs âgés atteints d’affections neurologiques pathologiques, la présente thèse vise à évaluer la pertinence de cette approche chez les conducteurs vieillissants de la population générale. Le principal objectif de cette thèse est ainsi d’obtenir une vue d’ensemble sur le rôle et la sensibilité des mesures neuropsychologiques dans la prédiction des habiletés et habitudes de conduite automobile sécuritaire chez les conducteurs âgés. Dans la même perspective, la thèse explore d’autre part le rôle de variables sociodémographiques et psychologiques. L’article 1 évalue la validité prédictive de sept tests des fonctions visuo-attentionnelles et de la mémoire de travail en regard des habiletés de détection périphérique chez 50 conducteurs âgés de 62 à 83 ans. L’étude sur simulateur de conduite comprend une condition de conduite simple et une condition plus soutenue incluant une distraction téléphonique de type « mains-libres ». Selon les résultats, certains tests cognitifs prédisent bien les temps de détection. En outre, la validité prédictive des tests est plus importante dans la situation de conduite plus exigeante. Cela dit, les résultats de l’article 2 révèlent que le recours aux stratégies d’évitement des situations exigeantes est plus prononcé chez les individus qui présentent des faiblesses à certains des tests neuropsychologiques proposés. Les résultats indiquent en outre que l’utilisation des stratégies d’évitement routier est plus fréquente chez les conducteurs ayant tendance à déprécier leurs habiletés de conduite générales, à exprimer une moindre perception de contrôle ainsi qu’une attitude défavorable à l’endroit des situations de conduite complexes ou risquées. Les stratégies d’évitement se révèlent donc comme des réponses autorégulatrices proportionnelles aux limitations cognitives et aux perceptions individuelles. Dans les deux études, l’âge ne permet pas d’expliquer les différences individuelles, ceci ni en termes d’habiletés de détection périphérique ni de tendances autorégulatrices. Le rôle du genre est cependant plus nuancé. Ainsi, le principal apport de la présente thèse réside dans la constatation que si d’une part, certaines limitations neuropsychologiques sont associées à une réduction des habiletés de détection périphérique, ces mêmes limitations s’accompagnent aussi de mesures autorégulatrices qui peuvent contribuer à réduire le risque routier. Il appert conséquemment que les méthodes de dépistage de l’insécurité routière chez les conducteurs âgés se basant sur l’évaluation des limitations cognitives et attentionnelles doivent également rechercher et évaluer la teneur de leurs comportements routiers autorégulateurs. Dans le contexte de vieillissement de la population, des interventions pourront également miser sur le renforcement de ces comportements. / The increase of crash rates in elderly population can be attributed in some part to the effects of normal aging on cognitive functioning. In the other hand, older drivers are likely to adopt self-regulated driving behaviours, such as driving habits to restrict their exposure to less complex situations. Neuropsychological assessments have shown some efficacy in the field of fitness-to-drive screening of older drivers suffering from neurological disorders. This thesis aims to assess the relevance of clinical neuropsychology in screening methods considering older drivers population. The main goal is thus to study the contribution and the sensitivity of neuropsychological testing in the prediction of skills and habits of safe driving among older drivers. In the same vein, the thesis investigates the role of other socio-demographic and psychological variables. To this end, article 1 evaluates the predictive validity of seven tests of visuo-attentional functions and working memory efficiency in relation to peripheral detection task performances in 50 drivers aged from 62 to 83 years in a simulated car driving environment. The driving simulation consisted of a simple driving condition and a condition including a "hands-free" cell phone distraction task. The results indicate that some neuropsychological tests, as opposed to age, are good predictors of detection performances. In addition, the predictive validity of the tests is more important in the most challenging driving condition. The Corsi Block Tapping test, assessing visuospatial working memory, is revealed as on of the best predictor of detection skills. Article 2 was carried from previous neuropsychological testing and self-administered questionnaires related to avoidance driving behaviours, drivers perceptions and attitudes. The results indicate that individuals who show higher difficulties in tests assessing visuospatial working memory, processing speed, and divided and selective attention capacities are significantly more likely to adopt avoidance driving strategies. The results also demonstrate that driving avoidance is higher among drivers who tend to depreciate their general driving skills, to express a lower perception of control and an unfavourable attitude towards risky driving. Avoidance strategies are thus proven to be self-regulatory responses which are proportionate to cognitive limitations and individual perceptions. In summary, this thesis demonstrates that peripheral detection performances of older drivers in a simulated car study, are well reflected in neuropsychological testing assessing working memory and other attentional abilities. Since detection skills are crucial for driving safety, an indirect link can be established between neuropsychological measures and road safety among older drivers. It also seems that those drivers, who have greater cognitive limitations, are more likely to avoid challenging driving situations, thereby balancing their crash risk. It is concluded that fitness-to-drive assessments based on neuropsychological screening need to be complemented with the assessment of self-regulatory behaviors. In the context of an aging population, new interventions should focus on strengthening self-regulatory behaviors of older drivers.

Driving a motor vehicle is a complex activity, and errors in performing the driving task can result in crashes which cause property damage, injuries, and sometimes death. It is important that the road environment supports drivers in safe performance of the driving task. At present, increasing amounts of visual information from sources such as roadside advertising create visual clutter in the road environment. There has been little research on the effect of this visual clutter on driving performance, particularly for vulnerable groups such as novice and older drivers. The present work aims to fill this gap. Literature from a variety of relevant disciplines was surveyed and integrated, and a model of the mechanisms by which visual clutter could affect performance of the driving task was developed. To determine potential sources of clutter, focus groups with drivers were held and two studies involving subjective ratings of visual clutter in photographs and video clips of road environments were carried out. This resulted in a taxonomy of visual clutter in the road environment: ‘situational clutter’, including vehicles and other road users with whom drivers interact; ‘designed clutter’, including road signs, signals, and markings used by traffic authorities to communicate with users; and ‘built clutter’, including roadside development and any signage not originating from a road authority. The taxonomy of visual clutter was tested using the change detection paradigm. Drivers were slower to detect changes in photographs of road scenes with high levels of visual clutter than with low levels, and slower for road scenes including advertising billboards than road scenes without billboards. Finally, the effects of billboard presence and lead vehicles on vehicle control, eye movements and responses to traffic signs and signals were tested using a driving simulator. The number of vehicles included appeared to be insufficient to create situational clutter. However billboards had significant effects on driver speed (slower), ability to follow directions on road signs (slower with more errors), and eye movements (increased amount of time fixating on roadsides at the expense of scanning the road ahead). Older drivers were particularly affected by visual clutter in both the change detection and simulated driving tasks. Results are discussed in terms of implications for future research and for road safety practitioners. Visual clutter can affect driver workload as well as purely visual aspects of the driving task (such as hazard perception and search for road signs). When driver workload is increased past a certain point other driving tasks will also be performed less well (such as speed maintenance). Advertising billboards in particular cause visual distraction, and should be considered at a similar level of potential danger as visual distraction from in-vehicle devices. The consequences of roadside visual clutter are more severe for the growing demographic of older drivers. Currently, road environments do not support drivers (particularly older drivers) as well as they could. Based on the results, guidance is given for road authorities to improve this status when designing and location road signage and approving roadside advertising.

The objective of this study is to analyse the formation of older and ageing drivers in Swedish transportation policy. Documents from the Swedish Government, the Riksdag and, in a few cases, public authorities and newspapers are analysed. The discourse-analytical framework is inspired by Foucault’s archaeology, which is used as a tool box. The study identifies/constructs three periods in the formation of older and ageing drivers. In the first period (1934–1967) there is a discursive gap between statements about driver selection and traffic safety. Driving in ‘old age’ is a problem for medical expertise and mandatory tests are proposed. The proposals are rejected, as older people’s driving is not a problem in the discourse of traffic safety. In the second period (1967–1991) ‘older drivers’ is made up as a category of interest. ‘Older drivers’ become an accident population in the discourse of traffic safety due to changes in statistical practices. In the third period (1991–2006) a discourse of older peo-ple’s mobility is appearing alongside the discourses of traffic safety and driver selection. Moreover, the study traces how the statements of older and ageing drivers are ordered by more general ideas of the aged and ageing. Double discourses of ageing are followed by a dichotomisation in ‘healthy’ and ‘sick older drivers’ in the 1990s. The idea of an abrupt exit in old age alters to a more gradual exit, in its turn followed by challenging the very idea of exit.

Maintaining independence is a primary reason that many older drivers continue to drive. Safety, however, is a growing concern for all older drivers. Numerous studies have noted that many older drivers lack an awareness of their driving abilities and driving safety issues for older adults. Identifying the awareness level of older drivers from a theoretical standpoint is important. The current educational interventions for older drivers show promising results and suggest that educational programs can impact older driver knowledge, self-reported awareness, and behaviours. However, rarely have older drivers with cognitive deficits been included. This research study fills a gap in the current literature regarding the utility of a theoretically-based intervention program to increase older driver awareness, improve attitudes towards driving, and increase behaviours around older driver safety. The purpose of this research study was to develop, pilot, and examine the effectiveness of a novel, theoretically based, in-class education program entitled “Safety Awareness for Elderly Drivers” (SAFE) for older drivers both with and without cognitive impairment. The SAFE education program was based on five relevant models/theories: 1) Driving as an Everyday Competence, 2) Hierarchical Awareness Theory, 3) Toglia & Kirk’s Awareness Model, 4) Theory of Planned Behaviour, and 5) Transtheoretical Model. A convenience sample of 47 current older drivers aged 70 years or older currently contemplating changing their driving behaviours and their passengers were recruited and randomly assigned. Participants in the intervention group received the group education session, while those in the treatment as usual control group received a copy of the Insurance Board of British Columbia’s “Roadsense for Driver’s” handbook. We measured general knowledge, awareness of individual driving abilities, attitudes, intention to change driving behaviours, driving behaviours, and readiness to change before, immediately after the intervention (intervention group only), and at 2-month follow-up. Results indicated that the “Safety Awareness for Elderly Drivers” education program was well received by older drivers. The education program demonstrated immediate impacts, such as increased knowledge of older driver safety issues (general level awareness), increased individual awareness, and some changes in attitude and intentions toward changing driving behaviours. Older drivers with mild cognitive impairment showed similar benefits from the education program. However, the program did not appear to be more effective than the review of a drivers handbook available though ICBC in follow-up, with most follow-up measures being similar to baseline. Implications of this research and further research suggestions for older drivers are discussed.