Vol. 145 No. 0708 (2015)
Saccadic eye movement performance as an indicator of driving ability in elderly drivers
- Kai-Uwe Schmitt
- Rolf Seeger
- Hartmut Fischer
- Christian Lanz
- Markus Muser
- Felix Walz
- Urs Schwarz
OBJECTIVE: Regular checking of the fitness to drive of elderly car-license holders is required in some countries, and this will become increasingly important as more countries face aging populations. The present study investigated whether the analysis of saccadic eye movements could be used as a screening method for the assessment of driving ability.
METHODS: Three different paradigms (prosaccades, antisaccades, and visuovisual interactive (VVI) saccades) were used to test saccadic eye movements in 144 participants split into four groups: elderly drivers who came to the attention of road authorities for suspected lack of fitness to drive, a group of elderly drivers who served as a comparison group, a group of neurology patients with established brain lesion diagnoses, and a young comparison group. The group of elderly drivers with suspected deficits in driving skills also underwent a medical examination and a practical on-road driving test. The results of the saccadic eye tests of the different groups were compared.
RESULTS: Antisaccade results indicated a strong link to driving behaviour: elderly drivers who were not fit to drive exhibited a poor performance on the antisaccade task and the performance in the VVI task was also clearly poorer in this group.
CONCLUSIONS: Testing saccadic eye movements appears to be a promising and efficient method for screening large numbers of people such as elderly drivers. This study indicated a link between antisaccade performance and the ability to drive. Hence, measuring saccadic eye movements should be considered as a tool for screening the fitness to drive.
- Fildes BN, Charlton J, Pronk N, Langford J, Oxley J, Koppel S. An Australasian model license reassessment procedure for identifying potentially unsafe drivers. Traffic Injury Prevention. 2008;9(4):350–9.
- Wheatley CJ, Di Stefano M. Individualized assessment of driving fitness for older individuals with health, disability, and age-related concerns. Traffic Injury Prevention. 2008;9(4):320–7.
- Hallett PE. Primary and secondary saccades to goals defined by instructions. Vision Res. 1978;18:1279–96.
- Everling S, Fischer B. The antisaccade: a review of basic research and clinical studies. Neuropsychologia. 1998;36:885–99.
- Schwarz U. Neuroophthalmology: a brief Vademecum. Eur J Radiol. 2004;49(1):31–63.
- Munoz DP, Everling S. Look away: the anti-saccade task and the voluntary control of eye movement. Nat Rev Neurosci. 2004;5(3):218–28.
- Pierrot-Deseilligny C, Rivaud S, Gaymard B, Agid Y. Cortical control of reflexive visually-guided saccades. Brain. 1991;114(Pt 3):1473–85.
- Gaymard B, Ploner CJ, Rivaud S, Vermersch AI, Pierrot D. Cortical control of saccades. Exp Brain Res. 1998;123:159–63.
- Leigh RJ, Kennard C. Using saccades as a research tool in the clinical neurosciences. Brain. 2004;127(3):460–77.
- Pierrot-Deseilligny C, Milea D, Muri RM. Eye movement control by the cerebral cortex. Curr Opin Neurol. 2004;17:17–25.
- Hutton SB. Cognitive control of saccadic eye movements. Brain Cogn. 2008;68(3):327–40.
- Garbutt S, Matlin A, Hellmuth J, Schenk A, Johnson J, Rosen H, et al. Oculomotor function in frontotemporal lobar degeneration, related disorders and Alzheimer's disease. Brain. 2008;131(5):1268–81.
- Anderson T, MacAskill M. Eye movements in patients with neurodegenerative disorders. Nat Rev Neurol. 2013;9:74–85.
- Folstein MF, Folstein SE, McHugh DR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res. 1975;12:189–98.
- Mosimann UP, Bächli-Biétry J, Boll J, Bopp-Kistler I, Donati F, Kressig RW, et al. Konsensusempfehlungen zur Beurteilung der medizinischen Mindestanforderungen für Fahreignung bei kognitiver Beeinträchtigung (Consensus recommendations for the assessment of fitness to drive in cognitively impaired patients). Praxis. 2012;101(7):451–64.
- Collewijn H, van der Mark F, Jansen TC. Precise recording of human eye movements. Vision Res. 1975;15(3):447–50.
- Robinson DA. A method of measuring eye movement using a scleral search coil in a magnetic field. IEEE Trans Biomed Eng. 1963;10:137–45.
- Schmitt KU, Muser MH, Lanz C, Walz F, Schwarz U. Comparing eye movements recorded by search coil and infrared eye tracking. J Clin Monit Comput. 2007;21(1):49–53.
- McDonald J. Handbook of Biological Statistics (3rd ed.). Sparky House Publishing, Baltimore, Maryland. 2014
- Becker W. Metrics. In: Wurtz RH, Goldberg ME, editors. The neurobiology of saccadic eye movements Reviews of oculomotor research Vol 3. New York: Elsevier. 1989;13–67.
- Schwarz U, Baumann K, Ilg U. Influence of global motion onset on goal-directed eye movements. NeuroReport. 2010;21(7):479–84
- Crawford TJ, Higham S, Renvoize T, Patel J, Dale M, Suriya A, et al. Inhibitory control of saccadic eye movements and cognitive impairment in Alzheimer's disease. Biol Psychiatry. 2005;57(9):1052–60.
- Corbetta M, Akbudak E, Conturo TE, Snyder AZ, Ollinger JM, et al. A common network of functional areas for attention and eye movements. Neuron. 1998;21:761–73.
- Sakai H, Takahara M, Honjo NF, Doi S, Sadato N, Uchiyama Y. Regional frontal gray matter volume associated with executive function capacity as a risk factor for vehicle crashes in normal aging adults. PLoS One. 2012;7(9):