The relationship between brain structure and function and driving performance in older adults with and without cognitive impairment: A systematic review

IF 3.5 2区工程技术 Q1 PSYCHOLOGY, APPLIED

Transportation Research Part F-Traffic Psychology and Behaviour Pub Date : 2025-02-01 DOI:10.1016/j.trf.2025.01.036

Sophie Branch , Nicole Espinosa , Andrew McKinnon , Joanne M. Bennett

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引用次数: 0

Abstract

Background

Cognitive deficits in older people are known to affect driving behaviours, however cognitive testing alone does not reliably distinguish safe from unsafe drivers. Research investigating alterations in key brain regions underpinning cognitive performance across cognitive domains may provide crucial additional evidence for fitness-to-drive assessments for older people both with and without cognitive decline.

Objective

This review synthesised studies that examined relationships between brain structure, function, and driving performance in older drivers with and without cognitive decline. We aimed to explore how changes in key brain regions that support cognitive performance across various domains may provide additional, critical evidence to improve fitness-to-drive assessments in this population.

Data sources: Published studies on Medline, PsycInfo, and Scopus as of October 2023 were examined in this review.

Results

Twenty studies were included, 14 for participants without cognitive impairment (CI) and six for participants with CI. Alterations in brain structure and function were differentially related to driving depending on whether or not participants had CI, as well as which driving behaviours were measured. Prefrontal cortical integrity, as well as hippocampal integrity demonstrated the most consistent relationship with driving for older drivers without CI. In those with CI, alterations in frontal, and parietal regions, as well as changes at the whole-brain level were most consistently related to driving performance. Errors emerged as the driving behaviour most consistently related to differences in brain structure and function across both groups.

Limitations: This review was limited to English language and peer-reviewed papers which potentially introduced bias.

Conclusions

Relationships between brain alterations and driving varied dependent on the presence of CI. Given that the extant literature is sparse, further investigations are warranted to confirm the key brain differences that reliably delineate these cognitive groups. Such findings would be invaluable for enhancing fitness-to-drive assessments for older adults by incorporating more precise neurobiological markers into evaluation protocols. Additionally, this field of study would benefit from the inclusion of other imaging techniques, such as diffusion-weighted imaging (DWI), which offers insights into white matter integrity and microstructural changes that other imaging techniques do not capture. Future investigations should also focus on specific driving behaviours, such as errors, and utilise validated measures for anatomy and driving.

Implications: Brain-based data could add reliable cumulative evidence to fitness-to-drive assessments and improve road safety for all road users.

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来源期刊

Transportation Research Part F-Traffic Psychology and Behaviour Multiple-

CiteScore

7.60

自引率

14.60%

发文量

239

审稿时长

71 days

期刊介绍： Transportation Research Part F: Traffic Psychology and Behaviour focuses on the behavioural and psychological aspects of traffic and transport. The aim of the journal is to enhance theory development, improve the quality of empirical studies and to stimulate the application of research findings in practice. TRF provides a focus and a means of communication for the considerable amount of research activities that are now being carried out in this field. The journal provides a forum for transportation researchers, psychologists, ergonomists, engineers and policy-makers with an interest in traffic and transport psychology.