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J.A. Brabyn, L.A. Lott, G. Haegerstrom-Portnoy, M.E. Schneck; Night Driving Avoidance and Vision in Old Age: The SKI Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1279.
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Purpose: To assess the relation between driving self-restriction and vision function in an older population with special emphasis on gender differences. Methods: A battery of vision tests was performed binocularly on 753 randomly selected community living older individuals who were current drivers (50% women). The mean age was 73.3 years (range 58-96 yrs). The test battery included several spatial vision measures under conditions of reduced contrast, reduced luminance and in the presence of glare, glare recovery, and standard and attentional visual fields. Driving behavior was evaluated through a questionnaire. Logistic regression analysis was used to test the hypothesis that poor low contrast vision function and/or poor disability glare performance are related to avoiding night driving when controlling for age, cognitive status, depression and number of medical conditions. Results: 28% of women and 14% of men self-restricted their driving to day time. Mean high contrast visual acuity was 20/30 or better for all groups. Drivers who avoided night driving had worse vision function on several measures including disability glare, contrast sensitivity, low contrast acuity and glare recovery. Men who restricted driving had significantly worse vision function than women in the same category. Disability glare performance was the most significant predictor of driving restriction in women, but not in men, consistent with the reported higher prevalence of cataracts in women. Contrast sensitivity predicted driving restriction best in men but not in women. Attentional visual field loss did not contribute independently to self-restriction for either gender in multivariate models. Age remained a significant factor for women but not for men. The odds of driving self-restriction increased by about a factor of two for each doubling of visual threshold for both men and women. Conclusions: Older men with reduced contrast sensitivity and older women with reduced disability glare sensitivity are more likely to avoid night driving. Men appear to require a larger vision loss before restricting driving. Both genders appear unaware of attentional visual field limitations.
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