Abstract
Driving is an important skill for older adults to maintain an independent lifestyle, and to preserve the quality of life. However, the ability to drive safely in older adults can be compromised by age-related cognitive decline. Performing an additional task during driving (e.g., adjusting the radio) increases cognitive demands and thus might additionally impair driving performance. Cognitive functioning has been shown to be positively related to physical activity/fitness such as cardiovascular and motor coordinative fitness. As such, a higher fitness level might be associated with higher cognitive resources and may therefore benefit driving performance under dual-task conditions. For the first time, the present study investigated whether this association of physical fitness and cognitive functioning causes an indirect relationship between physical fitness and dual-task driving performance through cognitive functions. Data from 120 healthy older adults (age: 69.56 ± 3.62, 53 female) were analyzed. Participants completed tests on cardiovascular fitness (cardiorespiratory capacity), motor coordinative fitness (composite score: static balance, psychomotor speed, bimanual dexterity), and cognitive functions (updating, inhibition, shifting, cognitive processing speed). Further, they performed a virtual car driving scenario where they additionally engaged in cognitively demanding tasks that were modeled after typical real-life activities during driving (typing or reasoning). Structural equation modeling (path analysis) was used to investigate whether cardiovascular and motor coordinative fitness were indirectly associated with lane keeping (i.e., variability in lateral position) and speed control (i.e., average velocity) while dual-task driving via cognitive functions. Both cardiovascular and motor coordinative fitness demonstrated the hypothesized indirect effects on dual-task driving. Motor coordinative fitness showed a significant indirect effect on lane keeping, while cardiovascular fitness demonstrated a trend-level indirect effect on speed control. Moreover, both fitness domains were positively related to different cognitive functions (processing speed and/or updating), and cognitive functions (updating or inhibition), in turn, were related to dual-task driving. These findings indicate that cognitive benefits associated with higher fitness may facilitate driving performance. Given that driving with lower cognitive capacity can result in serious consequences, this study emphasizes the importance for older adults to engage in a physically active lifestyle as it might serve as a preventive measure for driving safety.
Highlights
Driving a car is an essential skill for older adults to preserve mobility and independent living (Owsley, 2002; Musselwhite et al, 2015)
We investigated whether physical fitness is positively associated with driving performance under dual-task conditions by mediation through cognitive functioning in healthy older adults
We chose to analyze driving performance closely after task onset, and we utilized a uniform time window as we were not interested in the specific effects of different tasks or presentation modalities in the current study. We demonstrated that both cardiovascular and motor coordinative fitness are indirectly associated with driving in presence of additional cognitive demands in healthy older persons
Summary
Driving a car is an essential skill for older adults to preserve mobility and independent living (Owsley, 2002; Musselwhite et al, 2015) It has been suggested previously (Anstey et al, 2005; Karthaus and Falkenstein, 2016) that controlling a vehicle affords an effective integration of multiple perceptual (e.g., visual information), motor (e.g., upper and lower limb control), and cognitive functions (e.g., visuospatial skill, attention, cognitive processing speed).
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