Street-Crossing Decision-Making: A Comparison between Patients with Age-Related Macular Degeneration and Normal Vision

Abstract

We determined whether the street-crossing decisions of subjects with age-related macular degeneration (AMD) were as accurate and precise as those made by young and older subjects with normal vision. Street-crossing decisions in 13 AMD subjects, and 20 young and 20 older control subjects with normal vision were measured along an un-signalized street for nine different gap times. After calculating the discriminability (d') of the street-crossing decision variable for all gap pairs and entering these d' values into a one-dimensional scaling model, the means of each distribution of the decision variable relative to a "center of gravity" were estimated and plotted against gap time. The resultant plot was a nonlinear function. Street-crossing decision accuracy was computed for each subject as the difference between the x-intercept of the nonlinear function (t(COG)) and subjects' measured street-crossing time. Street-crossing decision-making precision was computed as the value of the slope of the nonlinear function at t(COG). We found that all subjects were precise in their street-crossing decisions (P = 0.55). Significant differences in street-crossing accuracy were found as a function of age (P = 0.003). Compared to either the older normally-sighted (P = 0.018) or AMD (P = 0.019) subjects, the young normally-sighted subjects made the least accurate street-crossing decisions. No significant difference in accuracy was found between the AMD and age-matched normally-sighted subjects (P = 0.90). Our data suggested that age and mild central vision loss did not affect significantly a subject's precision in their street-crossing decisions. Age, but not mild central vision loss, significantly affected a subject's accuracy in their street-crossing decisions.