Useful Field Of View Research Articles

A - 12 Neuropsychological Test Best Fit for Identifying on-the-Road Driving Behaviors in Normal and Abnormal Aging Populations: a Systematic Review

Abstract Objective This systematic review’s purpose is to identify neuropsychological assessments that are accurate at predicting driving behaviors in geriatric populations. The population included normal aging, mild cognitive impairment (MCI), and dementia. Data Selection PubMed and APA PsycNet databases were searched using two separate keyword searches: cognitive evaluation and driving behaviors and aging; neuropsychological test and driving behaviors and aging. The databases were searched March 10, 2024, and again on April 26, 2024. This yielded 278 articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to identify articles. Articles were excluded if they did not have on-road driving behaviors or simulated driving behaviors, neuropsychological test, if the average participant age was not geriatric, or if it was a non-peer reviewed article. Data Synthesis After following PRISMA selections, eight articles were included, creating a combined sample size of 927 (Mean age = 74.16, SD = 2.38; mean years of education = 14.17, SD = 1.09; female percentage = 40.78). The test deemed most correlated were Neuropsychological Assessment Battery: Driving Scene Test, Clock Drawing, Useful Field of View, Trail making task, Mini-Mental State Exam, verbal and visual memory components from the Wechsler Memory Scale, Rey-Osterrieth Complex Figure, and Maze Navigation Task. Conclusion General cognitive screening tests as well as visuomotor, visual–spatial, visual attention and verbal and non-verbal memory tests highly correlate with real driving behaviors and accurately predict on-the-road driving behaviors. This indicates the cognitive and behavioral complexity of driving. Though these tests accurately predict driving behaviors, their abilities to do so may differ depending on cultural groups.

Evaluation of Parameters Affecting Intrinsic Uniformity to Perform Best Optimum Daily QC

Nuclear Medicine plays a vital role in the diagnosis of benign and malignant cancer tissues. The quality assurance program of gamma cameras in nuclear medicine provides an artifact-free diagnosis. One of the most important quality control (QC) is to test the response of detectors to a uniform distributed source called as uniformity test. The QC of image uniformity test includes intrinsic uniformity (IU) and Differential uniformity (DU) of CFOV (Central Field of View) and UFOV (Useful Field of View). The purpose of this study is to evaluate the best value of parameters for getting the best uniformity results and set as a benchmark for checking the performance of gamma cameras in the future. It is analyzed that using an energy window placed at 140 KeV at 20%, with a matrix size of 256 x 256, acquiring 60 million counts and the source activity close to 500 µC obtained images are good and both uniformities are within the manufacturer’s requirements, however, increasing the number of acquired counts and by mounting a source at a distance larger than 2m, images become better.

Learning ratio performance on a brief visual learning and memory test moderates cognitive training gains in Double Decision task in healthy older adults.

Cognitive training using a visual speed-of-processing task, called the Useful Field of View (UFOV) task, reduced dementia risk and reduced decline in activities of daily living at a 10-year follow-up in older adults. However, there was variability in the achievement of cognitive gains after cognitive training across studies, suggesting moderating factors. Learning trials of visual and verbal learning tasks recruit similar cognitive abilities and have overlapping neural correlates with speed-of-processing/working memory tasks and therefore could serve as potential moderators of cognitive training gains. This study explored the association between the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) learning with a commercial UFOV task called Double Decision. Through a secondary analysis of a clinical trial, we assessed the moderation of HVLT-R and BVMT-R learning on Double Decision improvement after a 3-month speed-of-processing/attention and working memory cognitive training intervention in a sample of 75 cognitively healthy older adults. Multiple linear regressions showed that better baseline Double Decision performance was significantly associated with better BVMT-R learning (β = - .303). This association was not significant for HVLT-R learning (β = - .142). Moderation analysis showed that those with poorer BVMT-R learning improved the most on the Double Decision task after cognitive training. This suggests that healthy older adults who perform below expectations on cognitive tasks related to the training task may show the greatest training gains. Future cognitive training research studying visual speed-of-processing interventions should account for differing levels of visuospatial learning at baseline, as this could impact the magnitude of training outcomes and efficacy of the intervention.

Enhancing Cognitive Function in Older Adults through Processing Speed Training: Implications for Cognitive Health Awareness.

It may be possible to enhance adults' cognitive health and promote healthy aging through processing speed training using the Useful Field of View (UFOV) related activities and software. This study investigated the impact of utilizing UFOV on processing speed improvement in older adults in response to the growing global attention on cognitive health and aging issues. In this quasi-experimental study, 22 individuals (mean age ± SD = 71.9 ± 4.8) participated in the experimental group, and 20 community-based participants (mean age ± SD = 67.1 ± 4.8) were in the control group. The intervention involved ten sessions of UFOV training, each lasting 60 min, conducted twice a week for the experimental group while the control group engaged in volunteer service activities. Measurements of Counting Back, Fabrica, Double-Decision, and Hawkeye were administered to all participants before and after the intervention. The results showed significant improvements in the experimental group for the four measurements (p ≤ 0.01, 0.05, 0.001, 0.001) and non-significant gains in the control group (p ≥ 0.05) for all. Furthermore, mixed repeated-measures ANOVA analysis, with time 1 pre-test measures as the covariate, revealed significant interaction effects between time and group for all measurement indicators (p = 0.05, 0.01, 0.05) except for Fabrica (p > 0.05). In conclusion, these findings support the effectiveness of UFOV cognitive training interventions in enhancing specific cognitive abilities.

The impact of a tDCS and cognitive training intervention on task-based functional connectivity.

Declines in several cognitive domains, most notably processing speed, occur in non-pathological aging. Given the exponential growth of the older adult population, declines in cognition serve as a significant public health issue that must be addressed. Promising studies have shown that cognitive training in older adults, particularly using the useful field of view (UFOV) paradigm, can improve cognition with moderate to large effect sizes. Additionally, meta-analyses have found that transcranial direct current stimulation (tDCS), a non-invasive form of brain stimulation, can improve cognition in attention/processing speed and working memory. However, only a handful of studies have looked at concomitant tDCS and cognitive training, usually with short interventions and small sample sizes. The current study assessed the effect of a tDCS (active versus sham) and a 3-month cognitive training intervention on task-based functional connectivity during completion of the UFOV task in a large older adult sample (N = 153). We found significant increased functional connectivity between the left and right pars triangularis (the ROIs closest to the electrodes) following active, but not sham tDCS. Additionally, we see trending behavioral improvements associated with these functional connectivity changes in the active tDCS group, but not sham. Collectively, these findings suggest that tDCS and cognitive training can be an effective modulator of task-based functional connectivity above and beyond a cognitive training intervention alone.

Using Serial Trichotomization to Determine Fitness to Drive in Medically At-Risk Drivers.

Clinical tests that identify fit and unfit drivers with 100% sensitivity and specificity would reduce uncertainty and improve efficiency of occupational therapists performing comprehensive driving evaluations (CDEs). To examine whether serial trichotomization of clinical tests predicts pass-fail outcomes with 100% sensitivity and specificity in a sample of medically at-risk drivers and in drivers with and without cognitive impairment (CI) referred for a CDE. Retrospective data collection and analysis of scores on the Montreal Cognitive Assessment; Trail Making Test, Part A and Part B; and the Useful Field of View® Subtests 1 to 3 and outcomes on the CDE (pass-fail or indeterminate requiring lessons and retesting). Receiver operating characteristic curves of clinical tests were performed to determine 100% sensitivity and specificity cut points in predicting CDE outcomes. Clinical tests were arranged in order from most to least predictive to identify pass-fail and indeterminate outcomes. A driving assessment clinic. Among 142 medically at-risk drivers (M age = 69.2 yr, SD = 14.1), 66 with CI, 46 passed and 39 failed the CDE; 57 were indeterminate. On-road pass-fail outcomes. Together, the six clinical tests predicted 62 pass and 49 fail outcomes in the total sample; 21 pass and 34 fail outcomes in participants with CI; and 58 pass and 14 fail outcomes in participants without CI. Serial trichotomization of clinical tests increases the accuracy of making informed decisions and reduces the number of drivers undergoing unnecessary on-road assessments. Plain-Language Summary: Clinical tests and their cut points that identify fit and unfit drivers vary substantially across settings and research studies. Serial trichotomization is one method that could help control for this variation by combining clinical test scores showing 100% sensitivity and specificity to identify pass (fit drivers) and fail outcomes (unfit drivers) and to reduce the number of drivers undergoing unnecessary on-road assessments.

A Study on Increasing the Useful Field of View of Gamma Camera through the Expansion of the Use of Photosensors

A Study on Increasing the Useful Field of View of Gamma Camera through the Expansion of the Use of Photosensors

ENDORSEMENT OF DRIVING AVOIDANCE BEHAVIORS AND COGNITIVE, PHYSICAL, AND VISUAL PREDICTORS AMONG OLDER DRIVERS

Abstract Due to age-related changes in visual, physical, and cognitive abilities, certain driving conditions may become more challenging for older adults. Secondary analyses were conducted to assess driving avoidance habits of 72 healthy drivers (65 – 85 years old). Additionally, the physical function (Turn360, Timed Get Up and Go), cognitive (Useful Field of View, Mazes, Trails B, and Wechsler Memory Scale), and visual (visual acuity, Pelli-Robson contrast sensitivity) performance predictors of these habits were explored using linear regression. 59.7% of participants reported avoiding driving in bad weather, 44.4% of participants reported avoiding driving at night, and 40.3% of participants reported avoiding driving during rush hour, making these the most frequently avoided situations. Only 5.6% of participants reported avoiding driving alone and 15.3% of participants reported avoiding driving on high-speed interstates or expressways, making these the least often avoided situations. Women (β = -.393, p = .001) and poorer physical function (β= -.301, p = .018) were associated with greater driving avoidance. Cognition and vision performance did not predict the driving situations. While these results are limited by the high SES of the sample, the results indicate that driving avoidance interventions should consider gender and physical function. Implications and future directions are discussed.

THE RELEVANCE OF COGNITIVE ABILITIES IN FRAUD DETECTION

Abstract Some previous studies suggest that cognitive decline might be responsible for older adults being susceptible to phishing attempts and frauds, but results are not consistent. The current study utilized a structural equation modeling approach to examine the role of different cognitive abilities in fraud detection. We used data from the baseline of the Intervention Comparative Effectiveness for Adult Cognitive Training (ICE-ACT, NCT03141281) Trial. The sample included 230 cognitively normal community-dwelling older adults (Mean age = 72). Reasoning was measured by Raven’s Advanced Progressive Matrices and letter sets. Memory was measured by Hopkins Verbal Learning Test and Rey Auditory Verbal Learning Test. Processing speed was measured by Digit Symbol Substitution Test and Useful Field of View. Fraud detection was represented by d-prime score calculated from rating of fraudulence in 10 vignettes describing fraud and non-fraud scenarios. Latent factors were created for reasoning, memory, and processing speed. Results showed that reasoning, memory, and processing speed explained 14% of variance in fraud detection, however, none of those cognitive factors uniquely predicted fraud detection. A higher-order general cognitive factor indicated by the reasoning, memory, and processing speed factors significantly predicted fraud detection and explained 13 % of variance. These results showed that general cognitive abilities have a medium effect in fraud detection in cognitively normal community-dwelling older adults. Discussion will focus on implications of those results on training and interventions aiming to prevent fraud in older adults.

71 Feasibility of Virtual Useful Field of View Assessment and Equivalence with In-Person Administration Among Youth Clinically Recovered from Concussion and Uninjured Controls

Objective:Youth athletes with concussion are at an increased risk of sustaining new concussions and orthopedic injuries after clearance for return-to-play. There are training programs, extensively studied in other patient populations, which can improve performance in cognitive domains that have been implicated in sport-related injury and re-injury after concussion (i.e., visual attention/processing speed). The Useful Field of View (UFOV) is one such training program, accompanied by a computerized adaptive assessment for evaluating response to training and maintenance in clinical trials. Remote UFOV assessment administration may help improve adherence, particularly in assessing long-term training effects. The current study explores the feasibility of virtual UFOV assessment and equivalence with in-person administration in youth clinically recovered from concussion and healthy controls.Participants and Methods:Participants included youth ages 10-18 enrolled in a longitudinal study examining neural recovery following medical clearance from concussion. UFOV was attempted in 61 participants (Mage=15.06; SD=2.00; n=19 in-person; n=42). Of these, 7 virtual administrations were discontinued due to computer limitations, and 1 in-person administration was excluded due to overall performance validity concerns. This resulted in a total sample of 53 participants (Mage=15.02, SD=2.00, 58.5% male; n=14 concussion, Mdays_since_injury=272.64, SD=185.35; n=39 controls). UFOV was administered either in-person (n=18) using manual guidelines or virtually (n=35) on the participant’s computer using video-conference screen-share and a secondary device for an additional view of the participant and their keyboard/mouse. For virtual visits, the examiner recorded concerns about the remote testing environment (e.g., screen glare, viewing distance not measured appropriately), and analyses were conducted with and without cases with concerns. Between-group (in-person vs virtual administration) demographic differences were examined using chi-square tests/t-tests. Mann-Whitney U tests were used to examine for differences in UFOV scores (ms; higher scores are worse) by administration context (in-person vs. virtual) given threats to normality.Results:For virtual administrations, the most commonly reported concerns about the remote testing environment were related to lighting (n=12) and viewing distance (n=3). There were no significant differences in age, sex, concussion history, sport participation history, or IQ by administration context (in-person vs. virtual). UFOV performance did not vary significantly by administration context for processing speed or divided attention subtests, but performance on the selective attention subtest was significantly better in the virtual administration group (Median in-person =93.33; Medianvirtual=63.33; U=203.00, p=0.035). This trend persisted after removing an outlier (>2SD; p=0.065) and after removing cases where lighting (p=0.060) and screen-viewing distance (p=0.085) were not adequately controlled.Conclusions:Though preliminary, results suggest that UFOV can be administered virtually, in youth with and without a history of concussion, but that those assessed virtually using their home computer may have an advantage, particularly for the selective attention subtest. This may be due to comfort level within the home environment or subtle differences in viewing distance that were not appreciated by the examiner remotely. Importantly, not all participants were able to complete the assessment virtually due to computer limitations. Future work with larger samples size should examine the extent to which completers vary from non-completers in terms of sociodemographic variables.

2 Cognitive Processing Speed Training in Individuals with Multiple Sclerosis

Objective:Cognitive impairment is observed in up to two-thirds of persons with Multiple Sclerosis (MS). Impairments in cognitive processing speed (PS) is the most prevalent cognitive disturbance, occurs early in the course of disease and is strongly associated with disease progression, various brain parameters and everyday life functional activities. As such, cognitive rehabilitation for PS impairments should be an integral part of MS treatment and management. The current study examines the efficacy of Speed of Processing Training (SOPT) to improve processing speed (PS) in individuals with Multiple Sclerosis (MS). SOPT was chosen because of its significant positive results in the aging populations.Participants and Methods:This double-blind, placebo-controlled randomized clinical trial included 84 participants with clinically definite MS and impaired PS, 43 in the treatment group and 41 in the placebo control group. Outcomes included changes in the Useful Field of View (UFOV) and neuropsychological evaluation (NPE) including measure of PS (e.g., Pattern Comparison and Letter Comparison). Participants completed a baseline NPE and a repeat NPE post-treatment. Treatment consisted of 10 sessions delivered twice per week for 5 weeks. After the 5 weeks, the treatment group was randomized to booster sessions or no contact. Long-term follow-up assessments were completed 6 months after completion of treatment. The primary outcome were tests of PS including UFOV and neuropsychological testing.Results:A significant effect of SOPT was observed on both the UFOV (large effect) and Pattern Comparison with a similar pattern of results noted on Letter Comparison, albeit at a trend level. The treatment effect was maintained 6-months later. The impact of booster sessions was not significant. Correlations between degree of improvement on the UFOV and the number of levels completed within each training task were significant for both Speed and Divided Attention indicating that completion of more levels of training correlated with greater benefit.Conclusions:SOPT is effective for treating PS deficits in MS with benefit documented on both the UFOV and a neuropsychological measure of PS. Less benefit was observed as the outcome measures became more distinct in cognitive demands from the treatment. Long-term maintenance was observed. The number of training levels completed within the 10-sessions exerted a significant impact on treatment benefit, with more levels completed resulting in greater benefit.

Cognitive correlates of reduced driving performance in healthy older adults: A meta-analytic review

Aims / ObjectivesThis meta-analytic review examines the evidence for the relationship between cognitive function and driving performance in older adults. The primary aims of this review were: (a) to identify cognitive correlates of reduced driving performance in older adults and (b) to determine whether such measures reliably predict reductions in driving performance over time. MethodsThis review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer reviewed studies that examined the (cross-sectional or longitudinal) relationship between standardised neuropsychological test performance measures and driving performance (e.g., via an on-road test, in-vehicle monitoring system, hazard perception test or driving simulator) in healthy adults aged 60 years and older, were included. Results/DiscussionEighteen studies were eligible for inclusion, of which 12 met requirements for meta-analysis. The results indicated that reaction time and Trail Making Test (TMT) A scores exhibited small-to-moderate correlations with driving performance, with moderate effects identified for block design, TMT B, Useful Field of View (UFOV) 2 and 3 tests. Further, no significant relationships were observed between the Mini-Mental State Examination and UFOV 1 with driving performance. Due to a paucity of data, the longitudinal relationship between such measures and driving could not be identified. The findings highlight (a) the potential of cognitive assessments to identify older adults at risk of driving impairment (as part of a larger diagnostic assessment), and (b) the urgent need for prospective longitudinal studies in investigating the impact of age-related changes in cognition on driving performance over time.

The use of driver screening tools to predict self-reported crashes and incidents in older drivers

There is a clear need to identify older drivers at increased crash risk, without additional burden on the individual or licensing system. Brief off-road screening tools have been used to identify unsafe drivers and drivers at risk of losing their license. The aim of the current study was to evaluate and compare driver screening tools in predicting prospective self-reported crashes and incidents over 24 months in drivers aged 60 years and older. 525 drivers aged 63–96 years participated in the prospective Driving Aging Safety and Health (DASH) study, completing an on-road driving assessment and seven off-road screening tools (Multi-D battery, Useful Field of View, 14-Item Road Law, Drive Safe, Drive Safe Intersection, Maze Test, Hazard Perception Test (HPT)), along with monthly self-report diaries on crashes and incidents over a 24-month period. Over the 24 months, 22% of older drivers reported at least one crash, while 42% reported at least one significant incident (e.g., near miss). As expected, passing the on-road driving assessment was associated with a 55% [IRR 0.45, 95% CI 0.29–0.71] reduction in self-reported crashes adjusting for exposure (crash rate), but was not associated with reduced rate of a significant incident. For the off-road screening tools, poorer performance on the Multi-D test battery was associated with a 22% [IRR 1.22, 95% CI 1.08–1.37] increase in crash rate over 24 months. Meanwhile, all other off-road screening tools were not predictive of rates of crashes or incidents reported prospectively. The finding that only the Multi-D battery was predictive of increased crash rate, highlights the importance of accounting for age-related changes in vision, sensorimotor skills and cognition, as well as driving exposure, in older drivers when using off-road screening tools to assess future crash risk.

The cognitive-load effects associated with lying on useful field of view: Focusing on the falsity and intentionality of lies

本研究の目的は，嘘に伴う認知的負荷が有効視野を狭めるかについて検証することであった．実験では，参加者は嘘つき群と統制群のいずれかに割り当てられた．参加者はディスプレイに提示されたトランプカードを記憶した後，カードと同じ内容（一致条件）または異なる内容（不一致条件）を回答し，回答後に現れる光点の位置を同定するよう求められた．嘘つき群と統制群の相違は教示であり，嘘つき群の参加者は嘘をつく時には真実を話しているかのように振る舞い，実験者を騙すよう求められたが，統制群の参加者は求められなかった．光点の正答率から相対的に有効視野を測定した結果，嘘つき群は統制群よりも有効視野が狭まったが，一致条件と不一致条件の有効視野に差は示されなかった．以上の結果は，意図的に相手を騙すこと（嘘の意図性）による負荷は有効視野を狭めるが，事実と異なる内容を回答すること（嘘の虚偽性）および嘘をつく時に真実らしく振る舞うことによる負荷は有効視野を狭めないことを示唆するものである．

Severity and correlates of brain fog in people with traumatic brain injury.

Brain fog is one symptom that has been underexplored in traumatic brain injury (TBI). We explored the cognitive and affective correlates of brain fog in people with symptomatic mild TBI (n = 15), moderate-to-severe TBI (n = 15), and a healthy control group (n = 16). Measures across the studies assessed "brain fog" (Mental Clutter Scale), objective cognition (Useful Field of View® and Cogstate Brief Battery®), post-concussive symptoms (Post-Concussion Symptom Scale), and depressive symptoms (Profile of Moods Scale). Brain fog was higher in symptomatic mild TBI and moderate-to-severe TBI compared with healthy controls. Greater brain fog corresponded to greater depressive symptoms in symptomatic mild TBI. Greater brain fog corresponded to poorer episodic memory and working memory in moderate-to-severe TBI. Brain fog appears to reflect challenges in recovery, including depressive symptoms and worse cognitive function. Screening for brain fog might be worthwhile in people with brain injuries.

Feasibility and Tolerability of Useful Field of View Assessment in Youth with Concussion

<h3>Research Objectives</h3> To investigate the feasibility and tolerability of the Useful Field of View (UFOV) assessment, a computerized adaptive measure, in youth with mild traumatic brain injury (mTBI). <h3>Design</h3> Retrospective chart review. <h3>Setting</h3> Interdisciplinary pediatric concussion clinic. <h3>Participants</h3> Eight symptomatic patients with mTBI (M age=15.16, SD=2.67) were administered the UFOV assessment during their initial clinic visit. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Total UFOV administration time and report of symptoms prior to and following UFOV administration. <h3>Results</h3> All patients were able to understand and complete the UFOV assessment in less than 15 minutes (M=8.51, SD=2.35). The evaluation was well-tolerated (no patient experienced symptom exacerbation greater than 2 points on a scale from 0 to 10). Although all participants performed within normal limits on UFOV using manual cutoffs, three participants (all with prior mTBIs) performed below expectations relative to peers using published pre-commercialization normative data. On the divided attention subtest (Subtest 2), those with prior history of mTBI (n=3; M=64.33, SD=5.13) performed significantly worse than those without such history (n=5; M=32.97, SD=4.94), (t (6) = 8.58, p< .001). <h3>Conclusions</h3> The UFOV assessment has been well-studied in older adults and is predictive of driving performance in young adults and those with moderate to severe TBI. Useful field of view can be trained in older adults which may have implications for younger populations and those with acquired brain injury. Data suggest that UFOV assessment is both feasible and well-tolerated among youth with mTBI presenting to an interdisciplinary concussion clinic. Future research should seek to better understand the relationship between UFOV performance and risk of and recovery from mTBI in youth. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to disclose.

Using Serial Trichotomization to Determine Fitness to Drive in Medically At-Risk Drivers

<h3>Research Objectives</h3> To determine if serial trichotomization of cognitive tests predicts passing or failing a comprehensive driving evaluation (CDE) with 100% sensitivity and 100% specificity in medically at-risk drivers. <h3>Design</h3> Retrospective cohort of CDE data. <h3>Setting</h3> CDE's assessed by occupational therapists at two driving assessment centers in Canada. <h3>Participants</h3> Participants included 143 drivers (72% male; mean age = 69.3 ± 14.1 years, range 24-94) referred by physicians for suspicion of being unfit to drive, and who had complete data on all cognitive tests and the CDE outcome. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Cognitive tests included the Montreal Cognitive Assessment (MoCA), Trail Making Test Part A (Trails A) and Part B (Trails B), and Useful Field of View® subtests 1-3 (UFOV1-3). The CDE outcome, based on clinical and on-road driving performance, included a pass (considered fit to continue driving), fail (considered unfit to continue driving), or indeterminate outcome (requires lessons and retesting). Serial trichotomization involved performing a receiver operating characteristics curve for each cognitive test to determine cut points with 100% sensitivity and 100% specificity in predicting pass (i.e., pass and indeterminate) or fail outcomes on the CDE. A funnel was created by arranging the cognitive tests in order from most to least predictive and using the cut points to identify pass, fail, and indeterminate outcomes. <h3>Results</h3> Approximately 33% passed, 27% failed, and 40% had indeterminate outcomes on the CDE. Through serial trichotomization, the UFOV3, UFOV2, UFOV1, Trails B, MoCA, and Trails A (from most to least predictive) predicted more pass (44.1%) and fail outcomes (34.3%) with fewer indeterminate outcomes (21.6%). <h3>Conclusions</h3> Serial trichotomization of cognitive tests is more accurate in identifying fit and unfit drivers, reducing the number of unnecessary on-road assessments by approximately twofold (indeterminate outcomes from 40% to 21.6%). Further research using larger samples and more clinical tests will identify the best combination and most accuracy in predicting fit and unfit drivers via serial trichotomization. <h3>Author(s) Disclosures</h3> This work was supported by the University of Waterloo CIHR Research Incentive Fund (PI Crizzle).

Vision Impairment and On-Road Driving.

Good vision is important for safe driving. The impact of vision impairment associated with common eye diseases on driving performance, and the association between vision measures and driving performance, are discussed. Studies include those where participants drove a real vehicle on a closed road or on public roads. Closed-road studies include evaluation of both simulated and true vision impairment and day- and night-time driving. Collectively, the findings provide important insights into the impact of refractive conditions, cataracts, glaucoma, age-related macular degeneration, and hemianopic field loss on driving; however, study results show varying impacts on driving performance and are often limited by small sample sizes. Vision measures including motion sensitivity, contrast sensitivity, and useful field of view have stronger associations with driving performance than do visual acuity or visual fields, with studies suggesting that some drivers with field loss can compensate for their field defects through increased eye and head movements.

Task-based functional connectivity of the Useful Field of View (UFOV) fMRI task.

Declines in processing speed performance occur in aging and are a critical marker of functional independence in older adults. Numerous studies suggest that Useful Field of View (UFOV) training may ameliorate cognitive decline in older adults. Despite its efficacy, little is known about the neural correlates of this task. The current study is the first to investigate the coherence of functional connectivity during UFOV task completion. A total of 336 participants completed the UFOV task while undergoing task-based functional magnetic resonance imaging (fMRI). Ten spherical regions of interest (ROIs), selected a priori, were created based on regions with the greatest peak BOLD activation patterns in the UFOV fMRI task and regions that have been shown to significantly relate to UFOV fMRI task performance. We used a weighted ROI-to-ROI connectivity analysis to model task-specific functional connectivity strength between these a priori selected ROIs. We found that our UFOV fMRI network was functionally connected during task performance and was significantly associated to UFOV fMRI task performance. Within-network connectivity of the UFOV fMRI network showed comparable or better predictive power in accounting for UFOV accuracy compared to 7 resting state networks, delineated by Yeo and colleagues. Finally, we demonstrate that the within-network connectivity of UFOV fMRI task accounted for scores on a measure of "near transfer", the Double Decision task, better than the aforementioned resting state networks. Our data elucidate functional connectivity patterns of the UFOV fMRI task. This may assist in future targeted interventions that aim to improve synchronicity within the UFOV fMRI network.

Clinical Tests Predicting On-Road Performance in Older Drivers with Cognitive Impairment.

Background. The Trail Making Test Part B (Trails B) and Useful Field of View® (UFOV) can predict on-road outcomes in drivers with cognitive impairment (CI); however, studies have not included drivers referred for comprehensive driving evaluations (CDEs), who typically have more severe CI. Purpose. We determined the predictive ability of Trails B and UFOV on pass/fail on-road outcomes in drivers with CI (Montreal Cognitive Assessment <26) referred for CDEs. Method. Retrospective data collection from two driving assessments centers (N = 100, mean age = 76.2 ± 8.8 years). Findings. The Trails B (area under the curve [AUC] = .70) and UFOV subtests 2 (AUC = .73) and 3 (AUC = .76) predicted pass/fail outcomes. A cut-point ≥467 ms on UFOV subtest 3 better-predicted pass/fail outcomes with 78.9% sensitivity and 73.5% specificity. In comparison, a cut-point ≥3.58 min on Trails B had lower sensitivity (73.7%) and specificity (61.8%). Implications. The UFOV subtest 3 may be more useful than the Trails B for predicting pass/fail outcomes in drivers with more severe CI referred for CDEs.