Development of an Online Application that Enables Older Adults to Self-assess their Driving-related Cognitive Ability

Abstract

Our cognitive abilities can change as we age and these changes may reduce our ability to perform day to day activities, one of which is driving. Older adults with mild cognitive impairment or mild dementia have been shown to have a higher number of crashes per mile driven and are more vulnerable to injuries due to frailty. Driving cessation, however, not only curtails mobility but can cause social isolation and depression among older adults; this is especially true in countries like Canada that have relatively long driving distances and dependency on cars for transit. Driving is often synonymous with independence and hence any discussion about it requires careful consideration by physicians, family, and most importantly the drivers themselves. Motivated by the need to balance road safety and autonomy, this study aims to create and evaluate SmartDrive, which is a digital application that helps refocus the discussion about driving in a way that empowers the older adult. Developed using participatory design methods, SmartDrive is an online, self-assessment application that implements a collection of validated cognitive tasks that have been correlated with on-road driving performance namely, Trail Making Test (Part B), Porteus Mazes & Useful Field of View (subdivided attention). The objective of SmartDrive is to provide the older adult with accurate and useful feedback on their driving-related cognitive abilities in order to promote informed and safer driving decisions. The results from iterative testing of SmartDrive indicated a high acceptance of the app among older adults. The primary motivator for using the app was the need to monitor age-related cognitive decline and its effects on safe driving. Qualitative analysis of the semi-structured interviews conducted with 24 older adult drivers revealed themes that captured the preferred design features and underlying user characteristics that influenced the adoption of SmartDrive. The themes and sub-themes that were identified in this research contribute to the current usability frameworks and can be used as a guide for the development of other web-based applications that support older adults in self-assessment and periodic monitoring of different skills.