On-road driving impairment following sleep deprivation differs according to age

AbstractImpaired driving performance due to sleep loss is a major contributor to motor-vehicle crashes, fatalities, and serious injuries. As on-road, fully-instrumented studies of drowsy driving have largely focused on young drivers, we examined the impact of sleep loss on driving performance and physiological drowsiness in both younger and older drivers of working age. Sixteen ‘younger’ adults (M = 24.3 ± 3.1 years [21–33 years], 9 males) and seventeen ‘older’ adults (M = 57.3 ± 5.2, [50–65 years], 9 males) undertook two 2 h drives on a closed-loop track in an instrumented vehicle with a qualified instructor following (i) 8 h sleep opportunity the night prior (well-rested), and (ii) after 29-h of total sleep deprivation (TSD). Following TSD, both age groups displayed increased subjective sleepiness and lane departures (p < 0.05), with younger drivers exhibiting 7.37 × more lane departures, and 11 × greater risk of near crash events following sleep loss. While older drivers exhibited a 3.5 × more lane departures following sleep loss (p = 0.008), they did not have a significant increase in near-crash events (3/34 drives). Compared to older adults, younger adults had 3.1 × more lane departures (p = < 0.001), and more near crash events (79% versus 21%, p = 0.007). Ocular measures of drowsiness, including blink duration, number of long eye closures and PERCLOS increased following sleep loss for younger adults only (p < 0.05). These results suggest that for older working-aged adults, driving impairments observed following sleep loss may not be due to falling asleep. Future work should examine whether this is attributed to other consequences of sleep loss, such as inattention or distraction from the road.

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Acceptance of Transportation Technologies by Aging Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1822 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 555-555

Author(s):

Neil Charness ◽

Dustin Souders ◽

Ryan Best ◽

Nelson Roque ◽

JongSung Yoon ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Detection System ◽

Blind Spot ◽

Driving Performance ◽

Older Drivers ◽

Crash Risk ◽

Warning Systems ◽

Risk Of Death ◽

Spot Detection

Abstract Older adults are at greater risk of death and serious injury in transportation crashes which have been increasing in older adult cohorts relative to younger cohorts. Can technology provide a safer road environment? Even if technology can mitigate crash risk, is it acceptable to older road users? We outline the results from several studies that tested 1) whether advanced driver assistance systems (ADAS) can improve older adult driving performance, 2) older adults’ acceptance of ADAS and Autonomous Vehicle (AV) systems, and 3) perceptions of value for ADAS systems, particularly for blind-spot detection systems. We found that collision avoidance warning systems improved older adult simulator driving performance, but not lane departure warning systems. In a young to middle-aged sample the factor “concern with AV” showed age effects with older drivers less favorable. Older drivers, however, valued an active blind spot detection system more than younger drivers.

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New Strategies for the Treatment of Acute Myeloid Leukemia Including Antibodies and Other Novel Agents

Hematology ◽

10.1182/asheducation-2005.1.143 ◽

2005 ◽

Vol 2005 (1) ◽

pp. 143-150 ◽

Cited By ~ 40

Author(s):

Martin S. Tallman

Keyword(s):

Older Adults ◽

Acute Myeloid Leukemia ◽

Multidrug Resistance ◽

Myeloid Leukemia ◽

Cytotoxic Agents ◽

High Dose ◽

Farnesyltransferase Inhibitors ◽

Younger Adults ◽

The Impact ◽

Acute Myeloid

Abstract The prognosis for younger adults (≤ 55–60 years) with acute myeloid leukemia (AML) has improved during the last four decades. However, there has been little progress in the treatment of older adults. This disappointing observation is important because the median age of patients with AML is about 70 years. Approximately 60%–80% of younger adults with AML achieve complete remission (CR) with the cytotoxic agents cytarabine and an anthracycline such as daunorubicin or idarubicin or the anthracenedione mitoxantrone. However, only 30%–40% of such patients are alive and disease-free at 5 years. Among older adults, CR is achieved in 40%–55%, but there are very few long-term survivors. Many studies have evaluated the impact of alternative doses and schedules, as well as additional cytotoxic drugs, on the prognosis for this group of patients. The outcome has not improved substantially beyond that achieved with conventional doses of an anthracycline and cytarabine followed by high-dose cytarabine consolidation. Several factors identified at diagnosis can predict outcome. The most important of these is the karyotype of the leukemic cells. Another critical factor is the presence of transmembrane transporter proteins, which confer multidrug resistance and mutations in or overexpression of specific genes such as WT1, C/EBPα, BAX, and BCL-2/BAX ratio, BAALC, EVI1, KIT and FLT3. The development of specific agents directed at gene mutations, signal transduction pathways and unique cell surface antigens provide the foundation for new therapeutic strategies. Such agents include the immunoconjugate gemtuzumab ozogamicin, multidrug resistance inhibitors, farnesyltransferase inhibitors, histone deacetylase and proteosome inhibitors, antiangiogenesis agents, FLT3 inhibitors, apoptosis inhibitors, and nucleoside analogs. All of these agents can potentially address the heterogeneous abnormalities in AML and significantly improve the outcome for patients.

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Association of Photopic and Mesopic Contrast Sensitivity in older drivers with risk of motor vehicle collision using naturalistic driving data

BMC Ophthalmology ◽

10.1186/s12886-020-1331-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Cynthia Owsley ◽

Thomas Swain ◽

Rong Liu ◽

Gerald McGwin ◽

Mi Young Kwon

Keyword(s):

Older Adults ◽

Contrast Sensitivity ◽

Motor Vehicle ◽

Age Groups ◽

Time Of Day ◽

Motor Vehicle Crash ◽

Older Drivers ◽

Crash Risk ◽

Sensitivity Testing ◽

Naturalistic Driving

Abstract Background Older drivers have a crash rate nearly equal to that of young drivers whose crash rate is the highest among all age groups. Contrast sensitivity impairment is common in older adults. The purpose of this study is to examine whether parameters from the photopic and mesopic contrast sensitivity functions (CSF) are associated with incident motor vehicle crash involvement by older drivers. Methods This study utilized data from older drivers (ages ≥60 years) who participated in the Strategic Highway Research Program Naturalistic Driving Study, a prospective, population-based study. At baseline participants underwent photopic and mesopic contrast sensitivity testing for targets from 1.5–18 cycles per degree. Model fitting generated area under the log CSF (AULCSF) and peak log sensitivity. Participant vehicles were instrumented with sensors that captured continuous driving data when the vehicle was operating (accelerometers, global positioning system, forward radar, 4-channel video). They participated for 1–2 years. Crashes were coded from the video and other data streams by trained analysts. Results The photopic analysis was based on 844 drivers, and the mesopic on 854 drivers. Photopic AULCSF and peak log contrast sensitivity were not associated with crash rate, whether defined as all crashes or at-fault crashes only (all p > 0.05). Mesopic AULCSF and peak log sensitivity were associated with an increased crash rate when considered for all crashes (rate ratio (RR): 1.36, 95% CI: 1.06–1.72; RR: 1.28, 95% CI: 1.01–1.63, respectively) and at-fault crashes only (RR: 1.50, 95% CI: 1.16–1.93; RR: 1.38, 95% CI: 1.07–1.78, respectively). Conclusions Results suggest that photopic contrast sensitivity testing may not help us understand future crash risk at the older-driver population level. Results highlight a previously unappreciated association between older adults’ mesopic contrast sensitivity deficits and crash involvement regardless of the time of day. Given the wide variability of light levels encountered in both day and night driving, mesopic vision tests, with their reliance on both cone and rod vision, may be a more comprehensive assessment of the visual system’s ability to process the roadway environment.

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Assessment and Counseling of Older Drivers

10.1093/med/9780199374656.003.0013 ◽

2017 ◽

Author(s):

Thomas M. Meuser ◽

David B. Carr

Keyword(s):

Motor Vehicle ◽

Warning Signs ◽

Older Drivers ◽

Patient Centered ◽

Fitness Evaluation ◽

Centered Care ◽

Individualized Approach ◽

Health Related ◽

Safety Considerations ◽

The Impact

Driving a motor vehicle is an important instrumental activity of daily living and thus a target for health-related assessment and assistance. Most older drivers self-regulate in response to changes in medical and functional status. A minority may not recognize the impact of such changes on driving (e.g., in dementia) and so may continue driving when no longer safe to do so, despite warning signs. When evaluating driver fitness, clinicians must weigh individual rights of autonomy and choice against objective findings of deficits and broader safety considerations. Driver evaluation requires a sensitive, individualized approach that also takes daily-life mobility into account. This chapter discusses driver fitness evaluation in the context of patient-centered care and resources to support patients in the transition in mobility from driving to not driving.

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Analysis of Sleep Deprivation Effect to Driving Performance Using ReactionTest Simulation

Jurnal Teknologi ◽

10.11113/jt.v72.3915 ◽

2015 ◽

Vol 72 (4) ◽

Author(s):

Ika Nurlaili Isnainiyah ◽

Febriliyan Samopa ◽

Hatma Suryotrisongko ◽

Edwin Riksakomara

Keyword(s):

Sleep Deprivation ◽

Traffic Accidents ◽

Driving Simulator ◽

Driving Performance ◽

Deprivation Condition ◽

Falling Asleep ◽

Sleep Condition ◽

Lack Of Sleep ◽

The Difference ◽

Social Habits

Sleep deprivation condition might lead to falling asleep through inappropriate situations, such as driving. Driving in a state of fatigue or drowsy from lack of sleep will be far worse than driving after alcohol consumption. Hence, the authors develop a driving simulator using Java to modify the control and rules of OpenDS application in order to simulate and calculate the automatic ReactionTest for 25 respondents simulating in both normal conditions and sleepy conditions when driving. Through this study, the authors obtained that the difference of driving performance in terms of reaction rate when driving the car in sleep deprivation condition and the normal condition, is equal to 1.08 seconds. The results also shown that the risk of loss of control that can occur to the driver of the car in units of meters (m), is equal to 0.3024 x the car’s speed. This study aims to reduce the number of traffic accidents caused by sleep deprivation that occur in society by giving a recommendation to the driver that forced to drive in lack of sleep condition. In top of that, the authors propose to create an understanding for changing the social habits of driving toward a better way.

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342 The Association Between Benzodiazepine Use and Falls, and the Impact of Sleep Quality on this Association: Data from TILDA

Age and Ageing ◽

10.1093/ageing/afz103.224 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Louise Marron ◽

Ricardo Segurado ◽

Paul Claffey ◽

Rose Anne Kenny ◽

Triona McNicholas

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Effect Size ◽

Community Dwelling ◽

Public Health Issue ◽

P Value ◽

Poor Sleep ◽

Daytime Somnolence ◽

Falling Asleep ◽

The Impact

Abstract Background Benzodiazepines (BZD) are associated with adverse effects, particularly in older adults. Previous research has shown an association between BZDs and falls and BZDs have been shown to impact sleep quality. The aim of this study is to assess the association between BZD use and falls, and the impact of sleep quality on this association, in community dwelling adults aged over 50. Methods Data from the first wave of The Irish Longitudinal Study on Ageing were used. Participants were classed as BZD users or non-users and asked if they had fallen in the last year, and whether any of these falls were unexplained. Sleep quality was assessed via self-reported trouble falling asleep, daytime somnolence, and early-rising. Logistic regression assessed for an association between BZD use and falls, and the impact of sleep quality on this association was assessed by categorising based on BZD use and each sleep quality variable. Results Of 8,175 individuals, 302 (3.69%) reported taking BZDs. BZD use was associated with falls, controlling for con-founders (OR 1.40; 1.08, 1.82; p-value 0.012). There was no significant association between BZDs and unexplained falls, controlling for con-founders (OR 1.41; 95% CI 0.95, 2.10; p-value 0.09), however a similar effect size to all falls was evident. Participants who take BZDs and report daytime somnolence (OR 1.93; 95% CI 1.12, 3.31; p-value 0.017), early-rising (OR 1.93; 95% CI 1.20, 3.11; p-value 0.007) or trouble falling asleep (OR 1.83; 95% CI 1.12, 2.97; p-value 0.015), have an increased odds of unexplained falls. Conclusion BZD use is associated with falls, with larger effect size in BZD users reporting poor sleep quality in community dwelling older adults. Appropriate prescription of and regular review of medications such as BZDs is an important public health issue.

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AGE, EXPERIENCE OF RACIAL MICROAGGRESSIONS, AND DISTRESS

Innovation in Aging ◽

10.1093/geroni/igz038.2613 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S711-S712

Author(s):

Shayla Thompson ◽

Broderick Sawyer ◽

Suzanne Meeks

Keyword(s):

Older Adults ◽

Psychological Distress ◽

Well Being ◽

Racial Microaggressions ◽

Amazon Mechanical Turk ◽

Cross Sectional ◽

Younger Adults ◽

Anger Rumination ◽

The Impact ◽

The Relationship

Abstract Racial microaggressions are a common form of racial discrimination consisting of subtle or interpersonal slights. Racial microaggressions are linked to various kinds of psychological distress in younger adults, but have not been studied across the lifespan. We examined the relationship of racial microaggressions with psychological distress and anger rumination among younger and older adults identified as racial or ethnic minorities. We hypothesized that age would moderate the relationship between racial microaggressions and psychological distress and anger rumination, that is, the relationship would be weaker for older than for younger adults. Participants were recruited from Amazon Mechanical Turk and were compensated $1 for their participation. Preliminary tests of the hypotheses (N=220), using multiple regression analyses to test for moderation, failed to support the hypothesis that age would mitigate the impact of microaggressions on symptom severity. Both age and microaggressions were related to psychological distress and anger rumination, but contrary to prediction, older adults showed more exacerbation of distress in the face of microaggressions than younger adults. The results also differed by gender and ethnic groups, suggesting the importance of examining intersectional experiences of race, gender, and age in response to discrimination. These cross-sectional findings lend support to the importance of considering both subtle and overt discriminatory experiences in understanding the mental health challenges for minority groups in the U.S., but more work is needed to examine the intersection of ethnicity with other demographic variables, and to understand how the lifelong experiences of discrimination may shape older adults’ vulnerability, well-being, and resilience.

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Creating a driving profile for older adults using GPS devices and naturalistic driving methodology

F1000Research ◽

10.12688/f1000research.9608.2 ◽

2016 ◽

Vol 5 ◽

pp. 2376 ◽

Cited By ~ 10

Author(s):

Ganesh M. Babulal ◽

Cindy M. Traub ◽

Mollie Webb ◽

Sarah H. Stout ◽

Aaron Addison ◽

...

Keyword(s):

Older Adults ◽

Longitudinal Research ◽

Older Drivers ◽

School Of Medicine ◽

Level Data ◽

Primary Location ◽

Commercial Off The Shelf ◽

Instrumented Vehicle ◽

Gps Devices ◽

Tracking Device

Background/Objectives: Road tests and driving simulators are most commonly used in research studies and clinical evaluations of older drivers. Our objective was to describe the process and associated challenges in adapting an existing, commercial, off-the-shelf (COTS), in-vehicle device for naturalistic, longitudinal research to better understand daily driving behavior in older drivers. Design: The Azuga G2 Tracking DeviceTM was installed in each participant’s vehicle, and we collected data over 5 months (speed, latitude/longitude) every 30-seconds when the vehicle was driven. Setting: The Knight Alzheimer’s Disease Research Center at Washington University School of Medicine. Participants: Five individuals enrolled in a larger, longitudinal study assessing preclinical Alzheimer disease and driving performance. Participants were aged 65+ years and had normal cognition. Measurements: Spatial components included Primary Location(s), Driving Areas, Mean Centers and Unique Destinations. Temporal components included number of trips taken during different times of the day. Behavioral components included number of hard braking, speeding and sudden acceleration events. Methods: Individual 30-second observations, each comprising one breadcrumb, and trip-level data were collected and analyzed in R and ArcGIS. Results: Primary locations were confirmed to be 100% accurate when compared to known addresses. Based on the locations of the breadcrumbs, we were able to successfully identify frequently visited locations and general travel patterns. Based on the reported time from the breadcrumbs, we could assess number of trips driven in daylight vs. night. Data on additional events while driving allowed us to compute the number of adverse driving alerts over the course of the 5-month period. Conclusions: Compared to cameras and highly instrumented vehicle in other naturalistic studies, the compact COTS device was quickly installed and transmitted high volumes of data. Driving Profiles for older adults can be created and compared month-to-month or year-to-year, allowing researchers to identify changes in driving patterns that are unavailable in controlled conditions.

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A Genetic Polymorphism of the Human Dopamine Transporter Determines the Impact of Sleep Deprivation on Brain Responses to Rewards and Punishments

Journal of Cognitive Neuroscience ◽

10.1162/jocn_a_00939 ◽

2016 ◽

Vol 28 (6) ◽

pp. 803-810 ◽

Cited By ~ 13

Author(s):

Stephanie M. Greer ◽

Andrea N. Goldstein ◽

Brian Knutson ◽

Matthew P. Walker

Keyword(s):

Genetic Polymorphism ◽

Sleep Deprivation ◽

Dopamine Transporter ◽

Sleep Loss ◽

Functional Polymorphisms ◽

Motivated Behavior ◽

Brain Responses ◽

Lack Of Sleep ◽

Gains And Losses ◽

The Impact

Despite an emerging link between alterations in motivated behavior and a lack of sleep, the impact of sleep deprivation on human brain mechanisms of reward and punishment remain largely unknown, as does the role of trait dopamine activity in modulating such effects in the mesolimbic system. Combining fMRI with an established incentive paradigm and individual genotyping, here, we test the hypothesis that trait differences in the human dopamine transporter (DAT) gene—associated with altered synaptic dopamine signalling—govern the impact of sleep deprivation on neural sensitivity to impending monetary gains and losses. Consistent with this framework, markedly different striatal reward responses were observed following sleep loss depending on the DAT functional polymorphisms. Only participants carrying a copy of the nine-repeat DAT allele—linked to higher phasic dopamine activity—expressed amplified striatal response during anticipation of monetary gain following sleep deprivation. Moreover, participants homozygous for the ten-repeat DAT allele—linked to lower phasic dopamine activity—selectively demonstrated an increase in sensitivity to monetary loss within anterior insula following sleep loss. Together, these data reveal a mechanistic dependency on human of trait dopaminergic function in determining the interaction between sleep deprivation and neural processing of rewards and punishments. Such findings have clinical implications in disorders where the DAT genetic polymorphism presents a known risk factor with comorbid sleep disruption, including attention hyperactive deficit disorder and substance abuse.

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Audiovisual Integration Delayed by Stimulus Onset Asynchrony Between Auditory and Visual Stimuli in Older Adults

Perception ◽

10.1177/0301006616673850 ◽

2016 ◽

Vol 46 (2) ◽

pp. 205-218 ◽

Cited By ~ 14

Author(s):

Yanna Ren ◽

Weiping Yang ◽

Kohei Nakahashi ◽

Satoshi Takahashi ◽

Jinglong Wu

Keyword(s):

Older Adults ◽

Stimulus Onset Asynchrony ◽

Visual Stimuli ◽

Stimulus Onset ◽

Audiovisual Integration ◽

Peak Latency ◽

Younger Adults ◽

Temporal Factors ◽

Onset Asynchrony ◽

The Impact

Although neuronal studies have shown that audiovisual integration is regulated by temporal factors, there is still little knowledge about the impact of temporal factors on audiovisual integration in older adults. To clarify how stimulus onset asynchrony (SOA) between auditory and visual stimuli modulates age-related audiovisual integration, 20 younger adults (21–24 years) and 20 older adults (61–80 years) were instructed to perform an auditory or visual stimuli discrimination experiment. The results showed that in younger adults, audiovisual integration was altered from an enhancement (AV, A ± 50 V) to a depression (A ± 150 V). In older adults, the alterative pattern was similar to that for younger adults with the expansion of SOA; however, older adults showed significantly delayed onset for the time-window-of-integration and peak latency in all conditions, which further demonstrated that audiovisual integration was delayed more severely with the expansion of SOA, especially in the peak latency for V-preceded-A conditions in older adults. Our study suggested that audiovisual facilitative integration occurs only within a certain SOA range (e.g., −50 to 50 ms) in both younger and older adults. Moreover, our results confirm that the response for older adults was slowed and provided empirical evidence that integration ability is much more sensitive to the temporal alignment of audiovisual stimuli in older adults.

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