Visual and cognitive predictors of performance on brake reaction test: Salisbury Eye Evaluation Driving Study

Objectives: Concern for driving safety has prompted research into understanding factors related to performance. Brake reaction speed (BRS), the speed with which persons react to a sudden change in driving conditions, is a measure of performance. Our aim is to determine the visual, cognitive, and physical factors predicting BRS in a population sample of 1425 older drivers. Methods: The Maryland Department of Motor Vehicles roster of persons aged 67-87 and residing in Salisbury, MD, was used for recruitment of the study population. Procedures included the following: habitual, binocular visual acuity using ETDRS charts, contrast sensitivity using a Pelli-Robson chart, visual fields assessed with a 81-point screening Humphrey field at a single intensity threshold, and a questionnaire to ascertain medical conditions. Cognitive status was assessed using a standard battery of tests for attention, memory, visuo-spatial, and scanning. BRS was assessed using a computer-driven device that measured separately the initial reaction speed (IRS) (from light change to red until removing foot from accelerator) and physical response speed (PRS) (removing foot from accelerator to full brake depression). Five trial times were averaged, and time was converted to speed. Results: The median brake reaction time varied from 384 to 5688 milliseconds. Age, gender, and cognition predicted total BRS, a non-informative result as there are two distinct parts to the task. Once separated, decrease in IRS was associated with low scores on cognitive factors and missing points on the visual field. A decrease in PRS was associated with having three or more physical complaints related to legs and feet, and poorer vision search. Vision was not related to PRS. Conclusion: We have demonstrated the importance of segregating the speeds for the two tasks involved in brake reaction. Only the IRS depends on vision. Persons in good physical condition may perform poorly on brake reaction tests if their vision or cognition is compromised.