The influence of cognitive functioning on driving behaviour in older age

Morrissey, Sol (2025) The influence of cognitive functioning on driving behaviour in older age. Doctoral thesis, University of East Anglia.

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Abstract

Driving safety is reduced in older age, with cognitive, sensory, and physical decline considered key contributory factors to worse driving performance. Despite this, findings on the association between driving performance and cognitive tests are mixed, and little is known as to how spatial orientation performance relates to driving behaviour. Whilst clinical guidance from the DVLA recommends assessment of cognitive functioning in evaluating driving fitness, there is no uniformly recommended cognitive assessment for driving safety. This thesis therefore aims to establish the impact of cognitive changes – including spatial orientation – on driving behaviour within healthy older adults using a novel online cognitive battery.

There are four experimental chapters addressing this. Chapter 2 establishes the reliability and validity of the NeurOn battery, which validated against the MoCA, a clinical tool for evaluating cognitive impairment. Chapter 3 demonstrates that spatial orientation is a key cognitive component underpinning driving changes in ageing and is associated with driving frequency and driving difficulty – including making turns across oncoming traffic. In Chapter 4, it is shown how geographical settings, specifically living in rural or urban environments, mediates the relationship between cognitive ability and driving mobility and safety. Chapter 5 then explores how GPS technology affects driving behaviour, showing that it mitigates the impact of spatial orientation impairments to improve driving mobility.

Overall, this thesis advances the understanding in how cognitive functioning is associated with driving behaviour in ageing, and how this interacts with geographical settings and in-vehicle technology. These findings improve the understanding of how cognitive screening can be implemented in driving fitness assessments, provide insights into how cognitive impairments might exacerbate driving decline in dementia, and offer a foundation for policy recommendations to improve road safety and mobility for older drivers.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Kitty Laine
Date Deposited:	21 May 2025 09:30
Last Modified:	21 May 2025 09:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/99318
DOI:

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