Saccadic eye movement performance as an indicator of driving ability in elderly drivers.

Objective: Regular checking of the fitness to drive of elderly car-license holders is required in some countries, and this will become increasingly important as more countries face aging populations. The present study investigated whether the analysis of saccadic eye movements could be used as a screening method for the assessment of driving ability.

Methods: Three different paradigms (prosaccades, antisaccades, and visuovisual interactive (VVI) saccades) were used to test saccadic eye movements in 144 participants split into four groups: elderly drivers who came to the attention of road authorities for suspected lack of fitness to drive, a group of elderly drivers who served as a comparison group, a group of neurology patients with established brain lesion diagnoses, and a young comparison group. The group of elderly drivers with suspected deficits in driving skills also underwent a medical examination and a practical on-road driving test. The results of the saccadic eye tests of the different groups were compared.

Results: Antisaccade results indicated a strong link to driving behaviour: elderly drivers who were not fit to drive exhibited a poor performance on the antisaccade task and the performance in the VVI task was also clearly poorer in this group.

Conclusions: Testing saccadic eye movements appears to be a promising and efficient method for screening large numbers of people such as elderly drivers. This study indicated a link between antisaccade performance and the ability to drive. Hence, measuring saccadic eye movements should be considered as a tool for screening the fitness to drive.