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Updated: Aug 18, 2026

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
Published on: September 18, 2012
"CHOKING UNDER PRESSURE" IN OLDER DRIVERS
Kuan-Hua Chen1, Steven W Anderson1, Michelle L Rusch1
1University of Iowa, Iowa City, Iowa, USA.
Abstract:
Aging can impair executive control and emotion regulation, affecting driver decision-making and behavior, especially under stress. We used an interactive driving simulator to investigate ability to make safe left-turns across oncoming traffic under pressure in 13 older (> 65 years old) and 16 middle-aged (35-56 years old) drivers. Drivers made left-turns at an uncontrolled intersection with moderately heavy oncoming traffic. Gaps between oncoming vehicles varied and increased gradually from 2 s to 10 s. Drivers made two left-turns with a vehicle honking aggressively behind (pressure condition), and two left-turns without the honking vehicle (control condition). Results showed that middle-aged drivers made more cautious turning decisions under pressure (by waiting for larger and safer gaps, p < .001), but older drivers did not. Further, older driver turning paths deviated under pressure compared to the control condition (p < .05), but the middle-aged group did not. Moreover, across all subjects, better executive function was significantly correlated with larger increases of accepted gap size from control to honking (p < .01). The findings suggest that older drivers are more sensitive to traffic challenges from environmental pressure and that neural models of older driver performance and safety must factor in age-related changes in executive control and emotion processing.
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