The Effects of Age and Central Field Loss on Head Scanning and Detection at Intersections

Purpose Using a driving simulator, we quantified the effects of age and central field loss (CFL) on head scanning when approaching an intersection and investigated the role of inadequate head scanning in detection failures. Methods Participants with CFL (n = 20) and with normal vision (NV; n = 29), middle-aged (36–60 years) or older (67–87 years), drove along city routes with multiple intersections while head movements were recorded. The effects of age and CFL on scanning were analyzed at 32 intersections with stop/yield signs. The relationships between age, CFL, scanning, and detection were examined at four additional intersections with a pedestrian appearing on the far left. Results Older NV participants made fewer total scans than middle-aged NV participants and had smaller maximum scan magnitudes. Head scanning of older CFL and NV participants did not differ, but middle-aged CFL participants made fewer head scans, had higher rates of failing to scan, and made smaller head scans than middle-aged NV participants. For the older NV and both CFL groups, detection failures were high (≥58%); head scan magnitudes were 15° smaller when the pedestrian was not detected than when it was detected. Conclusions Both older NV and CFL participants exhibited head scanning deficits relative to middle-aged NV participants. Unexpectedly, however, it was the middle-aged CFL group that performed least well when scanning, a finding that warrants further investigation. Translational Relevance Failing to head scan sufficiently far at intersections may place older drivers and drivers with vision impairment at a higher risk for causing collisions.