Vision, attention, and self-reported driving behaviors in community-dwelling stroke survivors

Objective: To elucidate the relationships among vision, attention, driving status, and self-reported driving behaviors in community-dwelling stroke survivors. Design: A cross-sectional design to compare stroke survivors to older adults without stroke on visual measures, attentional measures, and self-reported driving behaviors. Setting: Rehabilitation center at a university hospital. Participants: Fifty stroke survivors and 105 older adults without neurologic or visual impairment. Interventions: Not applicable. Main Outcome Measures: Visual acuity, contrast sensitivity, peripheral vision, useful field of view (UFOV), Behavioral Inattention Test, and a driving habits questionnaire. Results: Stroke survivors had impaired contrast sensitivity, peripheral vision, and UFOV compared with older adults in good visual and neurologic health. Driving stroke survivors typically had less attentional impairment than nondrivers. Stroke survivors who returned to driving reported difficulty in challenging driving conditions, drove less, and relied more on other people for transportation than older adults without stroke. Conclusions: These results suggest that vision and attention, both of which are important for driving, are often impaired in stroke survivors. The severity of these deficits could be an influence on driving status and driving behavior. Stroke survivors who return to driving strategically limit their driving exposure and rely on others for transportation, which suggests that they may deliberately self-regulate their driving behavior.