Preservation and enhancement of skills

Preservation and enhancement of skills to facilitate the individual
mobility of elderlies
Y. Kaussner, R. Kenntner-Mabiala*, M. Volk, S. Hoffmann, A. Neukum
Wurzburg Institute for Traffic Sciences, WIVW, Veitshöchheim, Gemany
Abstract
The aim of the BMBF-funded project, “MobilTrain”, is to develop a multimodal programme to support the
individual mobility of elderlies. The programme consists of the following components: mobility analysis,
mobility training, and evaluation. The seniors´ need for mobility, depending on where they live (rural or urban
environment), and their overall fitness are analysed on an individual basis using qualitative interviews. Based on
these findings, different subgroups of elderlies are encouraged and advised to use alternative, applicable kinds of
mobility like car sharing, forming a carpool by means of social media, or senior-focused apps for mobility
management to enhance their radius of mobility. Since driving a car is a very important tool to compensate for
decreasing physical fitness and to stay mobile especially for elderlies in rural areas, a major focus of the
programme is the conduction of a senior-focused training in a driving simulator for active car drivers. Hereby,
recent technical developments in the field of driving simulation are specifically implemented for seniors as the
target group. Major characteristics of this training will be (a) an adaptive presentation of (b) driving scenarios
known to be difficult for elderly drivers according to the relevant literature and current accidents statistics (i.e.
intersections, merging into moving traffic), (c) enhanced reality elements to visualize safety relevant information
and (d) a video based feedback. For evaluation, a practical driving test in real traffic with a driving instructor will
be conducted before and after the simulator training. The trained subjects will be compared with a non-trained
advice group. Effects of the programme with respect to changes of the mobility behaviour and the acceptance of
the programme will be assessed by means of interviews.
Keywords: older drivers, rural areas, driving performance, training, compensation, driving simulation.
Résumé
L'objectif du projet nommé « MobilTrain » est le développement d'un programme multimodal pour améliorer la
mobilité individuelle des personnes âgées. Le projet comprend les composants de l'analyse de mobilité,
l'entraînement de mobilité et l'évaluation. Dans des interviews qualitatives, le besoin de mobilité des personnes
âgées dépendant de leur environnement de vie et leur forme est analysé sur une base individuelle. Se basant sur
les résultats de ces interviews, on encourage des sous-groupes différents de personnes âgées à utiliser des modes
de mobilité alternatifs et disponibles, par exemple l'autopartage, la formation d'un covoiturage via médias
sociaux ou des applications mobiles, adaptées aux personnes âgées afin d'agrandir leur rayon de mobilité.
Comme l'aptitude de conduire est très importante pour compenser l'effondrement de la forme physique et afin de
rester mobile, en particulier pour les personnes âgées dans les régions rurales, l'accent principal du projet sera
mis sur un entraînement dans un simulateur de conduite pour des conducteurs actifs. Pour cela, des récents
développements techniques dans le domaine de la simulation de conduite ont été spécialement implémentés pour
des personnes âgées en tant que groupe cible. Les caractéristiques essentiels de cet entraînement seront (a) une
présentation adaptive (b) des scénarios de conduite qui sont connus d'être difficiles pour des personnes âgées
selon la littérature pertinente et les statistiques d'accidents actuelles (c'est à dire les intersections, l'insertion dans
la circulation du trafic), (c) des éléments de réalité améliorés pour visualiser des informations importantes pour
la sécurité et (d) un feedback basé sur des vidéos. Pour l’évaluation, un test pratique de conduite dans le trafic
réel sera réalisé avec un instructeur de conduite devant et après l'entraînement de simulateur. Ainsi, des sujets
entraînés seront comparés avec un groupe consultatif non-entraîné. Les effets du programme avec respect des
changements du comportement de mobilité et de l'acceptation du programme seront évalués à l'aide des
interviews.
Mots clés: conducteurs plus âgés, régions rurales, performance de conduite, entraînement, compensation,
simulation de conduite.
*Corresponding author: Tel: +49-931-78009118; fax: +49-931-78009150
Email address: [email protected]
1. Introduction
In our times of demographic change, driving a car becomes more and more important in order to maintain
mobility and quality of life. The baby boomer generation, reaching slowly the age of 65 in the coming decade, is
characterized by an interest in technology, a heuristic orientation in their lifestyle and a life-long experience of
driving their own car. For elderlies, driving a car is important to compensate for decreasing flexibility.
Furthermore, it is an indispensable resource to maintain an autonomous lifestyle. But numerous changes of
performance and impairments, like a decline in perception (sensory functions), cognition (perceptual speed,
higher order cognitive functions) and physiological functions as well as medical conditions (e.g. Anstey et al.,
2005), go hand in hand with increasing age. These impairments may cause typical driving errors like failing to
yield right of way or merging into moving traffic (AGILE, 2003). These errors lead to specific traffic accidents.
Taking only accident at intersections into account, Preusser et al. (1998) found an exponential rise of the
accident risk with increasing age, resulting in a more than tenfold risk for drivers older than 85 in comparison to
middle-aged drivers. Consistently, in 2011, according to the Federal Statistical Office, the most frequent crashes
of older drivers were observed at intersections (Destatis, 2012). In line with this, until the age of 45, the mileagerelated accident risk decreases continually, but as of the age of 50, it begins to increase (e.g. SWOV, 2010).
However, Langford et al. (2006) found that most drivers aged 75 years and older were indicatively safer than all
other drivers; only older drivers travelling less than 3,000 km per year gave indication of elevated crash rates.
These rates are considered proof for the so called “low-mileage bias”.
Ultimately, these findings point out how important driving practice is for traffic safety. Accordingly, there is
empirical evidence that elderlies may benefit from specific driving trainings until a highly advanced age (see
Unsworth & Baker, 2014). Poschadel et al. (2012) showed that the individual driving competence of elderly
drivers aged 70 and up can be ameliorated by training in real traffic with a professional driving instructor. The
training was comprised of 15 driving sessions. Training objectives were arranged with the driving instructor, but
the driving instructor was completely free to decide how the training sessions were designed. To measure driving
competence, a test course was driven by the trainee four times (before and after the training, follow-up after six
and twelve months). This test course included police recorded hazard black spots for elderly drivers. This is a
very sophisticated way to ensure that the tested traffic situations are both relevant and difficult for elderly
drivers. However, some traffic situations only become difficult within the interaction of other road users and it is
not possible to reproduce and standardize the same traffic situation for each driver.
Driving training in real traffic might be considered the golden standard to test and train driver ability because ist
provides a direct insight into the actual driving performance. However, for safety reasons, it is not possible to
systematically train critical situations in real traffic. Furthermore, as noted above, driving in real traffic has the
significant drawback of insufficient standardization and reproducibility. Modern driving simulation may be a
good alternative since it combines the advantages of classical on road drives and solves its shortcomings (see
Lees et al. 2010): Test scenarios can be systematically designed, presented, and reproduced without endangering
trainees themselves or other road users (Verster & Roth, 2011). Additionally, subjects can practice compensatory
strategies as if they were in real traffic (s. Kaussner, 2007).
Casutt et al. (2014) found that training sessions in a relatively simple driving simulator increased cognitive and
on-road driving performance in 49 subjects with a mean age of 72 years. Moreover, they found that simulator
training was powerful for increasing older drivers´ safety on the road than the classical neurological training. The
results of the Casutt study are very convincing with respect to the benefit of driving simulator trainings for
elderly drivers. However, in contrast to the study of Poschadel et al. (2012), there was no main focus on
situations being specifically difficult and relevant for elderly drivers. Furthermore, recent technical
developments in the field of driving simulation (see e.g. Neukum, 2009) were not utilized in the Cassutt’s
training. But taking advantage of these technological developments, the training effect might be further
increased: For example, by means of an adaptive configuration of the training, based on the actual proficiency
level, well done training contents may be handled faster, whereas contents for which the trainee has an additional
need for training may be deepened. Thus, trainees who only need a little training save time, and trainees who
need more training have the opportunity to practice more intensively.
Another example for applications in the driving simulation that might be useful for training purposes are
enhanced reality elements: the trainee is clearly supported to modify his driving behaviour, e.g. in selecting
appropriate time gaps between other vehicles by the visualization of critical vs. adequate gaps (e.g. when
merging into moving traffic or passing crossroads).
As described above, training may ameliorate driving performance in elderly drivers and help to sustain their
fitness to drive. But surely there are certain limitations of driving trainings. For example, a person suffering from
dementia cannot be trained to drive safely again. Hence, it is important to open perspectives for a life without
using one´s own car by alternative forms of mobility at a young age. However, with respect to alternative forms
of mobility it has to be taken into account that there are many more possibilities for elderlies in urban regions
than in rural regions.
As Krüger (2006) describes, the age span between 60 and 80 years is characterized by an enormous
heterogeneity between individuals. Reviewing the literature about elderly drivers (Whelan et al. 2006), there is a
major focus on age-related deficits which may impair driving safety. However, successful aging in the elderly
population is widespread, and the elderly are generally healthy (Rice & Fineman, 2004). Due to this high
interindividual variance, prevention and rehabilitation programmes require an individual-centered approach. This
approach depends on the actual health status, the living environment (i.e. urban vs. rural), and the planned
activities.
The aim of the project “MobilTrain” is to develop a multimodal programme to support the individual mobility of
elderlies. Based on their individual needs, elderlies are encouraged and advised to use alternative, applicable
kinds of mobility. However, the core of the project is the development of a driving simulation training where
situations are trained that are known to be especially difficult for elderly drivers. Thereby, recent technical
developments in the field of driving simulations are specifically implemented for the target group of elderly
drivers in order to make the training as clear and effective as possible. Effects of the programme are evaluated.
In the following, the project “MobilTrain” will be described in more detail.
2. MobilTrain: A multimodal programme to support the individual mobility of elderlies
2.1. Overview
The programme consists of the components mobility analysis, mobility training, and evaluation (see Figure 1).
Figure 1. Overview of the project MobilTrain.
In the mobility analysis, the seniors´ need for mobility, depending on where they live (rural or urban
environment), and their overall fitness are analysed on an individual basis using qualitative interviews. Based on
these findings, in the mobility training, the elderlies are advised about their driving fitness and encouraged to use
alternative, applicable kinds of mobility like car sharing, forming a carpool by means of social media, or seniorfocused apps for mobility management to enhance their radius of mobility. The major focus of the mobility
training is the development of a senior-focused training in a driving simulator. Recent technical developments in
the field of driving simulation are specifically implemented for seniors as the target group. For evaluation, a
practical driving test in real traffic with a driving instructor will be conducted before and after the simulator
training. Thus, the trained subjects will be compared with a non-trained advice group. Effects of the programme
with respect to changes of the mobility behaviour and the acceptance of the programme will be assessed by
means of interviews.
2.2. Mobility analysis
Individual interviews and focus groups (see Figure 2) are conducted in workshops with different subgroups of
about ten seniors 65+ (urban vs. rural living environment, younger vs. older age, mildly vs. moderately
impaired) in order to investigate how they differ with respect to their mobility behaviour. Elderlies from three
different regions are recruited for participation (city of Wurzburg with a good traffic infrastructure,
Veitshochheim - a smaller village 10 km away from Wurzburg – and Boxberg – about 60 km away from
Wurzburg having a bad traffic infrastructure). The following themes are discussed:
• How do different sub-groups of elderlies differ in their need for mobility?
• Which trips are done with which modes of mobility for which purposes?
• What are individual impairments of mobility?
• How do elderlies subjectively assess their fitness to drive?
• Which compensatory strategies are used?
Figure 2. Workshop with the target group as a part of the mobility analysis.
2.3. Mobility training
First, all participants have the opportunity to drive with a driving instructor an on-road driving test course that
lasts about 90 minutes. Afterwards, individual counselling interviews (see Figure 3) are conducted with a major
focus on
• the discussion of driving-related strengths and weaknesses based on self-evaluations and the on-road
driving test
• an individualized optimization of the route planning depending on the health status, prescribed
medicines, and planned activities
• information about regional available alternative forms of mobility like local public transport, car
sharing, or forming a carpool by means of social media as well as senior-focused apps for mobility
management to enhance the radius of mobility.
After the interview, some helpful apps for mobility management are not only presented and explained, but
exercises for handling the apps are conducted. Participants who owe a smart-phone get the apps installed and
individually configured on their own device; the others may borrow a tablet PC for practicing the apps at home.
Figure 3. Individual counselling interview.
The core of the programme is the conduction of a senior-focused training in a driving simulator (see Figure 4)
for active car drivers. The high quality of the hardware used in this simulator with respect to the steering, the
pedals and the displays ensures a very realistic driving experience.
Figure 4. The static driving simulator of the WIVW. The mock-up is modelled on a passenger car.
The visual system comprises five image channels for realizing 300° horizontal field of view.
The whole driving simulator training comprises four sessions that last about two hours each. The first session
focuses on familiarizing participants with the driving simulator in order to avoid simulator sickness (see
Hoffmann & Buld, 2006). The second session comprises a representative test course with situations on high way,
on rural road and in urban areas (see Kaussner et al. 2013) in order to measure driving performance before the
training. Here, both, the operational and the tactical aspect of the driving task (Michon, 1985) are addressed.
Driving performance is assessed with the application S.A.F.E. (Standardized Application for Fitness to Drive
Evaluations, see Figure 5). S.A.F.E. allows to assess subjects’ driving performance and to register their driving
errors semi-automatically on a convenient interface according to the procedure described by Kaussner et al.
(2010) and Brenner-Hartmann (2002). The definition and classification of driving errors according to this
procedure are based on a review of the relevant literature on classifications of the driving task (Fastenmeier,
1995; Kroj & Pfeiffer, 1973; Maag,, 1995, Risser & Brandstädter, 1985; Steinbrecher, 1988; all cited according
to Brenner Hartmann, 2002).
Basically, the total number of driving errors and the following subcategories of errors are registered and
recorded:
• Tactical errors with respect to longitudinal control (speed too high, speed too low, inadequate
speed/acceleration/deceleration, time headway too low/tailgating).
• Operational errors with respect to lateral control (bad lane keeping/lane departures, lateral distance to
objects/vehicles too low).
• Cognitively based tactical errors (violating right of way, delayed securing, overcautious securing, errors
in changing/choosing lanes, driving on impermissible lanes, no/untimely blinking,
no/ambiguous/inappropriate dealing with communication with/of
with/of other road users).
• Collisions and critical situations with respect to endangering other vehicles, bicyclists or pedestrians.
Figure 5. Standardized Application for Fitness to Drive Evaluations
Evaluations for Tablet PC (S.A.F.E.)
In the third and fourth session, the actual training is conducted comprising three learning modules with practical
exercises on
o right of way rules
• refreshing the knowledge of
• merging into moving traffic and lane changes
• passing through complex intersections in urban
u
areas
As depicted in Figure 6, for the first learning module,
module five driving situations each with four priority of way rules
and five traffic light scenarios are presented. At the end of the module, a video-based
based feedback is given. When
required, participants may repeat several situations in order to become more self-confident.
self confident.
Figure 6. In the first learning
earning module of the driving simulator training, five situations x four priority of way rules are
presented (in addition to five traffic light scenarios not shown here).
here). The red square depicts the ego-vehicle.
ego
Arrows indicate
the intended driving direction.
The aim of the second learning module is to practice merging into moving traffic and changing lanes. Merging is
practiced with different velocities and different traffic densities on the target lane (see Figure 7). By means of
enhanced reality elements, critical vs. appropriate gaps can be visualized in terms of colour.
colou In comparison to
younger drivers, older drivers show a reduced frequency of visual
visu inspection toward the rear-view
rear
mirror and the
blind spot (Lavallière et al. 2011). In order to retrain this suboptimal visual strategy of elderlies, gaze behaviour
is tracked by a video eye-tracker.. If the frequency and the duration of gazes to the mirrors
rors and to the blind spot
are insufficient to negotiate a secure lane change, drivers will be especially instructed to check their gaze
behaviour.
Figure 7. Example for a “Merging Into Moving Traffic” scenario. Enhanced reality features support subjects in accepting
appropriate time gaps.
The aim of the third learning module is to practice passing-through complex intersections with different rules of
priority with three stages of difficulty. The intersections presented in this training module are based on the police
recorded hazard black spots for elderly drivers as described by Poschadel et al. (2012, see Figure 8).
Figure 8. Intersection Körner Hellweg / Am Zehnthof in Dortmund:
(a) Reality (Screenshot taken from Google Maps) vs. (b) simulation.
Three levels of difficulty are realized. These levels of difficulty are presented adaptively. This adaptiveness is
based on an ascending order of the three stages of difficulty and aims to allow additional training of easier
situations if significant driving errors have been detected and a faster completion of the training if the participant
shows a very good driving performance. For this purpose, driving scenarios are linked to each other during
runtime, depending on the performance of the participant (see Figure 9). Thereby, driving performance is
assessed by means of the application S.A.F.E.
Figure 9. Schematic illustration of adaptiveness. If the scenario of moderate difficulty is passed well, the more difficult
scenario is linked; else the easier scenario is presented.
By means of replay techniques, conflict situations may be video-recorded
video recorded from different perspectives (e.g. bird'seye view for a better overview, from the perspective of other road users to illustrate possible conflicts).
conflicts When
debriefing the exercises, the participants can observe their own driving errors in order to
t achieve a reasonable
estimation of their own coping strategies.
strateg
Since elderly drivers tend to overestimate their own driving
performance (e.g. Freund et al. 2005), the
t acquisition of this competence – a realistic balance between task
requirements and the own driving skills - is a central learning object to increasee driving safety.
safety
At the end of the fourth session, driving performance is reassessed by means of a parallel version of the
representative test course performed before the training in the second session.
session
2.4. Evaluation
Counselling interviews,, training pf mobility apps and the simulator training will be combined to
t a mobility
optimizing programme. The whole programme will be evaluated with N=20 newly recruited elderlies. Half of
them will receive the whole programme whilst the other half will only receive the counselling interviews and the
training of mobility apps (randomized allocation to training and control group).
For the evaluation of the driving simulator training, driving performance of the training and the control group
will be compared in a representative driving test in real traffic (see Figure 10). The on-road
on
test will be
conducted before and after the simulator training.
training Driving performance is cross-validated
validated by a traffic
psychologist registering and classifying driving errors by means of the application S.A.F.E. (being adapted to
real traffic conditions) as well as by the subjective rating of the driving instructor.
To evaluate the counselling interviews, all
a N=20 participants will be interviewed before and a few weeks after
the conduction of the programme to investigate if they have changed their mobility behaviour (usage frequency
of different mobility modalities, radius of mobility,
mobility, attitudes to alternative forms of mobility and apps). Finally,
subjects are questioned about the programme to investigate its acceptance as well as to identify possibilities of
improvement.
Figure 10. On-road driving test with driving instructor.
3. Outlook
The demand to assist elderly people who value mobility is growing; programs that counsel them about their
fitness to drive, train them, and introduce them them to mobility alternatives are vital. However, up to now, there
are no scientifically sound programmes
programme in Germany holistically train mobility and account for the very
heterogeneous mobility needs of this generation. MobilTrain
Train aims to narrow this gap. The long-term
l
goal is that
the training programme being developed within the framework of MobilTrain is applied by different multipliers
like geriatric clinics, driving schools or large companies.
Within MobilTrain, the enormous technical progresses that have recently been achieved in the area of driving
simulation are firstly implemented for the particular target group of elderlies. Starting from here, the contents of
the training may be adapted and enlarged by additional modules for rehabilitation of driving ability in various
age-related conditions and diseases (like e.g. conditions after stroke or early stages of Parkinson’s disease,
posttraumatic stress disorder). Therefore, disease-specific
d
training contents have to be derived from diseasecorrelated deficits in driving performance in an interdisciplinary cooperation of medicines,
medicines psychologists and
traffic scientists.
Acknowledgements
The project MobilTrain is funded by the Federal Ministry of Education and Research (BMBF). The VDI/VDE
Innovation + Technik GmbH is the project executing organization.
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