Hardly Silent: Exploring Civic Engagement and Participation among a Panel of Adults Ages 85.

The past twenty years have seen a surge of resources for and public attention devoted to civic participation opportunities for older adults in the United States. At the same time, technology has transformed the way information related to political and social issues is spread and shared. As more older adults migrate to using a wider range of communication tools and the internet, technology-mediated forms of engagement represent a new way for the oldest old to participate in society. In this study, a panel of adults ages 85 and older was surveyed to understand their experiences engaging with political and social issues. Responses to a questionnaire (N = 24) and focus groups (n = 22) indicate the oldest old are interested in social and political issues, and there are opportunities for technology to facilitate the oldest olds' civic and political action. This study identifies roles social workers may play in helping the oldest old engage with social and political issues in their communities.

The Influence of Feelings While Driving Regular Cars on the Perception and Acceptance of Self-Driving Cars.

Self-driving vehicles will affect the future of transportation, but factors that underlie perception and acceptance of self-driving cars are yet unclear. Research on feelings as information and the affect heuristic has suggested that feelings are an important source of information, especially in situations of complexity and uncertainty. In this study (N = 1,484), we investigated how feelings related to traditional driving affect risk perception, benefit perception, and trust related to self-driving cars as well as people's acceptance of the technology. Due to limited experiences with and knowledge of self-driving cars, we expected that feelings related to a similar experience, namely, driving regular cars, would influence judgments of self-driving cars. Our results support this assumption. While positive feelings of enjoyment predicted higher benefit perception and trust, negative affect predicted higher risk and higher benefit perception of self-driving cars. Feelings of control were inversely related to risk and benefit perception, which is in line with research on the affect heuristic. Furthermore, negative affect was an important source of information for judgments of use and acceptance. Interest in using a self-driving car was also predicted by lower risk perception, higher benefit perception, and higher levels of trust in the technology. Although people's individual experiences with advanced vehicle technologies and knowledge were associated with perceptions and acceptance, many simply have never been exposed to the technology and know little about it. In the absence of this experience or knowledge, all that is left is the knowledge, experience, and feelings they have related to regular driving.

Walking a mile in another's shoes: The impact of wearing an Age Suit.

The "Age Suit" described in this article was developed to enable future designers, business leaders, and engineers to experience navigating the world as many older adults must. Tools such as this Age Suit offer the opportunity to "walk a mile" in another's shoes to develop empathy that can result in better design of spaces, goods, and services to meet the needs of a rapidly growing older population. This work first examined, through a series of clinical tests, whether younger adults' physical capacities were reduced in a direction consistent with aging by wearing a suit developed by the MIT AgeLab. An experiential learning task was then completed with the suit to understand its impact on completion of an instrumental activity of daily living. Results showed that younger adults wearing the suit experienced changes in task performance consistent with expected changes associated with aging. Participants' self-reports from the experiential learning task indicated that they were able to empathize with older adults regarding some issues they face while completing a grocery shopping task. Future research with the suit should involve a wider range of individuals from the population and examine what effect participants' levels of fitness have on the experience of wearing the suit.

Utilising psychophysical techniques to investigate the effects of age, typeface design, size and display polarity on glance legibility.

Psychophysical research on text legibility has historically investigated factors such as size, colour and contrast, but there has been relatively little direct empirical evaluation of typographic design itself, particularly in the emerging context of glance reading. In the present study, participants performed a lexical decision task controlled by an adaptive staircase method. Two typefaces, a 'humanist' and 'square grotesque' style, were tested. Study I examined positive and negative polarities, while Study II examined two text sizes. Stimulus duration thresholds were sensitive to differences between typefaces, polarities and sizes. Typeface also interacted significantly with age, particularly for conditions with higher legibility thresholds. These results are consistent with previous research assessing the impact of the same typefaces on interface demand in a simulated driving environment. This simplified methodology of assessing legibility differences can be adapted to investigate a wide array of questions relevant to typographic and interface designs. Practitioner Summary: A method is described for rapidly investigating relative legibility of different typographical features. Results indicate that during glance-like reading induced by the psychophysical technique and under the lighting conditions considered, humanist-style type is significantly more legible than a square grotesque style, and that black-on-white text is significantly more legible than white-on-black.

Assessing the impact of typeface design in a text-rich automotive user interface.

Text-rich driver-vehicle interfaces are increasingly common in new vehicles, yet the effects of different typeface characteristics on task performance in this brief off-road based glance context remains sparsely examined. Subjects completed menu selection tasks while in a driving simulator. Menu text was set either in a 'humanist' or 'square grotesque' typeface. Among men, use of the humanist typeface resulted in a 10.6% reduction in total glance time as compared to the square grotesque typeface. Total response time and number of glances showed similar reductions. The impact of typeface was either more modest or not apparent for women. Error rates for both males and females were 3.1% lower for the humanist typeface. This research suggests that optimised typefaces may mitigate some interface demands. Future work will need to assess whether other typeface characteristics can be optimised to further reduce demand, improve legibility, increase usability and help meet new governmental distraction guidelines. Practitioner Summary: Text-rich in-vehicle interfaces are increasingly common, but the effects of typeface on task performance remain sparsely studied. We show that among male drivers, menu selection tasks are completed with 10.6% less visual glance time when text is displayed in a 'humanist' typeface, as compared to a 'square grotesque'.

An Intersectional Approach to Understanding the Psychological Health Effects of Combining Work and Parental Caregiving.

OBJECTIVES: Role theory suggests occupying simultaneous family caregiving and employment roles in midlife may exert positive and negative effects on psychological health. However, there is a lack of causal evidence examining the degree to which combinations of these roles influence psychological health at the intersection of gender and racial identity. METHODS: Longitudinal data from the Health and Retirement Study (2004-2018) are used to estimate a series of individual fixed effects models examining combinations of employment status and parental caregiving situation on Center for Epidemiological Studies-Depression Scale (CES-D) depression scores among Black and White men and women aged 50-65. Subsequent models were stratified by intensity of caregiving situation and work schedule. RESULTS: Individual fixed effects models demonstrate combining work, and parental caregiving is associated with greater depressive symptoms than only working, and with lower depressive symptoms than only caregiving, suggesting that paid employment exerts a protective effect on psychological health whereas parental caregiving may be a risk factor for depressive symptoms in later life. Analyses using an intersectional lens found that combining paid work with parental caregiving exerted a protective effect on CES-D scores among White women and men regardless of participants' intensity of care situation or work schedule. This effect was not present for Black men and women. DISCUSSION: Accounting for intersectionality is imperative to research on family caregiving, work, and psychological health.

Oldest old's travel mode choice and new mobility technology acceptance: case in America and China.

Introduction: The oldest olds (aged 85 and over) are the fastest-growing age segment. However, our understanding of their mobility is limited. To address this gap, we invited 19 U.S. and 30 Chinese "oldest old" to take part in focus groups and complete a mobility questionnaire. We focus on travel mode choice, which includes changes in travel modes, frequency of usage, and perceptions of comfort. Methods: Older adults' familiarity and acceptance of new mobility technologies (e.g., ridesharing, carsharing, and autonomous vehicles) were measured by questionnaire and focus group. Word clouds were also used to illustrate people's reasons for choosing their primary mode of transportation. Results and discussion: The results show that both panels of older adults similarly feel some extent of travel limitations. But the responses among the two groups differ: 18 American participants chose "drive myself" as their primary option a decade ago, while 11 chose it now; no Chinese participants selected it either a decade ago or now. Both currently and 10 years ago, there was a significant difference in mode choice between participants in China and the United States. However, this gap has narrowed over the past decade. Participants in China have significantly changed their transportation preferences compared to 10 years ago, while participants in the US have remained nearly unchanged. American respondents consider "ease" as an important factor, while Chinese respondents pay more attention to "safety" and "no other option to get around" when making travel mode choices. Compared to Chinese participants, American participants were more comfortable with driving an autonomous vehicle. These differences may result from the various developmental stages and transportation policies of the two countries. This study supports the development of new mobility technologies for the oldest old to improve their quality of life.

Non-task expert physicians benefit from correct explainable AI advice when reviewing X-rays.

Artificial intelligence (AI)-generated clinical advice is becoming more prevalent in healthcare. However, the impact of AI-generated advice on physicians' decision-making is underexplored. In this study, physicians received X-rays with correct diagnostic advice and were asked to make a diagnosis, rate the advice's quality, and judge their own confidence. We manipulated whether the advice came with or without a visual annotation on the X-rays, and whether it was labeled as coming from an AI or a human radiologist. Overall, receiving annotated advice from an AI resulted in the highest diagnostic accuracy. Physicians rated the quality of AI advice higher than human advice. We did not find a strong effect of either manipulation on participants' confidence. The magnitude of the effects varied between task experts and non-task experts, with the latter benefiting considerably from correct explainable AI advice. These findings raise important considerations for the deployment of diagnostic advice in healthcare.

Walking the tightrope: developing a systems approach to balance safety and mobility for an aging society.

In an aging population, safety and mobility are often viewed as being in conflict, when in fact they are two values that must be reflected equally in transportation policy. The challenge for policy makers and for society is to emphasize and optimize both. To achieve this, a comprehensive systems approach to driver health, personal decision-making and planning, community and transportation systems construction, vehicle design, and licensing regulations is needed. Such an approach requires crafting policies based on conceptualizing the issue as a continuum of resources facilitating safety and mobility regardless of driving status. The discussion that follows reviews components of the issue and suggestions for developing a comprehensive approach.

Do as AI say: susceptibility in deployment of clinical decision-aids.

Artificial intelligence (AI) models for decision support have been developed for clinical settings such as radiology, but little work evaluates the potential impact of such systems. In this study, physicians received chest X-rays and diagnostic advice, some of which was inaccurate, and were asked to evaluate advice quality and make diagnoses. All advice was generated by human experts, but some was labeled as coming from an AI system. As a group, radiologists rated advice as lower quality when it appeared to come from an AI system; physicians with less task-expertise did not. Diagnostic accuracy was significantly worse when participants received inaccurate advice, regardless of the purported source. This work raises important considerations for how advice, AI and non-AI, should be deployed in clinical environments.

The validity of driving simulation for assessing differences between in-vehicle informational interfaces: A comparison with field testing.

Data from on-road and simulation studies were compared to assess the validity of measures generated in the simulator. In the on-road study, driver interaction with three manual address entry methods (keypad, touch screen and rotational controller) was assessed in an instrumented vehicle to evaluate relative usability and safety implications. A separate group of participants drove a similar protocol in a medium fidelity, fixed-base driving simulator to assess the extent to which simulator measures mirrored those obtained in the field. Visual attention and task measures mapped very closely between the two environments. In general, however, driving performance measures did not differentiate among devices at the level of demand employed in this study. The findings obtained for visual attention and task engagement suggest that medium fidelity simulation provides a safe and effective means to evaluate the effects of in-vehicle information systems (IVIS) designs on these categories of driver behaviour. STATEMENT OF RELEVANCE: Realistic evaluation of the user interface of IVIS has significant implications for both user acceptance and safety. This study addresses the validity of driving simulation for accurately modelling differences between interface methodologies by comparing results from the field with those from a medium fidelity, fixed-base simulator.

Reducing Isolation and Loneliness Through Membership in a Fitness Program for Older Adults: Implications for Health.

Objectives: To explore the effects of membership in a fitness program for older adults on social isolation, loneliness, and health. Method: Using survey responses from SilverSneakers members and matched nonmembers, regression path analysis was used to examine the influence of SilverSneakers membership on physical activity, social isolation, loneliness, and health, and the interrelationships among these concepts. Results: SilverSneakers membership directly increased physical activity and self-rated health, directly decreased social isolation, and indirectly decreased loneliness. Decreased social isolation and loneliness were associated with better self-rated health: social isolation and loneliness had independent direct effects on health, while social isolation also had an indirect effect on health mediated through loneliness. Discussion: Members of SilverSneakers experienced better health through increased physical activity, reduced social isolation, and reduced loneliness. Future research should explore independent effects of social isolation and loneliness on health and the mechanisms by which membership reduces social isolation and loneliness.

Health, safety, self-regulation and the older driver: it's not just a matter of age.

PROBLEM: The purpose of this research was to examine the impact of age and health on patterns of driving and self-regulation among older adults who still drive. METHOD: This analysis presents the results of a nationwide survey of drivers who are 50+(N=3,824, 53.11% response rate), focusing on questions about the impact of their self-reported health on attitudes toward and self-regulation of driving. RESULTS: The data indicate that as age increases, so too does reported self-regulation of driving, increasing sharply among those ages 70 and older. The data also indicate that respondent's reported confidence in driving and their enjoyment of driving decline as they age. Health status bears a significant relationship with all three of these variables, positively related to confidence in driving skills and to enjoyment in driving, but negatively related to self-regulation reports. As self-reported health declines, respondent's report engages in greater voluntary restrictions of their driving. DISCUSSION: All too often, the driving decision is linked primarily to chronological age. Analysis done here indicates that age alone is not the best indicator of self-regulation and how older adults change their driving behaviors. SUMMARY: This research presents the results of a nationwide survey of 50+ drivers and their self-reported driving, self-regulation behaviors, and health status. Strong support was found for the argument that chronological age is not an adequate measure of self-regulating behaviors and driver safety among those 50+. In particular, it was found that a person's health status and the interaction between age and health are essential considerations in the decisions around self-regulation and driving. People tend to self-regulate more with age, but the effect becomes much more pronounced as health status declines. IMPACT ON INDUSTRY: In the coming years, if older adults can't get to where they want to go and continue to be viable consumers in our national fabric, all industries will eventually suffer. Transportation is a key component to the nation's social contract with older individuals and their families.

At the crossroads: development and evaluation of a dementia caregiver group intervention to assist in driving cessation.

Deciding when an individual with dementia must reduce or stop driving can be a stressful issue for family caregivers. The purpose of this study was to develop a group intervention to assist these caregivers with driving issues and to provide a preliminary evaluation of the comparative effectiveness of this At the Crossroads intervention. Participants were randomized to one of three arms: (1) active intervention (four 2-hour manualized educational/support group meetings; n = 31); (2) written materials only (participants received written materials after a pretest; n = 23); and (3)control (participants received written materials after a posttest; n = 12).Participants were administered a battery of self-report and interview-based questionnaires at baseline and again 2 months later. At follow-up, the active intervention group scored significantly better than both other groups on key outcome variables, including self-efficacy, communication, and preparedness. The At the Crossroads caregiver intervention appears to effectively provide education and support needed for caregivers to address driving-related issues with their loved ones.

Relationships Between Older Drivers' Cognitive Abilities as Assessed on the MoCA and Glance Patterns During Visual-Manual Radio Tuning While Driving.

Objective: Research has established that long off-road glances increase crash risk, and other work has shown increased off-road glance behavior in older drivers. This study investigated the relationship between older drivers' (M = 66.3, range 61-69 years) cognitive abilities and the duration of off-road glances while engaged in secondary visual-manual activities. Method: Twenty-two drivers completed the Montreal Cognitive Assessment (MoCA) prior to driving an instrumented vehicle and completing a set of radio-tuning tasks. Glance behavior was recorded and manually coded into 7 glance regions (toward the forward roadway, instrument cluster, center stack, rearview mirror, left, right, and other). Results: On average, older drivers with higher MoCA scores used shorter glances and glanced away from the forward roadway for less total time when manually tuning the radio. Discussion: These findings suggest that lower MoCA scores may represent a driving force behind the "age" differences reported in earlier studies of off-road glance behavior. Questions are raised concerning the identification of MoCA scores that might be used as inclusion cut-points in driving research and in identifying individuals needing further evaluation related to suitability for continuance of driving.

Task-induced fatigue and collisions in adult drivers with attention deficit hyperactivity disorder.

OBJECTIVE: This study compares collision involvement between adult drivers with attention deficit hyperactivity disorder (ADHD) and control participants in a simulation experiment designed to enhance the effects of fatigue. Because the effects of ADHD include difficulties in maintaining attention, drivers with ADHD were hypothesized to be more susceptible to the effects of fatigue while driving. METHODS: Data are drawn from a validated driving simulation study, portions of which were focused on enhancing the effects of fatigue. The simulator data are supplemented with written questionnaire data. Drivers with ADHD were compared with controls. RESULTS: The self-report data indicated that drivers with ADHD were more likely to report having been involved in an accident within the previous five years. Simulation data showed that time of day of participation in the experiment were significantly related to likelihood of collision, and that these effects were further exacerbated by ADHD status. Participants with ADHD were more likely than controls to be involved in a crash in the simulator regardless of time of day, but the effects were particularly pronounced in the morning, and the rate of increase in accident involvement from the late afternoon into the evening was greater among participants with ADHD. No differences in self-reported sleep patterns or caffeine use were found between participants with ADHD and controls. CONCLUSIONS: The results suggest that drivers with ADHD became fatigued more quickly than controls. Such drivers thus face greater risk of involvement in accidents on highways or open roadways where the visual and task monotony of the environment contribute to greater driver fatigue.

A laboratory driving simulation for assessment of driving behavior in adults with ADHD: a controlled study.

BACKGROUND: It is now estimated that attention deficit-hyperactivity disorder (ADHD) afflicts at least 4% of adults in the United States and is associated with high levels of morbidity and functional impairment. One key area of dysfunction associated with ADHD is impaired motor vehicle operation. Our goal was to examine the association between ADHD and specific driving outcomes in a sample of adults using a driving simulator. METHODS: Subjects were 20 adults with full DSM-IV ADHD and 21 controls without ADHD of equal gender distribution. However, the mean age of subjects with ADHD was somewhat older. All analyses were adjusted for age and gender. All subjects participated in a driving simulation that lasted for one hour and consisted of a short training period, a high stimulus segment and a low stimulus segment with two distinct monotonous periods. RESULTS: In the second monotonous period within the low stimulus environment, ADHD subjects were significantly more likely than controls to collide with an obstacle suddenly appearing from the periphery, adjusting for age and gender. CONCLUSION: Adults with ADHD were more likely than controls to collide with an obstacle during a driving simulation suggesting that deficits in directed attention may underlie driving impairments in this population.

Secondary analysis of time of day on simulated driving performance.

PROBLEM: Age and gender are frequently controlled for in studies of driving performance, but the effects of time of day or circadian cycles on performance are often not considered. Previous research on time of day effects of simulated driving is contradictory and provides little guidance for understanding the impact of these variables on results. METHODS: Using driving simulator data from 79 subjects ages 18 to 65, this paper focuses on the impact of age, gender, and time of day on the simulated driving performance of subjects who self-selected the time of participation. RESULTS: Time of day effects were consistently evident for drivers' speed overall and across different simulated environments. Drivers in the late afternoon period consistently drove significantly slower than drivers in other time periods. Age and gender affected speed such that women and those participants 50 and older tended to drive more slowly. Time of day also had an effect on reaction time and on speed variability measures. Gender did not have significant effects on reaction time or variability measures, but age effects were present. SUMMARY: Taken together, the results suggest that time of day effects should be considered as part of simulated driving performance, and that interactions between time of day and other variables, notably age, should be controlled for as part of future research. IMPACT ON INDUSTRY: Implications of these findings on current efforts for older driver testing are discussed.