Motion perception as a risk factor for motor vehicle collision involvement in drivers ≥ 70 years

•Visual function and association with rate of motor vehicle collision (MVC) among drivers 70 years and older was assessed.•For the first time impaired motion perception was shown to be a MVC risk factor in real-world settings.•Risk of MVC increases for impaired peripheral visual field sensitivity and visual acuity.•Severely impaired visual processing speed is associated with MVC. To evaluate the relationship between visual function and a five-year history of motor vehicle collision rates in older adults. Motion perception impairment was explored as a risk factor for motor vehicle collisions for the first time in this study. Participants were licensed drivers ≥70 years old enrolled in the Alabama VIP Older Driver Study who underwent functional assessments for motion perception, distance visual acuity, contrast sensitivity, visual field sensitivity, and visual processing speed. Participants were recruited based on their being patients in an ophthalmology clinic in the year prior to enrollment or had participated in an earlier driving study. Crash reports were obtained from the Alabama Law Enforcement Agency for the 5 years prior to enrollment and mileage estimated using the Driving Habits Questionnaire. Crude and age-adjusted rate ratios (RRs) and 95 % confidence intervals (95 % CIs) were calculated using Poisson regression. 159 participants enrolled with a mean age of 79 years. The age-adjusted crash rate was higher among those with worse motion perception (RR: 2.7, 95 % CI: 1.4−5.2), severe slowing in visual processing speed (RR: 3.6, 95 % CI: 1.5−8.5), and impaired peripheral visual field sensitivity (RR: 2.4, 95 % CI: 1.3−4.4). Among a sample of older drivers, crash rates were higher for those with impaired motion perception, severely slowed visual processing speed, and impaired peripheral visual field sensitivity. The association between motion perception and crash risk in older drivers has not been previously reported. Prospective analysis of the Alabama VIP Older Driver Study will examine these risk factors for future collision involvement based on naturalistic driving data.