Health & Medicinearticle2026-10-14

Visual Search Behavior Towards Reference Areas During an S-Curve Driving Task in Elderly Drivers with Mild Cognitive Impairment

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Abstract

Age- and cognitive-related changes in visual search behavior may affect driving performance, particularly during complex road maneuvers requiring continuous steering adjustments. The aim of this study was to clarify the characteristics of visual search behavior in elderly drivers during S-curve driving. Seven elderly drivers with a high prevalence of mild cognitive impairment (MCI) and ten expert drivers working as professional driving instructors performed crank and S-curve driving tasks. Their visual search behavior toward reference points and surrounding reference areas was monitored using an eye tracker (Tobii Pro Glasses 2). Linear mixed-effects model analysis revealed a significant Group × Area of Interest interaction: elderly drivers allocated significantly longer gaze dwell percentages to inner reference areas (specifically, Reference Areas 11 and 13) during the second half of the S-curve compared to expert drivers (p < 0.001). These findings imply that expanded gaze allocation toward reference areas may serve as a potential compensatory mechanism in elderly drivers with MCI features to construct spatial awareness under dynamic driving demands, representing one of several plausible interpretations alongside cognitive and task-related factors. These preliminary insights could contribute to understanding visual search mechanisms in elderly clinical populations.

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Authors: Takahiro Otsuka, Munkhbayasgalan Byambadorj, Ryoto Akiyama, Ken Kondo, Naoto Noguchi, Siyeong Kim, Lisa Sato, A Yanai, Ai Yanai, Hina Yoshizawa, Megumi Sakamoto, Takeru Nakajima, Bumsuk Lee

Institutions: Gunma University, Gunma University of Health and Welfare, Japan International Cooperation Agency, Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital, Maebashi Institute of Technology, Gumma Paz College, Gumi University, Maebashi Red Cross Hospital