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    <title>Transport Research International Documentation (TRID)</title>
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    <language>en-us</language>
    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
    <docs>http://blogs.law.harvard.edu/tech/rss</docs>
    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>Transport Research International Documentation (TRID)</title>
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      <link>https://trid.trb.org/</link>
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    <item>
      <title>Metacognitive judgments of alcohol-related intoxication and impairment: The Mellanby effect and alcohol myopia in low-risk drinkers</title>
      <link>https://trid.trb.org/View/2714767</link>
      <description><![CDATA[The decision to drive after alcohol consumption is largely influenced by an individual’s interpretation of their alcohol intoxication and level of driving impairment. However, such perceptions may be influenced by the level and duration of intoxication. This study investigated the effect of alcohol intoxication on drivers’ judgments of their impairment and driving capabilities across different blood alcohol concentration (BAC) levels.  One hundred and sixty blinded participants were randomly allocated into low (∼.025%), mid (∼.055%), or high (∼.085%) BAC condition groups and completed surveys about their perceived alcohol intoxication and driving capabilities at various time points.  The results showed that the mid BAC condition group was most accurate in estimating the number of standard drinks consumed, whereas the low condition group overestimated, and the high condition group underestimated their alcohol consumption. While participants overestimated their BAC, they became more accurate when their BAC was falling. Between-group comparisons showed that participants rated their driving capabilities lower in the higher BAC condition groups. However, prior to consuming alcohol, the mid and high condition groups were significantly more confident in their ability to drive over the legal limit. Despite having a higher average actual BAC, the high condition group reported greater driving capabilities when their BAC was falling and a lower estimated BAC compared to the mid condition group when BAC was rising. Finally, logistic regression analysis revealed that estimated BAC and estimation confidence, rather than perceived driving impairment, significantly predicted the decision to drive after drinking.  These findings suggest that the level and duration of alcohol intoxication may influence a driver’s perception of impairment and their subsequent decision to drive.]]></description>
      <pubDate>Fri, 21 Aug 2026 14:01:30 GMT</pubDate>
      <guid>https://trid.trb.org/View/2714767</guid>
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    <item>
      <title>Identifying neuropsychological correlates of driving performance in older adults: Findings from the ROADSAFE study</title>
      <link>https://trid.trb.org/View/2731156</link>
      <description><![CDATA[Previous research has identified a need for standardized assessment tools for assessing cognitive fitness to drive, given the increasing ageing population and emergence of age-related conditions that can ultimately affect driving and crash risk. This study examined whether neuropsychological test measures that have previously demonstrated sensitivity to subclinical changes in cognition arising from mild cognitive impairment correlate with measures of driving capacity (assessed via a hazard perception test [HPT] and driving simulator) in older adults. A total of 216 older adults with a mean age of 72 years (SD = 6.62; range 60–92 years) completed a comprehensive neuropsychological assessment battery, a HPT and simulated driving tasks. The relationships between neuropsychological test measures and driving performance metrics were examined. Poorer sustained attention (measured by the Cambridge Automated Neuropsychological Assessment Battery; CANTAB; Rapid Visual Processing accuracy) was associated with slower response latencies on the HPT. Further, lower visuo-spatial working memory (measured by the CANTAB subtest Spatial Span) was associated with slower speeds. Finally, greater response time variability during the subtest Five-Choice Reaction Time (a divided attention task) was associated with greater variability in headway distance. Small-to-moderate magnitude effects were observed. These findings represent an important starting point for developing screening tools for assessing cognitive fitness to drive.]]></description>
      <pubDate>Fri, 14 Aug 2026 15:04:42 GMT</pubDate>
      <guid>https://trid.trb.org/View/2731156</guid>
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    <item>
      <title>Sudden, powerful, unsafe and unintended accelerations: Pedal confusion and misapplication in drivers with diabetic peripheral neuropathy</title>
      <link>https://trid.trb.org/View/2725118</link>
      <description><![CDATA[Several road safety studies address the question of how many crashes are caused by pedal confusion, also called pedal errors, leading to mistaken and unintended accelerations. Perhaps the most important issue is to determine the causes of this phenomenon. The authors address here the scientific/physiological question of whether unintended accelerations (when the intention and need was to brake) could be a direct consequence of the sensorimotor functional impairment induced by diabetic peripheral neuropathy (DPN). The authors studied both measures of sensory and motor function, and observations in a driving simulation, in drivers with and without neuropathy affecting sensation in the feet and proprioception around the ankle. Only drivers with neuropathy exhibited sudden, powerful, unsafe and unintended accelerations when braking was needed − instances of pedal confusion and misapplication. The authors argue that this difference between drivers with versus without neuropathy demonstrates that DPN could be a direct cause of these dangerous events, and propose a candidate causal mechanism. The purpose is firstly to highlight that DPN increases the likelihood of making a mistake by pressing the wrong pedal, which places drivers with DPN at increased risk of crash as a consequence of unintended acceleration. This means, secondly, that these drivers will benefit from specific preventive countermeasures, and the authors recommend three that could be used: 1) choosing to drive a manual gear change vehicle rather than an automatic, 2) fitting an acceleration limiter, and 3) providing footwell illumination of the right foot and pedals during driving at night.]]></description>
      <pubDate>Fri, 14 Aug 2026 15:04:42 GMT</pubDate>
      <guid>https://trid.trb.org/View/2725118</guid>
    </item>
    <item>
      <title>Cannabis, self-ratings of cognition and driving behaviour among older adults: An exploratory study</title>
      <link>https://trid.trb.org/View/2735216</link>
      <description><![CDATA[Despite cannabis use increasing among older adults, scant research has explored the subjective effects of cannabis (both prescribed and non-prescribed) on cognitive and driving-related skills in older adults, and how these relate to driving following cannabis consumption. This study explored the nature of cannabis use (both prescribed and non-prescribed) in older adults and self-ratings of perceived cognitive and driving-related competence. In addition, this study aimed to identify factors that predict driving wait times following cannabis consumption among this cohort. A total of 283 participants aged 60 to 78 years (M age = 66 years) completed an online survey, comprising of questions relating to cannabis use (both prescribed and non-prescribed), self-ratings of perceived cognition and driving behaviors/competence following cannabis consumption, and driving wait times following consumption. Participants reported using cannabis for the first time at the age of 20 years. Ninety-six per cent reported using cannabis regularly (at least weekly). Further, 58% of the sample reported current prescribed medicinal cannabis use and 70% of the sample reported non-prescribed use. Earlier age of onset of cannabis use and higher self-ratings of perceived cognition/driving competence significantly increased the odds of driving within four hours of consuming cannabis (by 3% and 22% respectively). Further, holding a medicinal cannabis prescription reduced the odds of driving within four hours of consuming cannabis by 46%. The findings from this study provide insights into the nature of cannabis use in older adults, and the factors that influence driving wait times following cannabis consumption among this cohort.]]></description>
      <pubDate>Fri, 14 Aug 2026 15:04:42 GMT</pubDate>
      <guid>https://trid.trb.org/View/2735216</guid>
    </item>
    <item>
      <title>Early-stage dementia and driving: What do older adults want to happen when driving is no longer safe?</title>
      <link>https://trid.trb.org/View/2737133</link>
      <description><![CDATA[Driving cessation in older adults with dementia is associated with reduced independence, social isolation, and accelerated cognitive decline, yet determining fitness to drive remains challenging. This qualitative study explored older adults’ attitudes toward driving safety decisions and their preferred responses if informed that they may no longer be safe to drive. Twenty-two older adults, including individuals with mild cognitive impairment (MCI) at risk for dementia and cognitively healthy controls, participated in walking-talking interviews following cognitive and hazard perception screening assessments. Interviews explored participants’ views on what should happen next if test results suggested they were unsafe to continue driving. Audio-recorded interviews were transcribed verbatim and analyzed using thematic analysis. Six themes and sixteen codes were identified. Participants with MCI demonstrated greater acceptance of driving cessation, and sought confirmatory assessments, whereas healthy control participants prioritized transparency about test results, openness to remediation through lessons or vehicle adaptations, and preservation of independence. These findings highlight the importance of personalized interventions and the potential for non-invasive in-car technologies to support safe driving in individuals with early-stage dementia. This study highlights the value of qualitative methods in understanding the nuanced perspectives of older drivers and informs future strategies for managing driving cessation in cognitively impaired individuals at risk for dementia.]]></description>
      <pubDate>Thu, 13 Aug 2026 17:02:49 GMT</pubDate>
      <guid>https://trid.trb.org/View/2737133</guid>
    </item>
    <item>
      <title>Driving performance across the cognitive spectrum in active older adults: A simulator study</title>
      <link>https://trid.trb.org/View/2714570</link>
      <description><![CDATA[Cognitive decline is known to impair driving in older adults, yet how specific deficits emerge across the continuum from normal cognition to dementia remains insufficiently characterized. To examine how gradations of cognitive impairment influence driving performance using a high–fidelity simulator. In this retrospective study, 63 older drivers (79.32 ± 6.09 years) were classified into three cognitive groups: normal cognition (ND-D), mild cognitive impairment (MCI-D), and dementia (Dementia-D). Participants completed neuropsychological testing and simulator tasks assessing pedal control, traffic–sign recognition, and intersection navigation. A clear performance gradient was observed across cognitive levels. The MCI-D group preserved basic vehicle control but demonstrated attention–related failures, including selection errors and sign omissions, compared with the ND-D group. In contrast, the Dementia-D group showed widespread impairments, such as inconsistent pedal use, increased operational errors, and reduced intersection speeds (p < 0.05). Frontal–executive function (FAB) and divided attention (TMT) were strongly associated with these deficits. Driving performance declines systematically along the cognitive spectrum. Deficits in frontal–executive and attentional functions most strongly predict simulator errors, underscoring the importance of evaluating these domains when assessing driving safety. Driving–risk assessments should consider stage–specific vulnerabilities across the cognitive continuum. Integrating cognitive profiles with behavioral driving patterns may support individualized interventions to promote safe mobility in older adults. These findings inform targeted interventions to preserve driving independence safely.]]></description>
      <pubDate>Tue, 21 Jul 2026 09:49:51 GMT</pubDate>
      <guid>https://trid.trb.org/View/2714570</guid>
    </item>
    <item>
      <title>Effective measures for evaluating safe driving ability with a driving simulator and eye movement tracking</title>
      <link>https://trid.trb.org/View/2704810</link>
      <description><![CDATA[Stroke survivors often wish to resume driving, but objective and reliable indicators for assessing fitness to drive are lacking. The authors aimed to establish effective measures for evaluating safe driving ability in brain-injured patients by integrating driving simulator (DS) performance and eye movement analysis. Participants included brain-injured patients, classified into mild and severe groups using Trail Making Test-B scores and the presence of visual field defects, neglect, or aphasia, alongside healthy controls. Neuropsychological assessments (Trail Making Test-A/B, Kohs Block Design Test, Mini-Mental State Examination) were conducted. Driving performance was evaluated using the Honda Safety Navi DS, focusing on the standard deviation (SD) of steering angle on straight roads and the SD of velocity on curved roads. Eye movements were recorded with Tobii Pro Glasses 2 during hazard detection and dangerous situation scenes, with particular attention to saccade amplitude. Group differences were analyzed using Kruskal–Wallis and Mann–Whitney U tests. The SD of steering angle on straight roads and the SD of velocity on curved roads were significantly higher in mild or severe brain-injured groups compared with healthy controls. However, saccade amplitude was significantly lower in both mild and severe brain-injured groups than in healthy controls during hazard detection scenes, indicating impaired visual exploration. To measure driving ability in both mild and severe brain-injured patients, saccade amplitude provided a promising objective indicator for evaluating driving ability instead of DS alone. These findings support the development of evidence-based fitness to drive assessments for clinical and rehabilitation applications.]]></description>
      <pubDate>Thu, 04 Jun 2026 15:13:32 GMT</pubDate>
      <guid>https://trid.trb.org/View/2704810</guid>
    </item>
    <item>
      <title>Validation of an off-road cognitive and behavioral evaluation protocol for driving after a stroke</title>
      <link>https://trid.trb.org/View/2697887</link>
      <description><![CDATA[People who have experienced a stroke may exhibit neuropsychological and behavioral impairments that affect their ability to drive safely. To the authors’ knowledge, there is currently no standardized, validated assessment protocol for this purpose in the Spanish context. Consequently, the aim of this research was to validate a protocol to address this need. The authors conducted a comprehensive cognitive and behavioral assessment in a group of people with stroke. Different correlation analyses were carried out between the variables and the on-road score, as well as a linear regression analysis. Subsequently, serial trichotomization was performed. 45 people with stroke were evaluated. Several variables of bimanual coordination and motor planning, divided attention, visuospatial skills, executive functions, hazard prediction and dissociative driving style were related to the on-road score. The linear regression model, including the variables that correlated moderately, explained 71.8% of the on-road score (p = 0.014). Serial trichotomization with 4 tests (visual perception, divided attention, bimanual coordination, and hazard prediction) classified 22.72% of participants as fit and 2.72% as unfit. This study pioneers the validation of an off-road assessment protocol that measures the ability to drive safely in Spanish individuals who have suffered a stroke. The results help in clinical decision-making to reduce evaluation times and to work on possible rehabilitation of altered cognitive processes to return to driving.  ClinicalTrials.gov: This study is part of the project registered under NCT 05659667.]]></description>
      <pubDate>Tue, 19 May 2026 15:12:30 GMT</pubDate>
      <guid>https://trid.trb.org/View/2697887</guid>
    </item>
    <item>
      <title>Effects of Visual Field Loss on Drivers' Explicit and Implicit Initial Trust Preferences: Full Driving Automation versus Themselves</title>
      <link>https://trid.trb.org/View/2696280</link>
      <description><![CDATA[Level 5 automated driving systems (L5 ADS) require no human operation and thus offer potential mobility benefits for individuals with visual field loss (VFL). This study investigates how VFL influences individuals' explicit and implicit initial trust preferences between themselves and L5 ADS, defined as the relative tendency to trust L5 ADS over one's own driving capability, before real-world experience with such systems. Two studies were conducted. Study 1 employed a laboratory experiment in which VFL was simulated in healthy drivers to examine a causal relationship between the presence of VFL and initial trust preferences. To address the limitations of standardized VFL simulation, given that individuals with real VFL exhibit variability in disease progression and long-term adaptive strategies, Study 2 compared drivers with real VFL to healthy drivers. Results showed that, relative to the no-VFL condition, simulated VFL increased drivers' initial trust in L5 ADS and reduced their driving self-efficacy, leading to a stronger explicit initial trust preference for L5 ADS over themselves. In contrast, implicit initial trust preferences remained unchanged. In Study 2, drivers with real VFL demonstrated an implicit initial trust preference for themselves, which differed significantly from that of healthy drivers, who showed an implicit initial trust preference for L5 ADS. However, no significant group differences were observed in initial trust in L5 ADS, driving self-efficacy, or explicit initial trust preferences. Both groups explicitly preferred themselves. These findings suggest that assessments of initial trust attitudes toward L5 ADS among VFL populations should combine explicit and implicit measures to avoid misjudgment in contexts such as policymaking, market forecasting, and user evaluation and education.]]></description>
      <pubDate>Tue, 19 May 2026 15:12:29 GMT</pubDate>
      <guid>https://trid.trb.org/View/2696280</guid>
    </item>
    <item>
      <title>Structural Heart Disease in Aircrew</title>
      <link>https://trid.trb.org/View/2685713</link>
      <description><![CDATA[Heart muscle diseases are challenging for the aeromedical examiner due to their heterogeneous nature and widely varying natural history. The diagnosis of heart muscle disease is likely to have a significant impact on flying privileges, with the risk assessment requiring careful testing and careful follow up. Consideration must also be given to the treatments used in each individual, as these may also pose an aeromedical risk. In athletic aircrew, differentiating athletic adaptation from a cardiomyopathy is essential to decide if flying restrictions are necessary. This article provides insights into the appropriate investigation of aircrew with suspected or proven heart muscle disease, to assist with licensing decisions. Four case vignettes are presented (myocarditis, hypertrophic cardiomyopathy, dilated cardiomyopathy, and athletic heart) to give a broad overview of the commonest areas of heart muscle disease seen in aircrew. The relevant features of evaluation, treatment, and aeromedical relevance are provided in a brief discussion of each case. This paper presents the most current recommendations for assessing aircrew with heart muscle disease and cardiomyopathy with data derived from current aeromedical and clinical literature, as well as the expert consensus of the NATO Working Groups on Occupational Cardiology (HFM WG 251, 316)]]></description>
      <pubDate>Mon, 20 Apr 2026 09:23:40 GMT</pubDate>
      <guid>https://trid.trb.org/View/2685713</guid>
    </item>
    <item>
      <title>Longitudinal assessment of post-concussion driving reaction time</title>
      <link>https://trid.trb.org/View/2680640</link>
      <description><![CDATA[ObjectivesConcussed patients present multiple neurocognitive and motor impairments including slowed reaction time (RT), a function essential to driving. We compared driving RT between concussed and non-concussed individuals across their concussion recovery (aim 1) and explored whether clinical concussion outcomes were correlated with driving RT uniquely in the concussion group (aim 2).MethodsWe recruited collegiate athletes (26 concussed and 23 age- and sex-matched controls) to complete the sport concussion assessment tool (SCAT5), a computerized neurocognitive test (CNS Vital Signs), and a driving simulation across 3 timepoints: =72?h, asymptomatic, and unrestricted medical clearance. RTs were recorded in response to 4 unanticipated driving events. CNSVS included 10 measures of cognitive function. General linear mixed models assessed interaction between group and time for aim 1 and group and concussion assessment outcome for aim 2 (a?=?0.05). Pairwise comparisons with Cohen’s d values were used following significant interactions and main effects.ResultsThere was a significant main effect for timepoint, such that pedestrian RT was slower at the =72-h timepoint relative to both the asymptomatic (p value = 0.023) and unrestricted medical clearance (p- value = 0.022). There were no other significant group-by-timepoint interaction or timepoint main effects for yellow stoplight RT (p-value range = 0.334–0.798), vehicle incursion RT (p-value range = 0.234–0.925) or vehicle cross RT (p-value range = 0.177–0.364). There was no significant group main effect (p-value range = 0.077–0.955), assessment outcome main effect (p-value range = 0.099–0.999) or interaction (p-value range = 0.103–0.998) for predicting any of the RTs, except for executive function (p?=?0.046), motor speed (p?=?0.006), and psychomotor speed (p?=?0.027) predicting vehicle cross RT regardless of group.ConclusionThis study demonstrates that driving RT may not differ between acutely concussed and healthy individuals or may not be detected on a short, simulated drive. Current clinical concussion outcomes poorly relate to driving RT. More research is needed to determine when it is safe to return to driving post-concussion.]]></description>
      <pubDate>Wed, 15 Apr 2026 10:29:29 GMT</pubDate>
      <guid>https://trid.trb.org/View/2680640</guid>
    </item>
    <item>
      <title>Eye-tracking and visual processing tests for assessing driving ability in individuals with dementia and mild cognitive impairment: A pilot study</title>
      <link>https://trid.trb.org/View/2681652</link>
      <description><![CDATA[Changes in visual processing have been found to be affected in the early stages of dementia, potentially limiting driving ability. This pilot study investigated the sensitivity and specificity of eye-tracking, visual processing, and dementia screening tests in evaluating driving abilities among older drivers with and without cognitive impairment. Twenty-three participants aged 65+ years (n = 10 with cognitive impairment, 13 healthy controls) underwent dementia screening assessments including Mini Mental State Examination (MMSE) and Hopkins Verbal Learning Test (HVLT), a Visual Sensitivity Test (VST) and eye-tracking tasks (pro-saccade, anti-saccade, prospective eye movements) and compared these against a computerized driving-related hazard perception test (HPT) and self-report driving measures. Correlation analyses and ROC curves were used to explore relationships among the outcome measures. Drivers with cognitive impairment did not report different subjective driving performance, but had significantly lower HPT scores, with most scoring below the Driving and Vehicle Licensing Agency (DVLA) requirement for licensure. Eye-tracking data (n = 19) showed that drivers with cognitive impairment exhibited greater prosaccade latency variability. Antisaccade latency and prospective eye movement tests both correlated with self-reported in-vehicle task performance. The VST and HVLT tests strongly correlated with HPT scores and were highly predictive of scoring below the HPT DVLA cut-off scores. The VST and HVLT demonstrated high sensitivity and specificity for screening poor hazard perception performance in older drivers with cognitive impairment. Impaired eye movements correlated with self-reported difficulties in operating in-vehicle tasks, but not with HPT performance. Further research is needed to verify these findings in on-road assessments and with a larger sample size.]]></description>
      <pubDate>Wed, 08 Apr 2026 13:40:53 GMT</pubDate>
      <guid>https://trid.trb.org/View/2681652</guid>
    </item>
    <item>
      <title>The Impact of Different Spectacle Designs on the European Visual Field Requirements for Driving</title>
      <link>https://trid.trb.org/View/2672675</link>
      <description><![CDATA[Spectacles can obstruct the peripheral visual field (VF) and interfere with formal requirements for driving. The European VF standards can be assessed with perimetry using the European Driving Test (EDT). This study aimed to evaluate the impact of different spectacles on the EDT, and their compliance with the European VF standards for driving.  This cross-sectional study included 30 participants (15 males and 15 females) with normal VF. Participants underwent binocular EDT perimetry with three different spectacles. The number of missed test points were recorded and the vertex distance (VD), pupillary distance, and eye dominance were measured. Statistical comparisons were conducted using a generalized linear mixed model, with significance set at p < 0.05.  Peripheral VF loss was observed in 11 (37 %) participants (10 males) with spectacle B and in six (20 %) participants (five males) with spectacle C, whereas only one participant had a single missed test point with spectacle A. Participants with spectacle-related VF loss had significantly greater VD than those without. Moreover, there were a higher number of missed test points on the side of the dominant eye.  Spectacles with thin frames and temples had a negligible impact on the peripheral VF, whereas thicker frames and temples could compromise compliance with the VF standards. VF loss was associated with greater VD, which can explain why male participants exhibited more artefacts. These findings emphasize the need to consider spectacle design in fitness-to-drive assessments with perimetry and raise awareness of potential VF restrictions associated with certain eyewear.]]></description>
      <pubDate>Wed, 25 Mar 2026 11:43:31 GMT</pubDate>
      <guid>https://trid.trb.org/View/2672675</guid>
    </item>
    <item>
      <title>The difference in the ability to perceive danger while driving and when crossing a road between patients after a stroke and a healthy population</title>
      <link>https://trid.trb.org/View/2663652</link>
      <description><![CDATA[Clinicians should be aware of the decrease in driving as well as road-crossing abilities of post-stroke patients as they often resume driving and crossing roads while they have impaired skills. So, they should examine road-crossing and ensure safe crossing as they evaluate driving abilities before approving them to drive again.]]></description>
      <pubDate>Wed, 18 Mar 2026 09:00:16 GMT</pubDate>
      <guid>https://trid.trb.org/View/2663652</guid>
    </item>
    <item>
      <title>Active mobility in higher age: Regular cycling is associated with maintaining car driving performance</title>
      <link>https://trid.trb.org/View/2668544</link>
      <description><![CDATA[Regular physical activity has the potential to improve a person's physical and cognitive performance. This is relevant for traffic safety and car driving, for example, when coping with complex driving situations. This study investigated whether physical activity in form of regular bicycle use has a positive effect on driving performance in older adulthood and on changes in performance over time. Longitudinal data on the development of driving behavior over a period of around six years were analyzed from 260 participants aged between 67 and 78 years at the baseline measurement. The influences of self-reported bicycle use on driving performance during an approximately 45-min driving simulation as well as on the development of driving performance was analyzed. In addition, EEG-based neurocognitive correlates of mental states while driving were explored from a subgroup of 145 participants. Regular bicycle use was not associated with better driving per se, but it was associated with less deterioration in driving behavior over the observation period. Regular bicycle use was also associated with a lower level of mental workload while driving, as suggested by lower EEG theta power. There were no associations with other physical activity (such as walking or fitness training), the participants' age, or their annual mileage. The results suggest that regular cycling as a combination of physical activity and active traffic participation is associated with maintaining driving competence in old age.]]></description>
      <pubDate>Wed, 18 Mar 2026 09:00:16 GMT</pubDate>
      <guid>https://trid.trb.org/View/2668544</guid>
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