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Divided Visual Attention as a Predictor of Bumping while Walking: The Salisbury Eye Evaluation

¹From the Departments of Ophthalmology and ²Biostatistics, The Johns Hopkins University, Baltimore, Maryland; and the ³Institute of Ophthalmology, University College London, London, United Kingdom.

PURPOSE. The purpose of this study was to determine the association between bumping while walking and divided visual attention, as measured by the useful field of view (UFOV).

METHODS. The Salisbury Eye Evaluation is a population-based study of community-dwelling adults, aged 72 to 92 at the third round of data collection. Participants walked a circuitous 32.8-m course, seeded with obstacles, and the number of bumps made while traversing the course was counted. UFOV divided attention score was based on processing speed: the time taken to identify a central target, and the location of a peripheral target simultaneously. Association between number of bumps and UFOV score was assessed in a generalized linear model, with adjustment for vision and attention measures that might explain the UFOV score.

RESULTS. Of the 1504 participants in this study, 10.1% did not attempt the mobility course. In a model adjusting for demographic, physical, cognitive and attention, and vision measures, a decrease of 50 ms in processing speed for the divided-attention task was associated with a 4.9% increase (P = 0.004) in number of bumps made over the course. Receiver operating characteristic curves were created for the UFOV and visual field tests, to determine accuracy in detecting those with a high number of bumps. The visual field test had slightly higher area under the curve, but positive predictive value for both tests was low.

CONCLUSIONS. The UFOV test of divided attention, as measured by processing speed, independently predicted bumping while walking. These data suggest that poor visual attention is a significant risk factor for bumping while walking.

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