Braking Time and Cognitive, Visual, and Motor Determinants in Older Drivers With Type 2 Diabetes Mellitus With and Without Diabetic Peripheral Neuropathy: A Controlled Cross-Sectional Study.

BACKGROUND

Driving is a complex task that requires efficient integration of sensorimotor, visual, and cognitive systems. Although diabetic peripheral neuropathy (DPN) is associated with reduced driving performance, the impact of this condition when combined with aging is still poorly understood.

AIMS: To assess braking time in older drivers with Type 2 diabetes mellitus (T2DM), with and without DPN, comparing them with a control group and investigating associations with motor, cognitive, and visual characteristics.

METHODS

Cross-sectional study involving individuals aged 60-79 years, distributed into three groups: T2DM without DPN (n = 17), T2DM with DPN (n = 22), and control (n = 25). DPN was identified using the Michigan Neuropathy Screening Instrument, Brazilian version (MNSI-Brazil), with a cutoff score ≥ 2.5. Cognitive (Montreal Cognitive Assessment-MoCA, cognitive TUG), visual (acuity, stereopsis, color vision, and adaptometry), and motor assessments (handgrip strength and plantar flexor strength) were performed, along with a driving simulation.

RESULTS

Older adults with T2DM showed longer braking times than the control group (p < 0.01), regardless of the presence of DPN. Participants with DPN presented lower upper-limb strength (p = 0.01) and reduced strength of the right plantar flexor muscles (p < 0.01). Braking time was influenced by sex and plantar strength.

CONCLUSION

T2DM is associated with increased braking time in older adults, and reduced plantar flexor muscle strength, particularly among women, highlights the need for monitoring and targeted muscle strengthening to preserve driving safety and autonomy.