Abstract
ObjectivesTo examine the relationship between key functional impairments, co-morbid conditions and driving performance in a sample of cognitively normal older adults.DesignProspective observational studySettingThe Knight Alzheimer’s Disease Research Center, Washington University at St. LouisParticipantsIndividuals with normal cognition, 64.9 to 88.2 years old (N = 129), with a valid driver’s license, who were currently driving at least once per week, and who had participated in longitudinal studies at the Knight Alzheimer’s Disease Research CenterMeasurementsStatic visual acuity, contrast sensitivity, physical frailty measures, motor skills, total medical conditions, and the modified Washington University Road Test.ResultsWhen controlling for age, race, gender, APOE, and education the total number of medical conditions was unassociated with both road test scores (pass vs. marginal + fail) and the total driver error count. There were marginal associations of our measure of physical frailty (p = 0.06) and contrast sensitivity score (p = 0.06) with total driving error count.ConclusionFuture research that focuses on older adults and driving should consider adopting measures of physical frailty and contrast sensitivity, especially in samples that may have a propensity for disease impacting visual and/or physical function (e.g. osteoarthritis, Parkinson’s, eye disorders, advanced age >80 years, etc.).
Highlights
Driving an automobile is a crucial instrumental activity of daily living and it can become increasingly difficult with age
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Future research that focuses on older adults and driving should consider adopting measures of physical frailty and contrast sensitivity, especially in samples that may have a propensity for disease impacting visual and/or physical function
Summary
Driving an automobile is a crucial instrumental activity of daily living and it can become increasingly difficult with age. Even though many older persons self-restrict their driving to compensate for age-related changes and diseases [3], crash rates per mile traveled start increasing for drivers at age 70 and older and are highest after age 85 [1]. Two longitudinal driving studies that included samples of cognitively intact older adults have revealed deterioration in driving performance over time on standardized performance based road tests [4, 5]. The etiology for this decline in driving performance is unclear. Other causes should be considered since functional impairments in other key domains required for driving (e.g. vision, motor ability) and/or additional co-morbid conditions (e.g. diabetes, heart disease) could impair driving performance via other mechanisms
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