Frailty phenotype associated with traffic crashes among older drivers: A cross-sectional study in rural Japan

Abstract

IntroductionIn places such as Japan, driving safety and physical frailty are two urgent issues due to a rapidly aging population. However, few studies have focused on whether physical frailty is associated with traffic crashes among older drivers. This cross-sectional study aimed to investigate the association between frailty phenotype and self-reported traffic crashes in the past year among Japanese community-dwelling older adults. MethodsThe sample consisted of 349 community-dwelling older drivers (aged 74.4 ± 5.0 years) enrolled in the Kasama Health Checkup for Longevity survey in rural Japan. The Japanese version of the Cardiovascular Health Study was used to classify participants into a pre-frail/frail group (n = 155, 44.4%) and a robust group (n = 194, 55.6%). Physical and cognitive function were evaluated using performance-based measures, the Geriatric Depression Scale (GDS) was used to evaluate depressive symptoms, and information on risky driving behaviors and traffic crashes was obtained from a self-report questionnaire. ResultsCompared to robust participants, pre-frail/frail participants demonstrated poorer physical function, scored lower on a total five cognitive functions test (5-Cog), and were more prone to depression. Additionally, pre-frailty/frailty (34.2%) was significantly associated with near-miss traffic incidents, compared to robustness (18.0%). Moreover, 46 participants reported involvement in traffic crashes in the past year (33 of 46 were pre-frail/frail). After adjusting for age, sex, total 5-Cog scores, GDS scores, driving distances, and near-miss traffic incidents, pre-frail/frail participants showed higher rates of traffic crash involvement in the past year than robust participants (OR = 3.74, 95% CI: 1.75–7.96). ConclusionFrailty phenotype was shown to be associated with an increased rate of traffic crashes. Our findings can be applied to inform health promotion policies and provide timely interventions designed to improve driving safety among pre-frail/frail older adults.