Longitudinal Research On Aging Drivers Research Articles

Impact of driving cessation on health-related quality of life trajectories

BackgroundTrajectories of health-related quality of life (HRQoL) after driving cessation (DC) are thought to decline steeply, but for some, HRQoL may improve after DC. Our objective is to examine trajectories of HRQoL for individuals before and after DC. We hypothesize that for urban drivers, volunteers and those who access alternative transportation participants’ health may remain unchanged or improve.MethodsThis study uses data from the AAA Longitudinal Research on Aging Drivers (LongROAD) study, a prospective cohort of 2,990 older drivers (ages 65–79 at enrollment). The LongROAD study is a five-year multisite study and data collection ended October 31, 2022. Participants were recruited using a convenience sample from the health centers roster. The number of participants approached were 40,806 with 7.3% enrolling in the study. Sixty-one participants stopped driving permanently by year five and had data before and after DC. The PROMIS®-29 Adult Profile was utilized and includes: 1) Depression, 2) Anxiety, 3) Ability to Participate in Social Roles and Activities, 4) Physical Function, 5) Fatigue, 6) Pain Interference, 7) Sleep Disturbance, and 8) Numeric Pain Rating Scale.Adjusted (age, education and gender) individual growth models with 2989 participants with up to six observations from baseline to year 5 in the models (ranging from n = 15,041 to 15,300) were utilized.ResultsAbility to participate in social roles and activities after DC improved overall. For those who volunteered, social roles and activities declined not supporting our hypothesis. For those who accessed alternative transportation, fatigue had an initial large increase immediately following DC thus not supporting our hypothesis. Urban residents had worse function and more symptoms after DC compared to rural residents (not supporting our hypothesis) except for social roles and activities that declined steeply (supporting our hypothesis).ConclusionsEducating older adults that utilizing alternative transportation may cause initial fatigue after DC is recommended. Accessing alternative transportation to maintain social roles and activities is paramount for rural older adults after DC especially for older adults who like to volunteer.

UTILIZING ADVANCED DRIVER ASSISTANCE SYSTEMS IN LATER LIFE: INSIGHTS FROM A LONGITUDINAL STUDY ON AGING DRIVERS

Abstract Level 1 and 2 Advanced Driver Assistance System (ADAS) technologies (e.g., adaptive cruise control, blind spot warning, lane keep assist) are predicted to be available in approximately three-fourths of all vehicles worldwide by 2025. To realize the potential of these systems in extending safe mobility for aging adults, it is critical that the driver understands the functionality of the technology and uses the system appropriately. The current study examined demographic and vehicle technology questionnaire data from the Longitudinal Research on Aging Drivers (LongROAD) cohort study which concluded in December 2022. A total of 1,417 participants changed their vehicle throughout the study. There were statistically significant increases in the prevalence of all 15 ADAS technologies examined. Despite increases in prevalence, frequency of using the technologies remained unchanged across 5 years. Frequency of use also varied by functionality of the technology whereby participants reported higher frequency of using technologies that provide alerts, such as blind spot warning, than technologies that take action to assist drivers with vehicle operations, such as adaptive cruise control. Results showed differences in prevalence and use of technologies by income and education, suggesting disparities in access to vehicles with technologies that could help to create a safer driving experience. In consideration of the rapid proliferation of ADAS into the vehicle fleet, increased research into how older drivers learn about and use ADAS technologies will assist in efforts to develop tailored and accessible programs for training older adults to properly utilize ADAS available in their own vehicles.

PREVALENCE AND CORRELATES OF DEPRESSION IN OLDER ADULTS: FINDINGS FROM THE LONGROAD STUDY

Abstract As an important public health issue, depression has been studied extensively in children and young adults. Epidemiologic data on depression for older adults are scant. The Longitudinal Research on Aging Drivers (LongROAD) project was a prospective cohort study of 2990 drivers aged 65-79 years at baseline and recruited between July 2015 and March 2017 from five sites (Ann Arbor, Baltimore, Cooperstown, Denver, and San Diego) in the contiguous United States. Study participants were assessed at baseline with the Patient-Reported Outcomes Measurement Information System (PROMIS). The objective of this study was to examine the prevalence and correlates of depression in older adults participating in the LongROAD project. Of the 2990 older adults studied, 186 (6.2%) participants had depression at the time of enrollment, with the lifetime prevalence of depression being 20.3%. Only 21.9% of the older adults with depression were taking antidepressants. A significantly higher prevalence of depression was found among those who were female (7.2%), not currently married (9.1%), with annual household income less than $20000 (11.9%), having diabetes (9.1%), having anxiety disorder (15.5%), with exercising routine (6.9%), and without doing volunteering work (7.9%). No significant difference was found between urban and rural residents, but urban residents had slightly higher depression prevalence (6.4%). About 1 in 16 older adults has depression. The majority (78%) of older adults with depression are not treated with antidepressants. Depression screening and treatment programs are needed for older adults, particularly women, those living alone, and those in poverty. Volunteering work could potentially decrease depression prevalence.

Detecting mild cognitive impairment and dementia in older adults using naturalistic driving data and interaction-based classification from influence score

Several recent studies indicate that atypical changes in driving behaviors appear to be early signs of mild cognitive impairment (MCI) and dementia. These studies, however, are limited by small sample sizes and short follow-up duration. This study aims to develop an interaction-based classification method building on a statistic named Influence Score (i.e., I-score) for prediction of MCI and dementia using naturalistic driving data collected from the Longitudinal Research on Aging Drivers (LongROAD) project. Naturalistic driving trajectories were collected through in-vehicle recording devices for up to 44 months from 2977 participants who were cognitively intact at the time of enrollment. These data were further processed and aggregated to generate 31 time-series driving variables. Because of high dimensional time-series features for driving variables, we used I-score for variable selection. I-score is a measure to evaluate variables’ ability to predict and is proven to be effective in differentiating between noisy and predictive variables in big data. It is introduced here to select influential variable modules or groups that account for compound interactions among explanatory variables. It is explainable regarding to what extent variables and their interactions contribute to the predictiveness of a classifier. In addition, I-score boosts the performance of classifiers over imbalanced datasets due to its association with the F1 score. Using predictive variables selected by I-score, interaction-based residual blocks are constructed over top I-score modules to generate predictors and ensemble learning aggregates these predictors to boost the prediction of the overall classifier. Experiments using naturalistic driving data show that our proposed classification method achieves the best accuracy (96%) for predicting MCI and dementia, followed by random forest (93%) and logistic regression (88%). In terms of F1 score and AUC, our proposed classifier achieves 98% and 87%, respectively, followed by random forest (with an F1 score of 96% and an AUC of 79%) and logistic regression (with an F1 score of 92% and an AUC of 77%). The results indicate that incorporating I-score into machine learning algorithms could considerably improve the model performance for predicting MCI and dementia in older drivers. We also performed the feature importance analysis and found that the right to left turn ratio and the number of hard braking events are the most important driving variables to predict MCI and dementia.

DIABETES MELLITUS AND HARD BRAKING EVENTS IN OLDER DRIVERS

Abstract There are an estimated 37 million people with diabetes mellitus (DM) in the United States, including 16 million older adults. DM can impair patients’ driving safety due to diabetic peripheral neuropathy, hypoglycemia, or hyperglycemia, and eye diseases. However, few studies have examined the association between DM and driving safety based on naturalistic driving data. Data for this study came from the Longitudinal Research on Aging Drivers (LongROAD) project, a multisite naturalistic driving study of 2990 drivers aged 65–79 years at baseline. Driving data for the study participants were recorded by in-vehicle recording devices for up to 44 months. We used multivariable negative binomial modeling to estimate the incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of hard braking events (i.e., proxies for unsafe driving behavior defined as maneuvers with deceleration rates ≥ 0.4 g) associated with DM. Of the 2856 study participants eligible for this study, 482 (16.9%) reported having DM at baseline. The overall incidence rate of hard braking events was 1.16 per 1000 miles. Adjusted for age, race/ethnicity, marital status, education level, annual household income, urbanicity, history of stroke, and number of medications, drivers with DM had a 10% increased rate of hard braking events compared to drivers without DM (adjusted IRR 1.10; 95% CI: 1.08, 1.12). Results of this study indicates that DM is associated with a significantly increased rate of hard braking events in older drivers, suggesting less safe driving. Driving safety should be incorporated into DM management and care programs.

Comparing Nighttime to Rush Hour Avoidance as Initial Driving Self-Regulation Behaviors

Aging is associated with an increase in avoidance of challenging driving situations (e.g., driving at night, during rush hour, on freeways, and in unfamiliar areas). Such avoidance behavior may be due to driving self-regulation (SR), an intentional response to perceived declining abilities, or it may be due to other factors such as lifestyle changes or preferences. Most previous research has not studied SR as the reason for avoidance, and has treated avoidance behaviors interchangeably. In addition, previous research has not differentiated one’s first SR behavior from those reported later in the process. This study included 1,557 participants from the AAA Longitudinal Research on Aging Drivers (LongROAD) to assess older adults’ initial self-regulatory behavior by comparing the frequency of nighttime, rush hour, freeway, and unfamiliar area avoidance among those who reported only one SR behavior. Nighttime SR was most common (58.8%), followed by rush hour (25.5%), unfamiliar areas (11.0%), and freeways (4.8%). Binary logistic regression was used to assess how demographics, function, and self-reported driving variables were related to different odds of reporting nighttime vs. rush hour avoidance (the two most common) as one’s initial SR behavior. Higher odds of reporting nighttime avoidance (compared to rush hour) as one’s initial SR behavior were related to female gender, low income, impaired visual acuity, better self-reported ability to see during the day, worse self-reported ability to see at night, less comfort driving at night, and more comfort driving during rush hour, and in unfamiliar areas.

Using Naturalistic Driving Data to Predict Mild Cognitive Impairment and Dementia: Preliminary Findings from the Longitudinal Research on Aging Drivers (LongROAD) Study.

Emerging evidence suggests that atypical changes in driving behaviors may be early signals of mild cognitive impairment (MCI) and dementia. This study aims to assess the utility of naturalistic driving data and machine learning techniques in predicting incident MCI and dementia in older adults. Monthly driving data captured by in-vehicle recording devices for up to 45 months from 2977 participants of the Longitudinal Research on Aging Drivers study were processed to generate 29 variables measuring driving behaviors, space and performance. Incident MCI and dementia cases (n = 64) were ascertained from medical record reviews and annual interviews. Random forests were used to classify the participant MCI/dementia status during the follow-up. The F1 score of random forests in discriminating MCI/dementia status was 29% based on demographic characteristics (age, sex, race/ethnicity and education) only, 66% based on driving variables only, and 88% based on demographic characteristics and driving variables. Feature importance analysis revealed that age was most predictive of MCI and dementia, followed by the percentage of trips traveled within 15 miles of home, race/ethnicity, minutes per trip chain (i.e., length of trips starting and ending at home), minutes per trip, and number of hard braking events with deceleration rates ≥ 0.35 g. If validated, the algorithms developed in this study could provide a novel tool for early detection and management of MCI and dementia in older drivers.

The Influence of Hearing Impairment on Driving Avoidance Among a Large Cohort of Older Drivers.

As people age, some of the commonly experienced psychomotor, visual, and cognitive declines can interfere with the ability to safely drive, often leading to situational avoidance of challenging driving situations. The effect of hearing impairment on these avoidance behaviors has not been comprehensively studied. Data from the American Automobile Association (AAA) Longitudinal Research on Aging Drivers (LongROAD) study were used to assess the effect of hearing impairment on driving avoidance, using three measures of hearing. Results indicated that hearing loss plays a complex role in driving avoidance, and that an objective hearing measure was a stronger predictor than hearing aid use and self-rated hearing. Greater hearing impairment was related to less nighttime and freeway driving, more trips farther than 15 mi from home, and lower odds of avoiding peak driving times. The moderating influence of hearing on both vision and cognition is also discussed, along with study implications and future research.

Sensory Health and Social Well-Being

Scientific inquiry into the psychological and social issues surrounding age-related sensory impairments has focused on ways in which the conditions are a catalyst for negative outcomes. However, investigating the patterns associated with negative life events can offer guidance on ways to circumvent or mitigate negative outcomes, and even to foster and facilitate the positive outcomes of growth and thriving. This symposium will present findings from individual studies that describe how social well-being among older adults with sensory impairments can be protected, by assessing social isolation as a point of intervention to maintain cognitive function and to promote post-traumatic growth, and by understanding the unique social considerations relevant to Hispanic older adults, and to improve the physical safety of older drivers with sensory and cognitive impairment by reducing exposure-adjusted motor vehicle crash risk. Authors will present both cross sectional and longitudinal, population based data, and will explore patterns and relationships between known variables associated with sensory impairments including depression, cognitive processing, cognitive functioning, social network, social isolation, driving patterns, and posttraumatic growth. Findings from the Longitudinal Research on Aging Drivers (LongROAD) study, the National Health and Aging Trends Study (NHATS), and data from a mixed methods study, underscore the reality that the negative outcomes associated with age related sensory impairments are not necessarily imminent and that there may be multiple intervention points to optimize the social well-being of older adults with sensory impairments.

Medication use and driving patterns in older drivers: preliminary findings from the LongROAD study

BackgroundThe potential for impaired driving due to medication use can occur at any age, though older adults are more likely to take multiple prescribed medications and experience side effects that may affect driving ability. The purpose of this study was to characterize the relationship between medications and driving safety behaviors.MethodsData for this study came from the five-site Longitudinal Research on Aging Drivers (LongROAD) project. Participants were active drivers, age 65–79 years at enrollment, and patients at one of the 5 participating sites. Medication names and doses were obtained at baseline based on the “brown-bag review” method. Medications were coded using the American Hospital Formulary Service system. Driving data were collected by a GPS accelerometer installed in the study participants’ main vehicles.ResultsMedication data were available for 2949 (98.6%) of the 2990 participants, and 2898 (96.9% of all participants) had both medication data and at least 30 recorded days of driving. The median number of medications taken per study participant was seven, with a range of 0–51. Total number of medications was significantly associated with a higher rapid deceleration rate. Certain medication classes were significantly associated with other driving outcomes, including central nervous system agents (more speeding events), hormones and gastrointestinal medications (more rapid decelerations), electrolytes (fewer rapid decelerations), and antihistamines (greater right to left turn ratio).ConclusionsOlder adult drivers are taking large quantities of prescription and non-prescription medications that may affect their driving safety. Certain medication classes are associated with potentially adverse driving patterns, such as speeding and rapid decelerations, while others are associated with potentially protective maneuvers, such as right hand turning. Further research is warranted to identify and mitigate potential adverse effects of such medications on driving safety in older adults.

Self-Reported Opioid Use and Driving Outcomes among Older Adults: The AAA LongROAD Study.

Opioid medications are important therapeutic options to mitigate the harmful effects of pain but can also impair driving ability. We sought to explore opioid use, pain levels, and driving experiences among older drivers. Cognitively intact drivers ages 65 to 79 years were recruited for the multisite AAA Longitudinal Research on Aging Drivers (LongROAD) study (n = 2990). This cross-sectional analysis used data from the baseline questionnaire and "brown-bag" medication review. Among LongROAD participants (47% male, 88% white, 41% aged 65 to 69 years), 169 (5.7%) reported currently taking an opioid, with a median daily dose of 20 morphine milligram equivalents. Participants did not differ significantly in opioid use by age, gender, race, or ethnicity (P > .05). After adjustment for age, gender, race and ethnicity, participants who were taking opioids (vs not) were significantly more likely to report self-regulated driving reduction and reduced driving ability. However, these effects became nonsignificant when hospitalization, impaired physical function and other factors associated with opioid use were controlled. In this study from a large, geographically diverse sample of older adults, there was an association between opioid use and several self-reported measures of driving behavior and ability. However, future work should clarify the effects on driving of opioid use from the effects of the painful medical conditions for which the opioids are being taken. Clinicians should continue to discuss the risks and benefits of opioid medications with patients, including risks related to driving safety.

Social Support Moderates the Negative Association Between Reduced Driving and Life Satisfaction in Older Adults.

When older adults reduce their driving, there can be subsequent decreases in life satisfaction. In this cross-sectional study, we used baseline data from the multi-site Longitudinal Research on Aging Drivers (LongROAD) study to examine whether social support moderates the negative association between reduced driving and life satisfaction. The outcome variable was life satisfaction, and the main predictor variable was past-year reduced driving (yes/no). Emotional, instrumental, and informational social support were measured using PROMIS v2.0 (Patient-Reported Outcomes Measurement Information System) items. We used generalized linear regression models to examine how social support moderated the association between reduced driving and life satisfaction. Statistical adjustment for social support attenuated the negative effect of reduced driving on life satisfaction by ~10% for all three types of social support.

Prevalence of Potentially Inappropriate Medication use in older drivers

BackgroundPotentially Inappropriate Medication (PIM) use has been studied in a variety of older adult populations across the world. We sought to examine the prevalence and correlates of PIM use in older drivers.MethodsWe applied the American Geriatrics Society 2015 Beers Criteria to baseline data collected from the “brown-bag” review of medications for participants of the Longitudinal Research on Aging Drivers (LongROAD) study to examine the prevalence and correlates of PIM use in a geographically diverse, community-dwelling sample of older drivers (n = 2949). Proportions of participants who used one or more PIMs according to the American Geriatrics Society 2015 Beers Criteria, and estimated odds ratios (ORs) and 95% confidence intervals (CIs) of PIM use associated with participant characteristics were calculated.ResultsOverall, 18.5% of the older drivers studied used one or more PIM. The most commonly used therapeutic category of PIM was benzodiazepines (accounting for 16.6% of the total PIMs identified), followed by nonbenzodiazepine hypnotics (15.2%), antidepressants (15.2%), and first-generation antihistamines (10.5%). Compared to older drivers on four or fewer medications, the adjusted ORs of PIM use were 2.43 (95% CI 1.68–3.51) for those on 5–7 medications, 4.19 (95% CI 2.95–5.93) for those on 8–11 medications, and 8.01 (95% CI 5.71–11.23) for those on ≥12 medications. Older drivers who were female, white, or living in urban areas were at significantly heightened risk of PIM use.ConclusionAbout one in five older drivers uses PIMs. Commonly used PIMs are medications known to impair driving ability and increase crash risk. Implementation of evidence-based interventions to reduce PIM use in older drivers may confer both health and safety benefits.Trial registrationNot applicable.

Frailty phenotype and self-reported crashes and driving space: Baseline AAA LongROAD

IntroductionThe present study uses data from the American Automobile Association (AAA) Longitudinal Research on Aging Drivers (LongROAD) study to assess the association of the frailty phenotype with reduced driving space and involvement in motor vehicle crashes. MethodsThe LongROAD study is a multisite prospective cohort study of participants aged 65–79 years. Fried's frailty phenotype status at baseline and self-reported restricted driving space in the past three months and at least one self-reported crash in the recent year are examined. Multivariable logistic regression was used to obtain odds ratios, adjusting for covariates and clustering by site. ResultsPre-frail (i.e. only 1–2 indicators of frailty) participants had 30% higher odds (adjusted OR = 1.3, 95% CI:1.0–1.8) of reporting involvement in a crash in the prior year than non-frail participants after adjusting for sex, age, depression, word recall, average miles driven per week, and site. No association for reduced driving space for frail older drivers was found. ConclusionsThe frailty phenotype is associated with motor vehicle crashes, but not reduced driving space. Our findings suggest that future research should be focused on the identification of pre-frail older adult drivers to improve the health and quality of life of older adult drivers.

Factors related to rapid deceleration events among a large cohort of older drivers

Studies over the past two decades have attempted to document and understand factors related to crashes involving older drivers to develop more effective countermeasures to reduce the frequency and severity of these crashes. Studies in which vehicle acceleration data can be recorded have begun to explore the relationship between rapid deceleration events (RDEs) and functional abilities among older drivers as a surrogate measure of unsafe driving. Recent naturalistic driving studies with older adults have found differing results using different thresholds to define an RDE. The present study examined the relationship among RDE rates, demographics, visual abilities, cognitive abilities, and driving comfort among a large cohort of older drivers, using two definitions of RDEs—longitudinal deceleration of 0.35 g or greater (RDE35) and longitudinal deceleration of 0.75 g or greater (RDE75). The study utilized objective driving, objective functioning, and reported driving comfort data from 2774 participants of the multi-site AAA Longitudinal Research on Aging Drivers (LongROAD) study. RDE rates for each threshold were calculated per 1000 miles driven. Multivariate regression models with backward elimination were developed to examine how outcome measures were related to RDE rates. Too few RDE75 events were found for meaningful analysis. RDE35 rates were significantly associated with several covariates. RDE35 rates were related to declining functional abilities, but many other factors also played a significant role in the rate of RDE35s among older drivers, diminishing the value of using RDE35 rates as a surrogate measure of driving safety. In addition, because the AAA LongROAD sample was relatively healthy and high functioning, other ability-related covariates may also be significantly related to RDE35s but the lack of variance in these measures in the current study prevented these effects from emerging.

Physician and Family Discussions about Driving Safety: Findings from the LongROAD Study.

Older adult drivers may experience decreases in driving safety with age or health status change. Discussing driving safety may help them plan for driving restriction and eventual cessation. Here, we sought to examine conversations between older adults and their family members and physicians. In this multi-site cross-sectional analysis of baseline data from the AAA Longitudinal Research on Aging Drivers (LongROAD) cohort study, we measured the prevalence and characteristics of family and physician driving discussions. We examined associations between having driving discussions and participant characteristics using multivariate logistic regression. Of 2990 current drivers aged 65 to 79 years (53% female, 85.5% White), only 14.2% reported discussing driving safety with family and 5.5% had discussions with physicians. Men (adjusted OR, 1.32; 95% CI, 1.05 to 1.66) and those with Master's degrees or higher (adjusted OR, 1.65; 95% CI, 1.27 to 2.13) more often had family discussions. Those with at least a Master's degree were also more likely to speak with their physician (adjusted OR, 1.77; 95% CI, 1.17 to 2.68). Few older adults had driving safety conversations with their family or physicians. Practical and effective interventions are needed to engage family and physicians in assisting older adults with risk assessment and driving cessation planning to maintain mobility and well-being.

Patterns of Self-Reported Driving While Intoxicated Among Older Adults.

Objective: This study examines the prevalence of self-reported driving while intoxicated (DWI) among drivers aged 65 and older. Method: This cross-sectional study was based on baseline data from the AAA Longitudinal Research on Aging Drivers (LongROAD) study, a multisite prospective cohort study of 2,990 older adult drivers. Alcohol-related variables from the baseline questionnaire were examined in relation to demographics, health status, and driving behaviors. A logistic regression model assessed variables associated with DWI. Results: Of the 2,990 participants, 72.7% reported consuming alcohol, 15.0% reported high-risk drinking, and 3.3% reported DWI. High-risk drinking (OR = 12.01) and risky driving behaviors (OR = 13.34) were significantly associated with at least occasional DWI. Avoidance of hazardous driving conditions (OR = 0.71) and higher level of comfort during challenging driving scenarios (OR = 0.65) were less likely to be associated with DWI. Conclusion: A large number of older adults engage in high-risk drinking and DWI. Public health education and DWI-related interventions should include older adults.

Association of Physical Function With Driving Space and Crashes Among Older Adults.

Balancing both driver mobility and safety is important for the well-being of older adults. However, research on the association of physical function with these 2 driving outcomes has yielded inconsistent findings. This study examined whether physical functioning of older drivers, as measured by the Short Physical Performance Battery (SPPB), is associated with either driving space or crash involvement. Using cross-sectional data of active drivers aged 65-79 years from the AAA Longitudinal Research on Aging Drivers (LongROAD) study (n = 2,990), we used multivariate log-binomial and logistic regressions to estimate the associations of the SPPB with either self-reported restricted driving space in the prior 3 months or any crashes in the past year. Interaction with gender was assessed using likelihood ratio tests. After adjustment, older drivers with higher SPPB scores (higher physical functioning) had lower prevalence of restricted driving space (8-10 vs. 0-7, prevalence ratio [PR] = 0.88, 95% confidence interval [CI]: 0.78-0.99; 11-12 vs. 0-7, PR = 0.78, 95% CI: 0.61-0.99). Fair (8-10), but not good (11-12), scores were significantly associated with reduced crash involvement (8-10 vs. 0-7, odds ratio [OR] = 0.71, 95% CI: 0.60-0.84). Gender was not a significant effect modifier. This study provides evidence that higher physical functioning is associated with better driving mobility and safety and that the SPPB may be useful for identifying at-risk drivers. Further research is needed to understand physical functioning's longitudinal effects and the SPPB's role in older driver intervention programs.

Improving Safe Mobility: An Assessment of Vehicles and Technologies among a Large Cohort of Older Drivers

Evidence suggests that older driver safety may be improved by good vehicle maintenance, in-vehicle advanced technologies, and proper vehicle adaptations. This study explored the prevalence of several measures of vehicle maintenance and damage among older drivers through inspection of their vehicles. We also investigated the prevalence of in-vehicle technologies and aftermarket adaptations. Vehicle inspections were conducted by trained research staff using an objective, standardized procedure. This procedure, developed by a multidisciplinary team of researchers, was based on a review of inspection checklists used by automobile dealerships and the project team's expertise. The study used baseline data from vehicles of 2988 participants in the multi-site Longitudinal Research on Aging Drivers (LongROAD) study. Among this cohort, vehicles were well maintained, had little damage, and contained a range of advanced technologies but few aftermarket adaptations. Implications of study findings for occupational therapy practice are discussed.

Self-reported health conditions and related driving reduction in older drivers

We surveyed self-reported lifetime health conditions (using National Health and Aging Trends Study questions) and related driving reduction in a large multi-site older driver cohort (n = 2990) from the AAA Longitudinal Research on Aging Drivers (LongROAD) Study’s baseline assessment. Those reporting reduced driving (n = 337) largely attributed reduction to musculoskeletal (29%), neurologic (13%), and ophthalmologic (10%) conditions. Women reported health condition-related driving reduction more often than men (14% versus 8%, p<.001). Mobility affects well-being; health professionals should consider that health conditions may cause older adults to reduce driving. Gender differences deserve attention in future research and education efforts.