Motor Vehicle Collision Rates Research Articles

The effect of amantadine on acute cognitive disability after severe traumatic brain injury: An institutional pilot study

BackgroundAmantadine is used in the post-acute care setting to improve cognitive function after a traumatic brain injury. Its utility in the acute postinjury period is unknown. In this pilot study, we sought to examine the effect of amantadine on short-term cognitive disability among patients with a severe traumatic brain injury and hypothesized that patients receiving amantadine would have a greater improvement in disability throughout their acute hospitalization. MethodsWe performed a prospective, observational study of patients ≥18 years with severe traumatic brain injury (Glasgow Coma Scale ≤8) at a level I trauma center between 2020 and 2022. Patients with penetrating trauma, death within 48 hours of admission, and no radiographic evidence of intracranial pathology were excluded. Patients were grouped according to whether they received amantadine. Our primary outcome was the change in cognitive disability, measured by the Disability Rating Scale (DRS), over the index hospitalization. ResultsThere were 55 patients in the cohort: 41.8% (n = 23) received amantadine and 58.2% (n = 32) did not. There were higher rates of motor vehicle collisions (65.2% vs 46.9%, P = .02), diffuse axonal injury (47.8% vs 18.8%, P = .02), intracranial pressure monitor use (73.9% vs 21.9%, P = .0001), and propranolol use (73.9% vs 21.9%, P = .0001) in the amantadine. There was a larger improvement in DRS scores among patients receiving amantadine (7.8 vs 3.6, P = .001), and amantadine independently predicted improvement in DRS scores (β, 1.61; 95% confidence interval, 0.20–3.02, P = .03). Rates of discharge to traumatic brain injury rehabilitation were significantly higher in the amantadine group (73.9% vs 21.9%, P = .0002). ConclusionAmong patients with severe traumatic brain injury, amantadine use in the acute postinjury period may be associated with an improvement in cognitive disability and discharge to traumatic brain injury rehabilitation.

A decomposition of the effects of the COVID-19 pandemic on changes in the motor vehicle collision related mortality in Alabama

Background/ObjectiveMotor vehicle collisions are the leading cause of unintentional injury death in Alabama and at various points during the COVID-19 pandemic there were documented increases in the following risk driving behaviors: speeding, driving under the influence, and seat belt citations. Thus, the objective was to characterize the overall motor vehicle collision (MVC)-related mortality rate in Alabama and the contribution of each component over the first two years of the pandemic compared to before the pandemic by three different road classes: urban arterials, rural arterials, and all other road classes. MethodsMVC data were derived from the Alabama eCrash database, an electronic crash reporting system used by police officers across the state. Data on vehicle miles traveled each year were collected from the U.S. Department of Transportation’s Federal Highway Administration estimates of traffic volume trends. MVC-related mortality in Alabama was the primary outcome and year of MVC was the exposure. The novel decomposition method broke down population mortality rate into four parts: deaths per MVC injury, injury per MVC, MVC per vehicle miles traveled (VMT), and VMT per population. Poisson models with scaled deviance were used to estimate rate ratios of each component. Relative contribution (RC) of each component was calculated by taking the absolute value of the component’s beta coefficient and dividing by the sum of the absolute values of all components' beta coefficients. Models were stratified by road class. ResultsAcross all road classes combined, there were no significant changes to the overall MVC-related mortality rate (per population) and its components when comparing 2020–2022 to 2017–2019; this was due to the increased case fatality rate (CFR) being offset by decreases in the VMT rate and MVC injury rate. In 2020, among rural arterials a non-significant increased mortality rate was offset by a decreased VMT rate (RR 0.91, 95% CI 0.84–0.98, RC 19.2%) and MVC injury rate (RR: 0.89, 95% CI: 0.82–0.97, RC: 22.2%) when compared to 2017–2019. For non-arterials, a non-significant decreased MVC mortality rate was observed in 2020 when compared to 2017–2019 (RR 0.86, 95% CI 0.71–1.03). When considering 2021–2022 versus 2020, the only significant component for any road class was a decreased MVC injury rate for non-arterials (RR: 0.90,95% CI: 0.89–0.93) but this was offset by an increased MVC rate and CFR, resulting in no significant change to the mortality rate (per population). ConclusionsIn a state with one of the highest MVC-related mortality rates in the country, despite decreases in VMTs per population and injuries per MVC, the MVC mortality rate per population did not change during the pandemic due in part to the contributions of an increase in the case fatality rate. Future research should determine whether the increase in CFR was associated with risky driving behaviors during the pandemic.

Risk of motor vehicle collisions after methadone use.

Methadone maintenance treatment (MMT) can alleviate opioid dependence. However, MMT possibly increases the risk of motor vehicle collisions. The current study investigated preliminary estimation of motor vehicle collision incidence rates. Furthermore, in this population-based retrospective cohort study with frequency-matched controls, opiate adults receiving MMT (cases) and those not receiving MMT (controls) were identified at a 1:2 ratio by linking data from several nationwide administrative registry databases. From 2009 to 2016, the crude incidence rate of motor vehicle collisions was the lowest in the general adult population, followed by that in opiate adults, and it was the highest in adults receiving MMT. The incidence rates of motor vehicle collisions were significantly higher in opiate users receiving MMT than in those not receiving MMT. Kaplan-Meier curves of the incidence of motor vehicle collisions differed significantly between groups, with a significant increased risk during the first 90 days of follow-up. In conclusion, drivers receiving MMT have higher motor vehicle collision risk than those not receiving MMT in opiate users, and it is worthy of noticing road safety in such drivers, particularly during the first 90 days of MMT.

Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies.

International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate the possible mediation role played by defense strategies use in the relationship between alexithymia and MVCs. Our sample consisted of 297 adolescents divided into four subgroups, based on the number of visits to the emergency department due to an MVC. We assessed adolescents’ alexithymic traits and defense strategies use through self-report instruments. Results showed that males reported a higher rate of MVCs than females. Higher rates of MVCs are associated with more alexithymic traits and maladaptive defense strategies use. Adolescents’ Acting Out and Omnipotence use significantly mediated the relationship between alexithymia and MVCs. Our findings suggest the recidivism of MVCs as an attempt to cope with emotional difficulties, with important clinical implications.

The effect of visually significant dermatochalasis and blepharoptosis on driving safety

Objective To evaluate the impact of visually significant blepharoptosis and dermatochalasis on driving safety and performance. Patients with visually significant blepharoptosis often complain of difficulty with driving, but the impact of blepharoptosis on driving has not been evaluated in a real-world setting. Methods Retrospective cohort study of 610 consecutive adult patients undergoing bilateral functional blepharoplasty or ptosis repair surgery at a single, University-based practice between 2014 and 2017. This cohort had a median age of 65 and was predominantly female. Pre-operative rates of motor vehicle collisions (MVCs) and moving violations (MVs) extracted from state Department of Transportation (DOT) records were compared with post-operative rates, using each patient as their own control. Poisson models were used for analysis. Results Subjects were included in the study for a median of 730 days before eyelid surgery (IQR 346 − 730) and 783 days after surgery (IQR 449 − 1176). There were 30 total MVCs before surgery (0.024 per subject, per year) and 48 after surgery (0.036 per subject, per year) (p = 0.08). There were 81 MVs before surgery (0.065 per subject, per year) and 66 after (0.049 per subject, per year) (p = 0.11). The multivariable model comparing MVCs pre- versus post-surgery adjusting for age, ptosis severity, gender, and comorbidities yields a rate ratio of 0.63 (p = 0.05). The multivariable model comparing MVs pre- versus post-surgery demonstrates a rate-ratio of 1.2 (p = 0.20). Older age was associated with lower rates of moving violations (coefficient of −0.03, p < 0.01). None of the other variables included in the final models had a significant association with MVCs or MVs. Conclusions In this cohort, visually significant blepharoptosis and dermatochalasis were not associated with rates of MVCs or MVs. Further work is needed to study the impact of these common conditions on driving, for example adjusting MVC and MV rates by miles driven, which may influence decisions about when to operate on ptotic eyelids.

Young and under the influence: A systematic literature review of the impact of cannabis on the driving performance of youth

BackgroundYoung drivers ages 15–24 continue to constitute a high-risk population for fatal motor vehicle collisions (MVCs) compared to all other age groups. Driving under the influence of cannabis is an important contributor to the high rates of MVCs among youth. Understanding the specific impact of cannabis on the driving performance outcomes of young drivers can inform injury prevention, education, and intervention strategies. ObjectivesThis systematic literature review (SLR) aims to determine the Class (I- highest to IV-lowest) of evidence and level of confidence (A-high to U-insufficient) in the effects of cannabis on the driving performance of young drivers. MethodsRegistered in PROSPERO (#CRD42020180541), this SLR searched seven data bases and appraised the quality and confidence in the evidence using an established research methodology. ResultsClass II evidence suggests that THC is likely to reduce mean speed and increase headway distance; and increase reaction time, lane, and steering wheel position variability among young drivers (Level B, moderate confidence). ConclusionsThis study shows that there is a moderate to low level of confidence on the impact of cannabis on the specific driving performance outcomes of young drivers. A need remains for Class I and II studies that focus on the specific effects on young drivers, distinguish between the biological and socially constructed variables of sex and gender, and includes larger and more representative samples.

Motor Vehicle Crashes Involving a Bicycle Before and After Introduction of a Bike Share Program in Philadelphia, Pennsylvania, 2010-2018.

Objectives. To quantify the impact of a citywide bicycle share program on rates of motor vehicle collisions involving a bicycle.Methods. We conducted an interrupted time series analysis, using crash records from the Pennsylvania Department of Transportation for Philadelphia County from 2010 through 2018. We also calculated summary statistics to illustrate annual and monthly trends in rates of motor vehicle crashes involving a bicycle.Results. The baseline rate of bike events was 106% greater (95% confidence interval [CI] = 1.25, 3.38) at the time bicycle share was implemented compared with January 2010. Before bicycle share implementation, the rate of bicycle events decreased 1% (95% CI = 0.95, 1.03) annually. After the bicycle share program started, the rate of bicycle events decreased 13% (95% CI = 0.82, 0.94) annually.Conclusions. In the long term, programs that increase the number of bicycles on the road, such as bike share, may reduce rates of motor vehicle crashes involving a bicycle.

Effect of a cognitive test at license renewal for older drivers on their crash risk in Japan

ObjectiveTo evaluate the effect of adding a cognitive test to a license renewal procedure for drivers aged 75 years or older in reducing their motor vehicle collisions (MVCs). The test...

The short-term impact of economic uncertainty on motor vehicle collisions

Stress and anxiety lead to attention loss and sleep deprivation and may reduce driving performance, increasing the risk of motor vehicle collision. We used evidence from a natural experiment to examine whether daily changes in economic uncertainty, potentially leading to attention or sleep loss, are associated with collisions in Great Britain. Daily data from the economic policy uncertainty index, derived from analysis of daily UK newspapers, were linked to the daily number of motor vehicle collisions in Great Britain over the period 2005–2015, obtained from the Department for Transport. Exploiting daily variations in economic uncertainty, we used a GARCH approach to model daily rates of motor vehicle collisions as a function of economic uncertainty, controlling for month and day of the week, monthly unemployment rates and weekly unleaded petrol prices. A spike in the daily economic uncertainty index was associated with an immediate increase in the number of motor vehicle collisions. Results were robust to various sensitivity analyses. Overall, daily increases in economic uncertainty are associated with short-term spikes in motor vehicle collisions. Preventive and traffic control measures may need to increase during periods of economic uncertainty.

The Alabama VIP older driver study rationale and design: examining the relationship between vision impairment and driving using naturalistic driving techniques

BackgroundOlder drivers aged ≥70 years old have among the highest rates of motor vehicle collisions (MVC) compared to other age groups. Driving is a highly visual task, and older adults have a high prevalence of vision impairment compared to other ages. Most studies addressing visual risk factors for MVCs by older drivers utilize vehicle accident reports as the primary outcome, an approach with several methodological limitations. Naturalistic driving research methods overcome these challenges and involve installing a high-tech, unobtrusive data acquisition system (DAS) in an older driver’s own vehicle. The DAS continuously records multi-channel video of driver and roadway, sensor-based kinematics, GPS location, and presence of nearby objects in front of the vehicle, providing an objective measure of driving exposure. In this naturalistic driving study, the purpose is to examine the relationship between vision and crashes and near-crashes, lane-keeping, turning at intersections, driving performance during secondary tasks demands, and the role of front-seat passengers. An additional aim is to compare results of the on-road driving evaluation by a certified driving rehabilitation specialist to objective indicators of driving performance derived from the naturalistic data.MethodsDrivers ≥70 years old are recruited from ophthalmology clinics and a previous population-based study of older drivers, with the goal of recruiting persons with wide ranging visual function. Target samples size is 195 drivers. At a baseline visit, the DAS is installed in the participant’s vehicle and a battery of health and functional assessments are administered to the driver including visual-sensory and visual-cognitive tests. The DAS remains installed in the vehicle for six months while the participant goes about his/her normal driving with no imposed study restrictions. After six months, the driver returns for DAS de-installation, repeat vision testing, and an on-road driving evaluation by a certified driving rehabilitation specialist (CDRS). The data streams recorded by the DAS are uploaded to the data coordinating center for analysis.DiscussionThe Alabama VIP Older Driver Study is the first naturalistic older driver study specifically focused on the enrollment of drivers with vision impairment in order to study the relationship between visual dysfunction and driver safety and performance.

Distance matters: Effect of geographic trauma system resource organization on fatal motor vehicle collisions.

Trauma systems improve outcome; however, it is unclear how geographic organization of trauma system resources (TSR) affects outcome. Our objective was to evaluate the relationship of fatal motor vehicle collision (MVC) rates and the distance from individual MVC locations to the nearest TSR as a measure of the geographical organization of trauma systems, as well as how theoretical changes in the distribution of TSR may affect fatal MVC rates. All fatal MVC in Pennsylvania 2013-2014 were mapped from the Fatality Analysis Reporting System database. Deaths on scene were excluded. TSR including trauma centers and helicopter bases were mapped. Distance between each fatal MVC and nearest TSR was calculated. The primary outcome was fatal MVC rate per 100 million vehicle miles traveled (VMT). Empiric Bayes kriging and hot spot analysis were performed to evaluate geographic patterns in fatal MVC rates. Association between fatal MVC rate and distance to the nearest TSR was evaluated with linear regression. Spatial lag regression evaluated this association while controlling for MVC and county-level characteristics. We identified 886 fatalities from 863 fatal MVC. Median fatal MVC rate was 0.187 per 100 million VMT. Higher fatal MVC rates and fatality hot spots occur in locations farther from TSR. The fatal MVC rate increased 0.141 per 100 million VMT for every 10 miles farther from the nearest TSR (p < 0.01). When controlling for confounders, the fatal MVC rate increased by 0.089 per 100 million VMT for every 10 miles farther from the nearest TSR (p < 0.01). If two helicopters stationed at trauma centers were relocated into the highest fatality regions, our model predicts a 12.3% relative reduction in the overall MVC fatality rate. Increasing distance to the nearest TSR is associated with increasing fatal MVC rate. The geographic organization of trauma systems may impact outcome, and geospatial analysis can allow data-driven changes to potentially improve outcome. Prognostic/Epidemiologic, level III; Case management, level III.

Motor Vehicle Collision Involvement among Persons with Hemianopia and Quadrantanopia.

Persons with homonymous quadrantanopia and hemianopia experience driving restrictions, yet there is little scientific evidence to support driving prohibition among persons with these conditions. This retrospective cohort study compares motor vehicle collision (MVC) rates among 27 current licensed drivers with hemianopic and quadrantanopic field defects, who were ≥6 months from the brain injury date with that of 27 age-matched drivers with normal visual fields. Information regarding all police-reported MVCs that occurred over a period of nine years was obtained. MVC rates per year and per mile travelled were calculated and compared using conditional Poisson regression. Drivers with hemianopia or quadrantanopia had more MVCs per mile driven compared to drivers with normal visual fields; specifically their overall MVC rate was 2.45-times (95% confidence interval (CI) 0.89–3.95) higher and their at-fault MVC rate was 2.64-times (95% CI 1.03–6.80) higher. This study indicates that drivers with hemianopia or quadrantanopia have elevated MVC rates. This is consistent with previous research despite studies showing wide individual variability from excellent to poor driving skills. Future research should focus on the functional and driving performance characteristics associated with superior driving skills and/or those that may be amenable to improvement via behavioral and/or engineering interventions.

Driving with pets and motor vehicle collision involvement among older drivers: A prospective population-based study

ObjectiveDistracted driving is a major cause of motor vehicle collision (MVC) involvement. Pets have been identified as potential distraction to drivers, particularly in the front. This type of distraction could be worse for those with impairment in the cognitive aspects of visual processing. The purpose of this study is to evaluate the association between driving with pets and rates of motor vehicle collision involvement in a cohort of older drivers. MethodsA three-year prospective study was conducted in a population-based sample of 2000 licensed drivers aged 70 years and older. At the baseline visit, a trained interviewer asked participants about pet ownership, whether they drive with pets, how frequently, and where the pet sits in the vehicle. Motor vehicle collision (MVC) involvement during the three-year study period was obtained from the Alabama Department of Public Safety. At-fault status was determined by the police officer who arrived on the scene. Participants were followed until the earliest of death, driving cessation, or end of the study period. Poisson regression was used to calculate crude and adjusted rate ratios (RR) examining the association between pet ownership, presence of a pet in a vehicle, frequency of driving with a pet, and location of the pet inside with vehicle with any and at-fault MVC involvement. We examined whether the associations differed by higher order visual processing impairment status, as measured by Useful Field of View, Trails B, and Motor-free Visual Perception Test. ResultsRates of crash involvement were similar for older adults who have ever driven with a pet compared to those who never drove with their pet (RR=1.15, 95% CI 0.76–1.75). Drivers who reported always or sometimes driving with their pet had higher MVC rates compared to pet owners who never drive with a pet, but this association was not statistically significant (RR=1.39, 95% CI 0.86–2.24). In terms of location, those reporting having a pet frequently ride in the front of the vehicle had similar rates of MVC involvement compared to those who did not drive with a pet in the front. A similar pattern of results was observed for at-fault MVCs. This association was not modified by visual processing impairment status. ConclusionThe current study demonstrates a positive but non-significant association between frequently driving with pets and MVC involvement. More research is needed, particularly on restraint use and whether the pet was in the car at the time of the crash, to help characterize the public safety benefit of regulations on driving with pets.

Zolpidem use and motor vehicle collisions in older drivers

ObjectivePrescription sleep medication use is most prevalent among women and older adults. Morning drowsiness and impaired coordination are side effects of sleep medications that may affect driving safety. The association between current use of zolpidem-containing medications and motor vehicle collisions (MVCs) was evaluated among drivers of advanced age. MethodsParticipants were current drivers aged ≥70 years residing in north-central Alabama, spoke English, had a valid driver's license, and had driven within the past three months (n = 2000). Current zolpidem use was determined by pill bottle review. The participant's five-year MVC history was determined from Alabama Department of Public Safety accident reports. The five-year MVC and at-fault MVC rate ratios (RR) were estimated comparing zolpidem users with nonusers in the overall sample and a priori–defined age and sex subgroups. ResultsThe unadjusted RR (95% confidence interval [CI]) of MVCs comparing zolpidem users with nonusers was attenuated after adjustment (1.46 [1.02–2.08] and 1.38 [0.97–1.98], respectively). Among women, the unadjusted and adjusted RRs (95% CI) were 1.65 (1.03–2.66) and 1.61 (1.00–2.60), respectively. The unadjusted and adjusted RRs (95% CI) among those aged 80 years or more were 2.24 (1.19–4.57) and 2.35 (1.20–4.61), respectively. There were no statistically significant associations among men or participants less than 80 years old. Similar patterns were present for at-fault MVCs. ConclusionCurrent zolpidem users, specifically women and individuals aged 80 years or more, had higher MVC rates than nonusers. Practitioners should consider behavioral treatment before initiating low doses of zolpidem and increasing it as needed to achieve restorative sleep in women and individuals aged 80 years or more to reduce the risk of zolpidem-associated MVCs.

Association between Glaucoma and At–fault Motor Vehicle Collision Involvement among Older Drivers: A Population-based Study

To examine the association between glaucoma and motor vehicle collision (MVC) involvement among older drivers, including the role of visual field impairment that may underlie any association found. A retrospective, population-based study. A sample of 2000 licensed drivers aged ≥70 years who reside in north central Alabama. At-fault MVC involvement over the 5 years before enrollment was obtained from state records. Three aspects of visual function were measured: habitual binocular distance visual acuity, binocular contrast sensitivity (CS), and the binocular driving visual field constructed from combining the monocular visual fields of each eye. Poisson regression was used to calculate crude and adjusted rate ratios (RRs) and 95% confidence intervals (CIs). At-fault MVC involvement over the 5 years before enrollment. Drivers with glaucoma (n = 206) had a 1.65 times higher MVC rate (95% CI, 1.20-2.28; P = 0.002) compared with those without glaucoma after adjusting for age, and mental status. Among those with glaucoma, drivers with severe visual field loss had higher MVC rates (RR, 2.11; 95% CI, 1.09-4.09; P = 0.027), whereas no association was found among those with impaired visual acuity and CS. When the visual field was subdivided into 6 regions (upper, lower, left, and right visual fields; horizontal and vertical meridians), we found that impairment in the left, upper, or lower visual field was associated with higher MVC rates, and an impaired left visual field showed the highest RR (3.16; P = 0.001) compared with other regions. However, no association was found in deficits in the right side or along the horizontal or vertical meridian. A population-based study suggests that older drivers with glaucoma are more likely to have a history of at-fault MVC involvement than those without glaucoma. Impairment in the driving visual field in drivers with glaucoma seems to have an independent association with at-fault MVC involvement, whereas visual acuity and CS impairments do not.

Previous Driving Experience, but Not Vision, Is Associated With Motor Vehicle Collision Rate in Bioptic Drivers.

Bioptic telescopic spectacles (BTS) consist of a small telescope (or telescopes) mounted high in a pair of spectacle lenses. More than 40 states allow for some form of bioptic driving licensure for people with decreased central vision. The purpose of this study was to determine significant associations among previous driving experience, vision, and motor vehicle collisions (MVCs) for bioptic drivers in Ohio. We conducted a retrospective study of patients who received a vision examination and subsequently obtained bioptic licensure. We obtained driving records from the Ohio Bureau of Motor Vehicles in order to determine MVC involvement. Relationships among vision measures, age, sex, previous experience, and MVCs were investigated using time-to-event analysis and the Cox proportional hazards regression model. We identified 237 bioptic drivers (65% male). Age at initial exam ranged from 16 to 81 years, and mean visual acuity was approximately 20/120. The number of MVCs per driver ranged from 0 to 11, with 124 (52%) drivers having had at least one MVC. Visual acuity and contrast sensitivity were not significant predictors of MVC. Drivers without previous driving experience were significantly more likely to have been involved in an MVC (P < 0.001), and this association remained significant after adjusting for age and sex (P = 0.01). The rate of MVC per year decreased steadily over a 10-year period for drivers without previous experience. Previous nonbioptic driving experience, but not visual acuity or contrast sensitivity, was associated with yearly MVC rate in bioptic drivers.

Binocular Visual Field Impairment in Glaucoma and At-Fault Motor Vehicle Collisions

To evaluate the association between the binocular visual field defects in drivers with glaucoma and the risk of motor vehicle collision (MVC) involvement. A retrospective cohort study was conducted on 438 drivers with glaucoma aged 55 years or older using data from 1994 through 2000. Demographic, clinical, and driving characteristics were obtained from chart abstractions and patient survey. Binocular field measures were generated by combining data from the monocular (central 24-degree radius) fields whereby the binocular field measure was defined as the more sensitive point at each monocular field location. Measures included threshold (TH), total deviation (TD), and pattern deviation (PD); severe impairment in these measures was defined as falling into the worst quartile. MVC data were obtained from police records. Rate ratios (RR) and 95% confidence intervals (CI) were calculated. Drivers with severely impaired PD measures were twice as likely to have an at-fault MVC compared with those not severely impaired (RR, 2.13; 95% CI, 1.21-3.75); those with severely impaired TH (RR, 1.49; 95% CI, 0.81-2.74) and TD (RR, 1.50; 95% CI, 0.82-2.74) also had an increased rate of at-fault MVCs, although these were not significant. When the binocular central visual field was stratified into 9 regions, drivers with impaired TH, TD, or PD had similarly elevated MVC rates in all regions compared with those not severely impaired, though not all reached statistical significance. On the basis of clinical measures of visual field routinely used in the management of glaucoma, drivers with glaucoma with severe PD field defects in the binocular field have a higher rate of at-fault MVC compared with those with less impaired or unimpaired binocular visual fields.

Impact of mandating a driving lesson for older drivers at license renewal in Japan

In Japan, a driving lesson consisting of a lecture, a driver aptitude test, on-road driving assessment and a discussion session was added to the driving license renewal procedure for drivers aged 75 years or older in 1998 and for drivers aged 70 years or older in 2002. We investigated whether these additions contributed to a reduction in at-fault motor vehicle collisions (MVCs) by examining the trend of the at-fault MVC rates per licensed driver and the rate ratios of the older drivers relative to those aged 65–69 years for the years 1986–2011. All data were derived from nationwide traffic statistics. If the introduction of the lesson was effective in reducing at-fault MVCs of older drivers, the rate ratio should have declined, given that the lesson targeted only the older drivers. We found this was not the case, i.e., there was no declining trend in the at-fault MVC rate ratios of both drivers aged 75 years or older and drivers aged 70 years or older, relative to drivers aged 65–69 years, after the driving lesson at license renewal became mandatory for these older drivers. Therefore, the mandatory lesson for the older drivers at license renewal needs to be reconsidered.

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Examining the association between age-related macular degeneration and motor vehicle collision involvement: a retrospective cohort study

BackgroundLittle is known about motor vehicle collision (MVC) risk in older drivers with age-related macular degeneration (AMD). The purpose of this study is to examine associations between MVC involvement and...