Older Adult Drivers Research Articles

The development and validation of a Japanese hazard perception task

Objectives This study aimed to validate the hazard perception task developed for Japanese drivers with brain damage. Methods A total of 36 professional driving instructors, 67 older adult drivers, 39 young drivers, and 72 patients with brain damage participated in the study. A video-based hazard perception task measured the hazard perception skills of each group. Participants were instructed to touch the screen as soon as they identified a hazard. Outcome measures included the number of hazards identified and response latency. Comparisons were made between groups for each hazard type: environmental prediction hazard (EPH) and behavioral prediction hazard (BPH). Results Patients with brain damage demonstrated fewer hazard detections and longer response latencies than driving instructors and older adult drivers, regardless of the hazard type. The hazard perception skills of patients with brain damage were comparable to those of young drivers across both hazard types. Driving instructors exhibited the highest number of hazard detections and the fastest response latencies among all groups, with differences being more pronounced for EPH than for BPH. Conclusions Thus, the validity of the hazard perception task developed for Japanese drivers with brain damage was confirmed. Future research should examine the predictive validity of the developed task, particularly its relationship with crash rates in individuals with brain damage.

Dietary supplement use is common in older adult drivers: an analysis from the AAA LongROAD study

BackgroundDietary supplement (DS) use is common and increasing among older adults, though much data available on use frequencies are from surveys and performed cross-sectionally. This paper sought to assess the frequency and pattern of dietary supplement use among older adults over time.MethodsA secondary analysis of data from the AAA LongROAD study, a longitudinal prospective cohort study of older adult drivers, using data from baseline and the first two years of follow up included a total of 2990 drivers aged 65–79 years recruited at five study sites across the US from July 2015 to March 2017. Participants underwent baseline and annual evaluations, which included a “brown bag” medication review. DS were identified and categorized according to type and key components. Prevalence and pattern of DS use over time and relationship to demographics were measured with frequency and Chi squared analyses.Results84% of participants took at least one dietary supplement during the 2-year study period, and 55% of participants continually reported use. DS accounted for approximately 30% of the total pharmacologic-pill burden in all years. Participants who were White non-Hispanic, female, 75–79 years of age at baseline, and on more non-supplement medications took significantly more dietary supplements (P < 0.05). Vitamin D, multivitamins, calcium, and omega-3 formulations were the most common supplements, with stable use over time. Use of individual herbal supplements and cannabis products was uncommon (< 1% participants per year).ConclusionsDS use among older adults is common and relatively stable over time and contributes to polypharmacy. In clinical settings, providers should consider the influence of DS formulations on polypharmacy, and the associated cost, risk of medication interactions, and effect on medication compliance.

Transferability of Effective Consultation Skills for Decision-Making Support in the Voluntary Surrender of Older Adult Drivers' Licences in Super-Aged Japan.

Previously, we identified eight effective consultation skills to support decision-making in the voluntary surrender of older adult drivers' licences in super-aged Japan. This study aimed to clarify the transferability of these skills. We collected text data by interviewing 11 safe-driving counsellors (four police officers, four clerical staff and three nurses) in the License Division of the National Police Agency from February to March 2022. Interviews were semi-structured and conducted by telephone or email. During the interview, participants were asked to recall their experiences as counsellors providing decision-making support to older drivers and to compare their experiences with the eight consultation skills. We analysed the content of the responses by quantitative text analysis with KH Coder 3 software. As a characteristic of the words and phrases used by counsellors in their narratives about consultation skills, the most frequently extracted words from among 3147 words were think, parties and family, and promote had the highest mediation centrality. The eight subgraphs were 'Respecting the will of relevant parties from their standpoint is natural', 'Listening attentively and empathetically to relevant parties is effective', 'Presenting objective data to guide decisions is successful', 'Showing cognitive functioning test results is often effective', 'Counselors with medical expertise can elicit positive counseling outcomes', 'Intervention by medical or police counselors facilitates the decision to surrender voluntarily', 'Counseling skills need to be improved' and 'A diagram of the 8 skills is helpful for inexperienced counselors'. The results suggest that the eight consultation skills have similarities and are transferable. This transferability might contribute to practical application or cohort follow-up study research. These skills can be incorporated into counsellor training, and counsellors can be expected to use these skills in the future. Regardless of the safe-driving counsellor's years of experience, the skills can help them provide uniform and accurate support in decision-making regarding the voluntary surrender of older adult drivers' licences. These skills are a promising approach to help older adults lead safe and secure lives as they age.

Metacognitive Awareness of Older Adult Drivers with Mild Cognitive Impairment: Relationships with Demographics, Subjective Evaluation of Cognition, and Driving Self-Efficacy.

(1) Self-regulation of driving is a means of maintaining one's driving identity. The purpose of this study was to investigate the extent to which older drivers with Mild Cognitive Impairment (MCI) are metacognitively aware of the requirements of specific demanding driving conditions and whether this awareness is linked to subjective assessments of cognition. (2) One hundred seventeen (117) older MCI drivers participated in a telephone survey in which they reported their metacognitive experiences in nine driving conditions, listed as an aim of self-regulation. The analyses included the participants' subjective cognitive assessments, both in terms of their cognitive state and their perceived driving self-efficacy. (3) The analyses pointed out a direct and negative effect of age on the formation of the metacognitive feeling of certainty. Furthermore, an indirect effect of sex through driving self-efficacy was established. This effect was negative in the case of the metacognitive feeling of difficulty and the estimation of effort and positive in the case of the metacognitive feeling of certainty. (4) This position points out the need to establish appropriate levels of the perceived self-efficacy of older drivers with MCI, and it raises issues when it moves to fictitious levels.

Diabetes mellitus and hard braking events in older adult drivers

BackgroundDiabetes mellitus (DM) can impair driving safety due to hypoglycemia, hyperglycemia, diabetic peripheral neuropathy, and diabetic eye diseases. However, few studies have examined the association between DM and driving safety in older adults based on naturalistic driving data.MethodsData for this study came from a multisite naturalistic driving study of 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 adjusted incidence rate ratios (aIRRs) and 95% confidence intervals (CIs) of hard braking events (HBEs, defined as maneuvers with deceleration rates ≥ 0.4 g) associated with DM.ResultsOf the 2856 study participants eligible for this analysis, 482 (16.9%) reported having DM at baseline, including 354 (12.4%) insulin non-users and 128 (4.5%) insulin users. The incidence rates of HBEs per 1000 miles were 1.13 for drivers without DM, 1.15 for drivers with DM not using insulin, and 1.77 for drivers with DM using insulin. Compared to drivers without DM, the risk of HBEs was 48% higher for drivers with DM using insulin (aIRR 1.48; 95% CI: 1.43, 1.53).ConclusionOlder adult drivers with DM using insulin appear to be at increased proneness to vehicular crashes. Driving safety should be taken into consideration in DM care and management.

A Systematic Review of Effective Interventions and Strategies to Support the Transition of Older Adults From Driving to Driving Retirement/Cessation.

In most western countries, older adults depend on private cars for transportation and do not proactively plan for driving cessation. The objective of this review was to examine current research studies outlining effective interventions and strategies to assist older adults during their transition from driver to driving retirement or cessation. A search was completed across 9 databases using key words and MeSH terms for drivers, cessation of driving, and older adult drivers. Eligibility screening of 9,807 titles and abstracts, followed by a detailed screening of 206 papers, was completed using the Covidence platform. Twelve papers were selected for full-text screen and data extraction, comprising 3 papers with evidence-based intervention programs and 9 papers with evidence-informed strategies. Three papers met the research criteria of a controlled study for programs that support and facilitate driving cessation for older adults. Nine additional studies were exploratory or descriptive, which outlined strategies that could support older drivers, their families, and/or healthcare professionals during this transition. Driving retirement programs/toolkits are also presented. The driver retirement programs had promising results, but there were methodological weaknesses within the studies. Strategies extracted contributed to 6 themes: Reluctance and avoidance of the topic, multiple stakeholder involvement is important, taking proactive approach is critical, refocus the process away from assessment to proactive planning, collaborative approach to enable "ownership" of the decision is needed, and engage in planning alternative transportation should be the end result. Meeting the transportation needs of older adults will be essential to support aging in place, out-of-home mobility, and participation, particularly in developed countries where there is such a high dependency on private motor vehicles.

Demographic and injury trends for car crash casualties hospitalized in Level I Trauma centers over two decades: data from the National Trauma Registry

BackgroundDuring the past two decades, there have been many changes in automotive and medical technologies, road infrastructure, trauma systems, and demographic changes which may have influenced injury outcomes. The aim of this study was to examine injury trends among traffic casualties, specifically private car occupants, hospitalized in Level I Trauma Centers (TC).MethodsA retrospective cohort study was performed based on data from the Israel National Trauma Registry. The data included occupants of private cars hospitalized in all six Level I TC due to a traffic collision related injury between January 1, 1998 and December 31, 2019. Demographic, injury and hospitalization characteristics and in-hospital mortality were analyzed. Chi-squared (X2) test, multivariable logistic regression models and Spearman’s rank correlation were used to analyze injury data and trends.ResultsDuring the study period, 21,173 private car occupants (14,078 drivers, 4,527 front passengers, and 2,568 rear passengers) were hospitalized due to a traffic crash. The percentage of females hospitalized due to a car crash increased from 37.7% in 1998 to 53.7% in 2019. Over a twofold increase in hospitalizations among older adult drivers (ages 65+) was observed, from 6.5% in 1998 to 15.7% in 2018 and 12.6% in 2019. While no increase was observed for severe traumatic brain injury, a statistically significant increase in severe abdominal and thoracic injuries was observed among the non-Jewish population along with a constant decrease in in-hospital mortality.ConclusionsThis study provides interesting findings regarding injury and demographic trends among car occupants during the past two decades. Mortality among private car occupant casualties decreased during the study period, however an increase in serious abdominal and thoracic injuries was identified. The results should be used to design and implement policies and interventions for reducing injury and disability among car occupants.

Relationship between Driving Ability and Physical Fitness Factors in Older Adults: A Multiple Linear Regression Analysis.

The number of older drivers is increasing with the aging population; this has led to concerns about traffic accidents involving older drivers. For older adults, the automobile is not just a means of transportation, but a life necessity that promotes social activities and maintains and improves health-related quality of life. In this study, we aimed to clarify the relationship between driving ability and physical fitness factors among 70 older adult drivers using a single regression analysis and multiple regression models adjusted for age, sex, and other factors. Driving ability was evaluated by driving an actual car on an ordinary road without a simulator. The single regression analysis revealed no relationship between driving ability and any physical fitness factor. In the multiple regression model analysis, only grip strength was an important explanatory factor; however, the driving ability scores decreased as grip strength scores increased. By clarifying the physical fitness factors that influence the maintenance and improvement of driving ability, it is possible to propose more efficient intervention programs to maintain and improve driving ability. We could not identify the relevant physical fitness factors in this study; therefore, further research is required to improve safe driving among older adults.

Motor Vehicle Crash Risk in Older Adult Drivers With Attention-Deficit/Hyperactivity Disorder

Symptoms of attention-deficit/hyperactivity disorder (ADHD), such as inattentiveness and impulsivity, could affect daily functioning and driving performance throughout the life span. Previous research on ADHD and driving safety is largely limited to adolescents and young adults. To examine the prevalence of ADHD and the association between ADHD and crash risk among older adult drivers. This prospective cohort study collected data from primary care clinics and residential communities in 5 US sites (Ann Arbor, Michigan; Baltimore, Maryland; Cooperstown, New York; Denver, Colorado; and San Diego, California) between July 6, 2015, and March 31, 2019. Participants were active drivers aged 65 to 79 years at baseline enrolled in the Longitudinal Research on Aging Drivers project who were studied for up to 44 months through in-vehicle data recording devices and annual assessments. The data analysis was performed between July 15, 2022, and August 14, 2023. Lifetime ADHD based on an affirmative response to the question of whether the participant had ever had ADHD or had ever been told by a physician or other health professional that he or she had ADHD. The main outcomes were hard-braking events defined as maneuvers with deceleration rates of 0.4g or greater, self-reported traffic ticket events, and self-reported vehicular crashes. Multivariable negative binomial modeling was used to estimate adjusted incidence rate ratios (aIRRs) and 95% CIs of outcomes according to exposure status. Of the 2832 drivers studied, 1500 (53.0%) were women and 1332 (47.0%) were men with a mean (SD) age of 71 (4) years. The lifetime prevalence of ADHD in the study sample was 2.6%. Older adult drivers with ADHD had significantly higher incidence rates of hard-braking events per 1000 miles than those without ADHD (1.35 [95% CI, 1.30-1.41] vs 1.15 [95% CI, 1.14-1.16]), as well as self-reported traffic ticket events per 1 million miles (22.47 [95% CI, 16.06-31.45] vs 9.74 [95% CI, 8.99-10.55]) and self-reported vehicular crashes per 1 million miles (27.10 [95% CI, 19.95-36.80] vs 13.50 [95% CI, 12.61-14.46]). With adjustment for baseline characteristics, ADHD was associated with a significant 7% increased risk of hard-braking events (aIRR, 1.07; 95% CI, 1.02-1.12), a 102% increased risk of self-reported traffic ticket events (aIRR, 2.02; 95% CI, 1.42-2.88), and a 74% increased risk of self-reported vehicular crashes (aIRR, 1.74; 95% CI, 1.26-2.40). As observed in this prospective cohort study, older adult drivers with ADHD may be at a significantly elevated crash risk compared with their counterparts without ADHD. These findings suggest that effective interventions to improve the diagnosis and clinical management of ADHD among older adults are warranted to promote safe mobility and healthy aging.

“But I'm a Good Driver!”: A Standardized Patient Simulation to Teach Nurse Practitioner Students to Screen Older Adult Drivers

BackgroundChanges of aging put older adult drivers at risk of motor vehicle crashes, injury, and death. Nurse Practitioners (NP) can make clinical decisions regarding counseling at-risk drivers about transitioning away from driving. However, NP students typically receive little deliberate instruction in this content. MethodsStandardized Patients portrayed at-risk older adult drivers during a 25-minute simulated office visit. Four hundred eight-one NP students participated (in-person, n = 234; telehealth, n = 247). Students conducted brief driving histories, performed one cognitive and one physical screening measure, discussed results using best-practice communication skills, recommended appropriate referrals, and documented findings. Self-debriefing worksheets, faculty observation, debriefing discussion, and the Simulation Effectiveness Tool-Modified (SET-M) were examined. ResultsWritten debriefing and faculty-facilitated debriefing demonstrated desire to know more about reporting/referral and expressed the value of practicing difficult conversations related to driving transition. SET-M scores revealed all subscale means above 2, indicating positive perceptions of the experience. ConclusionsThis simulation provided clinical decision-making opportunities to discuss driving transition with at-risk older adult drivers using best-practice communication skills and resulted in positive perceptions reflecting beneficial learning.

What triggers road traffic fatalities among older adult drivers? An investigation based on the Swedish register for in-depth studies of fatal crashes

IntroductionRoad traffic fatalities among drivers result not only from erroneous driving manoeuvres. They can also be triggered by poor mental or physical health like suicidal acts and acute disease attacks, the latter being more frequent with age. There are few studies comprising all the different triggers of fatal crashes among older drivers and on how these triggers evolve over time. This Swedish national study aims to investigate this, considering drivers 50+ years. MethodFor the period 2010–2019, data on non-commercial car drivers aged 50 and older were extracted from the Swedish Transport Administration’s in-depth studies of fatal crashes, compiled in a register encompassing all road traffic fatalities. The crash triggers reported were classified as suicide, acute disease, own manoeuvre (single or other type of crash), external, and undetermined. Total and annual frequencies were presented by crash trigger, overall and stratified by sex and age groups. ResultsIn total, 762 fatalities were identified and with 709 of them, it was possible to classify the crash trigger: 12% resulting from suicide; 29% from acute disease; 49% from the driver’s own manoeuvre; and 10% from an external crash trigger. Suicides increased from 9% in average 2010–2014 to 15% in 2015–2019 while acute disease decreased (from 32% to 27%). The overall male-to-female ratio was 4.5, and as high as 8.7 for acute disease. The relative importance of each trigger varied with age with, for instance, acute disease being more frequent in the two younger age groups; 31% for 50–64 and 52% for 65–79 years old drivers, while own manoeuvre was more prominent for drivers aged 80 and older (23%). ConclusionThe distribution of the four different triggers of road traffic fatalities varies only slightly over time and, a majority are triggered by the driver’s own manoeuvre. However, a substantial proportion, about four out of ten,are triggered by a health condition, of which some are suicide but the major part an acute disease, mainly cardiovascular. In some instances, such crashes can be harmful to other road users. Having in mind the need for safety and mobility of older drivers and the protection of all road users, there is a need for the promotion of road safety policies that encompass a wider range of measures to help reducing the likelihood of fatal and severe crashes to happen e.g., targeting incapacitated drivers.

Driving under the influence of substances and motor vehicle fatalities among older adults in the United States

Objective This study examines contribution of substance use (including alcohol, cannabinoids, stimulants, narcotics, depressants, and hallucinogens) on the probability of drivers being at-fault for a crash on U.S. public roads, with specific emphasis on older adult drivers. Methods Data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System (FARS) for the years 2010–2018 were employed for 87,060 drivers (43,530 two-vehicle crash pairs) involved in two moving vehicle crashes. The quasi-induced exposure (QIE) method was used to compute the relative crash involvement ratios (CIRs) for each relevant substance and illicit drug. Mixed-effect generalized linear regression models were fit to examine the effect of substance use on the probability of a driver being at-fault for a crash. Results There were 75.51% males and 73.88% Non-Hispanic Whites in our sample. The CIR for those aged 70–79 years was 1.17, and more than double (2.56) for the ≥80 years old drivers, while being relatively low among drivers of ages 20 to 69. Substance use, in general, disproportionately increased the probability of being at-fault during a crash, regardless of driver’s age. Though older drivers are less likely than other age groups to report substance use, presence of substances among older drivers increased the probability of their being at-fault two to four times during a crash across almost all substances. The regression models, after adjusting for driver’s sex, road grade, weather, light conditions, distraction, and speeding at time of crash, revealed that older drug-impaired drivers were twice as likely to be at fault in a fatal crash (aOR = 1.947; 95% CI = 1.821, 2.082; <0.0001) compared to their middle-aged counterparts. Similarly, most substance use categories were responsible for the probabilities of higher CIRs among the drivers. Conclusion These findings necessitate continued efforts to bring awareness to the deadly consequences of “drugged driving,” especially among older adult drivers.

Risk Assessment of Traffic Accidents Involving Young Adult Drivers by Identification of Subjective and Objective Factors

Young drivers represent the most vulnerable age group at risk of participating in traffic accidents. In order to reduce the occurrence of traffic accidents involving young drivers, various models for assessing the risk of accidents have been studied. Inexperience, lack of driving skills and risky behaviour in traffic are the main characteristics of traffic accidents involving young adult drivers. On the contrary, traffic accidents involving older adult drivers are characterised by reduced visual and cognitive stimuli and reduced mobility. Based on the data about traffic accidents from the available databases relevant for road traffic safety in the Republic of Kosovo over a four-year period, the road characteristics that caused the majority of traffic accidents involving young adult drivers and the subjective and objective factors that affected the occurrence of traffic accidents the most have been defined. To conclude the research, a correlation has been defined between objective and subjective factors that increase the risk of traffic accidents, as well as the frequency of single safety factors (human, vehicle, road and environment) in traffic accidents involving young adult drivers.

Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic.

Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having access to a driving risk assessment tool could help older adults and their caregivers prepare for discussions around driving retirement. This study compares the clinical profiles of older adult drivers assessed in an academic memory clinic who were referred to the driving authority to older drivers who were not with a focus on instrumental activities of daily living (iADLs). Data on referred (R) and not-referred (NR) drivers were extracted from medical records. Elements from the medical history, cognitive history, functional abilities, Modified Mini-Mental State (3MS) examination, Trails A/B, and clock drawing were included in the analysis. Four risk factors of interest were examined in separate logistic regression analyses, adjusted for demographic variables. 50 participants were identified in each group. The R group was older on average than the NR. As expected, R were more likely to have Trails B scores over 3 min and have significantly abnormal clock drawing tests. R also showed lower 3MS scores and a higher average number of functional impairments (including managing appointments, medications, bills, or the television). Beyond standard cognitive tests, impairment in iADLs may help general practitioners identify at-risk drivers in the absence of standardized guidelines and tools. This finding can also inform the design of a risk assessment tool for driving and could help with approaches for drivers with otherwise borderline test results.

IMPACT OF A DRIVING DECISION AID ON DECISIONAL CONFLICT AMONG OLDER ADULT DRIVERS AND THEIR STUDY PARTNERS

Abstract Forty-four million US licensed drivers are ≥65 years old and at higher crash risk. Decision-making about stopping or continuing driving is difficult and often involves family and friends. This study examines if decision conflict about changing driving habits is associated between older adult drivers and their study partners (SPs) (i.e., family member or friend). Data were from a multi-site trial assessing a driving decision aid. Decision conflict about stopping or continuing driving for drivers and their SPs were measured with the Decision Conflict Scale (DCS). Dyadic associations between drivers’ and SPs’ DCS scores pre- and post-decision aid implementation were analyzed using an actor-partner interdependence model. Among 228 driver-SP dyads, driver mean (SD) age was 77.1 (5.1) years; 50.0% female; 98.7% non-Hispanic; 94.7% white; and 97.8% urban-dwelling. SPs mean age was 66.1 years (13.9); 65.8% female; 95.6% non-Hispanic; 92.1% white; and commonly the driver’s spouse (54.6%) or adult child (21.1%). Most drivers (71.7%) and SPs (63.3%) had baseline DCS scores &amp;lt; 25 (drivers mean 18.5 (SD 12.3); SPs 20.5 (16.8)), suggesting low decision conflict. DCS was correlated within dyads at baseline (r=0.18, p &amp;lt; 0.01), and baseline DCS was associated with post-decision aid DCS (p &amp;lt; 0.001 for SPs [β=0.73] and drivers [β=0.73]). While SPs’ baseline DCS was not associated with drivers’ post-decision aid DCS, drivers’ baseline DCS and SPs’ post-decision DCS were (β=0.10; p=0.036). Higher decision conflict about driving felt by older drivers is frequently shared by their SPs, in whom decision conflict may persist even after a driving decision aid intervention.

A fundamental study on the relationship between cognitive function and psychological load while driving in older adult drivers.

Although many media outlets have sounded the alarm about dangerous driving by elderly drivers, serious accidents do not occur on a daily basis, and the dangerous events of daily driving have not been clarified. However, serious accidents do not occur on a daily basis, and the risk events of daily driving have not been clarified. Also, the relationship between cognitive function and drivers' cognitive function has not been clarified. In addition, cognitive function fluctuates from day to day, and it is difficult to obtain an accurate picture of cognitive function from a one-time test. However, in Japan, the system currently determines whether a driver's license is revoked or not depending on the results of the test, and it is difficult to say that we can properly diagnose the driving of elderly drivers. In this study, we observed the heart rate during driving and examined the changes in psychological load that occur during driving. I observed 80 subjects' driving data. As a result, it was found that the heart rate of drivers with cognitive decline increased when they were approached by a trivial voice or an unexpected obstacle, followed by a rapid decrease in the heart rate and a state of excessive relaxation.In addition, when they were in the state of excessive relaxation, they slowed down their obstacle avoidance behavior and forgot to activate the blinker. Therefore, it is necessary to find a way to equalize the tension during driving in order to support the safe driving of elderly drivers.

Driving, Residential Location, and Employment Outcomes Among Older Adults.

The ability to drive is positively associated with workforce participation among older adults. However, residence in neighborhoods where destinations are easy to reach by public transit could potentially narrow the employment gap between older drivers and non-drivers. This study examines the relationship between driving, residential location characteristics, and employment outcomes among older adults. Findings show that both drivers and non-drivers are more likely to be employed if they live in neighborhoods with high levels of access to jobs via public transit. However, the positive relationship between transit access to jobs and employment outcomes is particularly strong among non-drivers. These findings indicate that although older adult drivers are more likely to work than their non-driving counterparts, the gap in employment outcomes is mitigated by living in dense, transit-rich neighborhoods. Results suggest that policies supporting both automobile access and transit-rich residential environments can facilitate labor force participation among older adults.

Mortality due to road traffic injuries in older adults in the Republic of Ecuador between 1990 and 2018: a descriptive study

Mortality due to road traffic injuries in older adults in the Republic of Ecuador between 1990 and 2018: a descriptive study

Driving Performance in Older Adults: Current Measures, Findings, and Implications for Roadway Safety.

Over 10,000 people a day turn 65 in the United States. For many older adults, driving represents an essential component of independence and is one of the most important factors in overall mobility. Recent survey studies in older adults suggest that up to 60% of older adult drivers with mild cognitive impairment, and up to 30% with dementia, continue to drive. The purpose of this review is to provide a comprehensive and detailed resource on the topics of cognition and driving for clinicians, researchers, and policymakers working on efforts related to older adult drivers. Publications on PubMed and Medline and discussions with experts working in geriatrics, technology, driving policy, psychology, and diverse aspects of driving performance were utilized to inform the current review. Research indicates that there is a complex and inverse correlation between multiple cognitive measures, driving performance, and risky driving behaviors. The fragmented nature of available peer-reviewed literature, and a reliance on correlative data, do not currently allow for the identification of the temporal and reciprocal nature of the interplay between cognition and driving endpoints. There are currently no widely accepted definitions, conceptual models, or uniform set of analyses for conducting geriatric research that is focused on driving. Establishing conventions for conducting research that harmonizes the fields of geriatrics, cognition, and driving research is critical for the development of the evidence base that will inform clinical practice and road safety policy.

Lower risk of car crashes among older drivers compared with younger drivers: analysis of 10 years of data

Objective: Traffic crashes are a significant cause of health expenditure, mainly considering disability and death. Driving skills are key when it comes to traffic crashes, and older drivers may be unfit to drive. The statistics of traffic crashes involving older drivers can contribute to planning actions that reduce accidents. This study aimed to present statistical data on traffic crashes among older adults in a Brazilian state. Methods: This is an epidemiological study performed with data from the Traffic Accident Information System of the Federal District Traffic Department, Brazil, ranging from 2008 to 2017 and comparing the incidence of injury crashes between older drivers and adult drivers. Results: Although the system recorded 60 705 drivers involved in injury crashes, a 24% reduction was seen in the overall crash incidence during the studied period (2008 – 2017); within the older drivers group, this reduction was two times smaller (12%). Despite the smaller drop in incidence, older car drivers presented around three times less risk of crashes when compared to adult drivers, along with a lower risk of accidents on urban, low-speed streets, and were mostly involved in collisions during the day. Conclusion: We found that the risk of older drivers being involved in injury crashes was three times smaller than that of adult drivers. The behavior of older drivers can influence the occurrence of accidents.