Are rural older drivers subject to low-mileage bias?

Hanson, Trevor; Hildebrand, Eric

doi:10.1016/j.aap.2011.04.028

Cited by 18 publications

(9 citation statements)

References 7 publications

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“…However, our results are consistent with those studies that show that drivers of extreme ages are involved in more crashes due to a riskier driving behavior rather than different environmental or vehicle circumstances. According to other studies, a driver's error was the critical reason in 97% of crashes involving older drivers [14], and low-mileage bias has been reported to be insignificant in the rural context [29]. Regarding younger drivers, human factors were more influential than environmental factors in road crashes [1], especially executive function capacities and negative driving behavior [30].…”

Section: Discussionmentioning

confidence: 90%

Explaining the Association between Driver’s Age and the Risk of Causing a Road Crash through Mediation Analysis

Gomes-Franco

Rivera-Izquierdo

Martín-delosReyes

et al. 2020

IJERPH

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It has been widely reported that younger and older drivers have an excess risk of causing a road crash. Two casual hypotheses may coexist: the riskier driving behaviors and age-related mechanisms in extreme age groups (direct path) and the different environmental and vehicle circumstances (indirect path). Our aim was to quantify, through a mediation analysis, the percentage contribution of both paths. A case-control study was designed from the Spanish Register of Road Crashes with victims from 2014 to 2017. Assuming a quasi-induced exposure approach, controls were non-responsible drivers involved in clean collisions between two or more vehicles (n = 52,131). Responsible drivers for these collisions plus drivers involved in single crashes constituted the case group (n = 82,071). A logit model in which the outcome was the log (odds) of causing a road crash and the exposure was age groups was adjusted for driver, vehicle and environmental factors. The highest crash risk was observed in extreme age groups, compared to the 35–44 year old age group: the youngest (18–24 years old, odds ratio = 2.14, 95% confidence interval: 2.06–2.24) and the oldest drivers (>74 years old, odds ratio = 3.30, 95% confidence interval: 3.04–2.58). The mediation analysis identified the direct path as the main explanatory mechanism for these increases: 89% in the youngest and 93% in the oldest drivers. These data support the hypothesis that the excess crash risk observed for younger and older drivers is mainly related to their higher frequency of risky driving behaviors and age-related loss of capabilities. Preventive strategies in extreme-aged drivers should focus on decreasing these behaviors.

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Section: Discussionmentioning

confidence: 90%

Explaining the Association between Driver’s Age and the Risk of Causing a Road Crash through Mediation Analysis

Gomes-Franco

Rivera-Izquierdo

Martín-delosReyes

et al. 2020

IJERPH

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“…cognition on driving restriction [40]. Especially rural residents need to drive farther to access such services and have been found to show higher collision rates than an elderly urban population [41].…”

Section: Discussionmentioning

confidence: 99%

Executive Dysfunctions Predict Self-Restricted Driving Habits in Elderly People with or without Alzheimer’s Dementia

et al. 2017

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The purpose of this study was to elucidate the impact of specific cognitive functions on self-restricted driving habits in healthy elderly drivers and patients suffering from mild cognitive impairment (MCI) and Alzheimer's dementia (AD). Our study population included 35 cognitively healthy controls, 10 MCI patients, and 16 patients with AD. All participants completed a neuropsychological examination and a self-reported questionnaire assessing driving habits and patterns. In challenging driving conditions, patients with MCI or AD showed significantly more driving self-restriction than healthy subjects (effect size d=1.06, p=0.007). Ordinal regression analysis across the entire group revealed that deficits in executive functions and reaction had a higher impact on driving restriction (p=0.002) than deficits in memory functions (p=0.570). Additionally, our data showed that 40% of patients with mild to moderate AD still drive in challenging conditions. Our results illustrate that elderly individuals use self-imposed driving restrictions as compensatory strategies. These restrictions increase with cognitive decline mainly in the field of executive functions, but they do not change once patients convert from MCI to AD.

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“…Potential explanations for the lack of health influences on the driving-mortality association among small-city drivers include the following. First, drivers from small cities and the surrounding rural areas may continue driving even after their health declines, because it is the only way they can get access to services (Hanson & Hildebrand, 2011; Johnson, 1998, 2002). Smaller cities tend to have fewer alternative transportation options relative to larger cities, so driving cessation may be a last resort for small-city residents.…”

Section: Discussionmentioning

confidence: 99%

“…The strength of the relationship between driving cessation and mortality found in Edwards, Perkins, and colleagues (2009) could be due to geographical region, because older adults from the South Central United States are among the most isolated when they cease driving (Bailey, 2004). Research has shown that older adults from small cities and rural areas tend to continue driving despite health difficulties (Hanson & Hildebrand, 2011; Johnson, 2002), because they view driving cessation as a last resort due to the limited opportunities to access the community (Hanson & Hildebrand, 2011; Johnson, 1998; Lee et al, 2011). Therefore, for older adults in less populous regions, health and physical performance may not completely mediate the association between driving cessation and mortality, indicating a direct connection between the latter two variables.…”

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confidence: 99%

Mediators of the Association Between Driving Cessation and Mortality Among Older Adults

et al. 2013

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Objectives The present study examined health and physical performance as mediators of the association between driving cessation and mortality among older residents of small and large cities. Methods Participants (N=2,793) were from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. Participants’ driving status and health were measured at baseline, and mortality rates were observed across the subsequent five years. Results Overall, mortality risk was 1.68 times higher for nondrivers versus drivers; this relationship was significantly mediated by physical performance and social, physical, and general health. For large city residents, mediation effects for all mediators were significant and complete. For small city residents, only physical and general health were significant mediators, and these effects were partial. Discussion Health difficulties that accompany or follow driving cessation may explain the association between driving cessation and mortality, particularly for residents of large cities, where alternative transportation options may be more numerous.

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Are rural older drivers subject to low-mileage bias?

Cited by 18 publications

References 7 publications

Explaining the Association between Driver’s Age and the Risk of Causing a Road Crash through Mediation Analysis

Explaining the Association between Driver’s Age and the Risk of Causing a Road Crash through Mediation Analysis

Executive Dysfunctions Predict Self-Restricted Driving Habits in Elderly People with or without Alzheimer’s Dementia

Mediators of the Association Between Driving Cessation and Mortality Among Older Adults

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