Avoidance Behavior Is an Independent Indicator of Poorer On-road Driving Skills in Older Adults

Abstract

Objectives The aim of the current work was to investigate the relationship between avoidance of specific driving situations and on-road driving skills in older drivers considering factors found to be related to both avoidance behavior and driving skills. Method Seventy-two older drivers (M = 76 years) from the general population were included in this study. Self-reported avoidance behavior, driving practice, perceived driving difficulties, driving-related cognitive functions, as well as medical conditions were assessed within two sessions. Standardized on-road assessments served for assessing on-road driving skills in a third session. Results Self-reported avoidance behavior was associated with reduced driving skills (r = −.41), and this relationship remained significant beyond the influence of cognitive skills, self-reported health, driving practice, and perceived driving difficulties. Specifically, avoidance of driving in bad weather, poor visibility and complicated parking was found to be associated with reduced driving skills. Discussion This study suggest that avoidance behavior is an independent indicator of impaired driving skills in older drivers. Our results argue against the assumption that avoidance behavior may be a reasonable strategy for safe traffic participation. Longitudinal studies are urgently needed to get more evidence on safety aspects of avoidance behavior.

Predicting On-Road Driving Skills, Fitness to Drive, and Prospective Accident Risk in Older Drivers and Drivers with Mild Cognitive Impairment: The Importance of Non-Cognitive Risk Factors

“…Although the validity of our results was not affected by the problem of multicollinearity between the different predictor variables, the above factors are associated with each other to some extent. This relationship may be reciprocal or even circular [ 30 ]: Age-related cognitive, motor, and somatic changes lead to impaired driving skills. Consequently, certain traffic conditions may be avoided leading to a reduction of driving practice (e.g., reduced driving space, range, and/or distance).…”

“…These results illustrate the importance of motor functions for driving safety [ 20, 39, 40 ], since rapid and flexible head movements facilitate fast and adequate reactions in complex and unexpected traffic situations. For example, drivers with restricted cervical spine mobility might avoid complicated parking processes, which was recently reported to be associated with reduced on-road driving performance [ 30 ]. Finally, the number of prescription drugs was a marginally significant predictor of prospective accident frequency, confirming an association between somatic health and on-road driving performance [ 19, 33, 34 ].…”

“…The study protocol was in accordance with the Declaration of Helsinki and approved by the institutional review board of Muenster University. Parts of the subgroup of healthy older drivers participated in a previous study [ 30 ].…”

“…Non-cognitive predictor variables were years of age, number of prescription drugs, annual mileage (in kilometers), self-reported accidents within the last two years (yes/no), external concerns (relatives‘ reports of unsafe driving) (yes/no), impaired uncompensated vision (e.g. visual acuity <60% or visual field <140°) (yes/no), impaired cervical spine mobility (e.g., <45°) (yes/no), and avoidance behavior (total score in a situational avoidance questionnaire [ 30 ]). In MCI patients, kind and number of prescription drugs were taken from the patient file in our memory clinic.…”

“…Healthy older drivers 27 Aging is associated with increasing cognitive, 28 motor, and sensory impairments. These impairments 27,28], avoidance behavior [19,29,30], relatives' reports of unsafe driving [19,31], the number of accidents in the past years [19,27,32], and reduced driving practice [19,33,34]. Moreover, visual impairments [35][36][37][38], impaired cervical spine mobility [20, 39,40], and other indicators of poor physical health status [20, 28,41] were reported to be relevant pre- Table 1 The most robust evidence-based cognitive and non-cognitive predictors of practical driving behavior in healthy older drivers and drivers with MCI nitive and non-cognitive risk factors (Table 1) in a previous study [30].…”