Comparing the impairment profiles of older drivers and non-drivers: Toward the development of a fitness-to-drive model

Abstract

The purpose of this research effort was to compare older driver and non-driver functional impairment profiles across some 60 assessment metrics in an initial effort to contribute to the development of fitness-to-drive assessment models. Of the metrics evaluated, 21 showed statistically significant differences, almost all favoring the drivers. Also, it was shown that a logistic regression model comprised of five of the assessment scores could completely and accurately separate the two groups. The results of this study imply that older drivers are far less functionally impaired than non-drivers of similar ages, and that a parsimonious model can accurately assign individuals to either group. With such models, any driver classified or diagnosed as a non-driver would be a strong candidate for further investigation and intervention.

Longitudinal Associations Between Changes in Physical Function and Driving Mobility Behaviors of Older Adults

“…Consistent with some prior work (44), changes in physical function were positively related to driving behavior trajectories, after controlling for demographics, baseline cognitive function and visual acuity, attrition, and changes in general health. Specifically, changes in grip strength were associated with changes in driving space and number of miles driven in an average week, while changes in the number of steps and self-reported physical function were positively associated with driving exposure and driving frequency changes.…”

“…First, only three physical functioning measures are available in the ACTIVE data set. Numerous physical functioning measures with variable levels of standardization, reliability, and validity are available, some of which may be more sensitive indicators of physical functioning as related to driving mobility; for example, time to reach peak force production at the ankle joint (44). An additional potential limitation is that driving mobility indices were self-reported and may not necessarily accurately capture true driving habits.…”

“…In cross-sectional work, physical functioning operationalized as lower foot extremity function, walking frequency per week, and exercise frequency did not significantly predict driving exposure, driving frequency, driving avoidance, or driving status (8; 20; 21). Conversely, other cross-sectional work that conceptualized physical functioning as joint rotational torque, reaction time for upper and lower body, and self-reported ability to walk a half mile, found that physical functioning predicted driving status (16) and reported driving difficulty (22). The discrepant findings between these studies, and the wide operationalization of physical functioning, clearly underscore the need for further work.…”

“…Persons who report diabetes, heart disease, or poorer health are also at greater risk for future driving mobility declines (9; 13; 15). Finally, worse cognitive performance, particularly with fluid process-based abilities such as speed of processing, divided attention, and executive function, is also associated with poorer driving mobility (7-9; 16; 17). Given that driving is a complex activity that involves consistent monitoring and planning of corresponding actions to a constantly changing environment, the relationships between poor vision, fluid processed-based cognitive abilities, health, and driving is not surprising.…”

Drug Use and the Risk of Motor Vehicle Collision in Adults 65 Years of Age and Older

“…Two studies have investigated the relationship between physical limitations and fitness-to-drive (Reimer, D'Ambrosio et al 2008;Antin, Lockhart et al 2012). A study by Antin compared 49 drivers and non-drivers 65 years of age and older on various physical and mental assessments (Antin, Lockhart et al 2012). Results showed that non-drivers had more physical and cognitive limitations than those who continued to drive (Antin, Lockhart et al 2012).…”