Driving Cessation and Health Trajectories in Older Adults

Edwards, Jerri D.; Lunsman, Melissa; Perkins, Martinique; Rebok, George W.; Roth, David L.

doi:10.1093/gerona/glp114

Cited by 233 publications

(212 citation statements)

References 24 publications

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“…While taking drivers with cataracts off the road might be a safe option, the negative consequences of losing one's driver licence include social isolation, decreased out of home activities, depressive symptoms and declines in health. [27][28][29] There were a significant proportion of the current drivers (31 per cent) and a greater proportion of the former drivers (54 per cent) who did not meet the Austroads guidelines for fitness to drive, although they may be eligible for a conditional licence after further assessment. 18 Keeffe and colleagues 30 reported only a small proportion of the general driving population failing this same criteria: 2.6 per cent had vision less than 6/ 12 in a sample of 1,787 current drivers aged 40 years and older in the Melbourne Vision Impairment Project (VIP).…”

Section: Discussionmentioning

confidence: 99%

Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists

Keay

Palagyi

et al. 2016

Clinical and Experimental Optometry

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Background: Although cataract surgery can restore sight, lengthy waiting times are common in public hospitals in Australia. We investigated the driving status of older people during their surgical waiting period. Methods: Baseline, cross-sectional data from two prospective cohort studies of patients aged 50 years and older on Australian public hospital cataract surgery waiting lists were analysed. Participants underwent assessment of vision and completed the Driving Habits Questionnaire. The vision status was compared between current drivers and former drivers. Results: Participants (n = 442) were on average 73 ± 8 years of age and approximately half were women (229/442, 52 per cent). Habitual vision was 6/12 +2 on average (0.26 ± 0.21 logMAR).There were 263 (60 per cent) current drivers, 110 (25 per cent) former drivers and 69 participants (16 per cent) who had never driven. Among the current drivers, 82/263 (31 per cent) failed visual acuity requirements for an unconditional drivers' license (6/12 acuity with one or both eyes). The former drivers had worse visual acuity than the current drivers (between group difference 0.12 ± 0.20 logMAR, p < 0.0001) and worse contrast sensitivity (between group difference À0.14 ± 0.22 log units, p < 0.0001). Both high contrast visual acuity and contrast sensitivity were independently associated with still driving. More than half (140/263, 53 per cent) of the drivers believed that their cataract had affected their driving and 23 current drivers (nine per cent) reported a crash in the last 12 months. Conclusion:We report on the level of visual impairment among older drivers waiting for cataract surgery. Approximately one-third did not meet the required visual acuity standard for driving and hence would require further ophthalmic assessment and a conditional license to continue to drive. Approximately one-quarter of the surgical candidates were no longer driving and this was associated with greater visual impairment. These findings support a need for timely and appropriately prioritised access to cataract surgical services.

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Section: Discussionmentioning

confidence: 99%

Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists

Keay

Palagyi

et al. 2016

Clinical and Experimental Optometry

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“…Edwards et al (2009) indicated that driving cessation is associated with declines in physical and social functioning, as well as in general health (Edwards, Lunsman, Perkins, Rebok, & Roth, 2009). …”

Section: Mobility and Quality Of Lifementioning

confidence: 99%

Effects of hearing loss on traffic safety and mobility

Thorslund¹

2014

Studies From the Swedish Institute for Disability Research

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Research into the effect of hearing loss (HL) on traffic safety and mobility is limited and the empirical findings are somewhat inconsistent. HL is one of the most frequent sensory deficits in humans, leading to loss of auditory information, which may affect behavior in traffic situations and might reduce traffic safety and mobility. The prevalence of age-related HL in Europe is roughly 30% for men and 20% for women at the age of 70 years, and 55% for men and 45% for women at the age of 80 years. The prevalence of age-related HL is increasing, and as a consequence the number of road users with HL will also increase.The aim of this PhD thesis was to investigate traffic safety and mobility for individuals with HL. Three studies were conducted: 1. a questionnaire survey aimed to evaluate differences in choice of transportation that might be related to HL, 2. a driving simulator study that looked into compensatory strategies and evaluated the efficiency of a tactile signal to alert the driver, and 3. a field study to evaluate these effects in real traffic and to evaluate a navigation system with a supportive tactile signal.The results of the three studies indicate that there are effects of HL on traffic safety and mobility. The effects are relatively small and often bound to driving complexity; but, systematic and consistent in replicated studies. Differences in transportation habits related to HL include less likelihood of having a driver's license and a higher valuing of written information, with the latter possibly prioritized before time and safety issues. Moreover, respondents with more HL were less concerned about the effects of HL, which suggests that they might be using compensatory strategies.In the experimental studies, differences in driving behavior related to HL were bound to driving conditions and occurred when the complexity of the driving task increased. There was also an effect of HL on visual behavior, indicated in the simulator and confirmed in the field study, suggesting that drivers with HL have more active visual behaviors with more frequent glances in the rear-view mirror and a general scanning of the environment before looking away from the road. A tactile signal in the driver seat was found useful in both experimental studies, both for calling for the driver's attention and facilitating navigation using a GPS navigation device.It was concluded that there are effects of HL on both traffic safety and mobility, consistently pointing toward a generally more cautious driving behavior with the use of both compensatory and coping strategies, which suggests a difference in experienced safety. Compensatory strategies associated with HL include driving at lower speeds and using a more comprehensive visual search behavior. Coping strategies associated with HL include engaging less in distracting activities. Evaluation of the tactile signal suggests that it may make driver assistance systems more accessible, not only to drivers with HL, but to all drivers. At the same time, the systems might bec...

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“…This driving cessation could have negative consequences, such as social isolation or increased risk of depression [7][8][9][10]. However, older drivers can adapt their driving behavior to the age-related functional and cognitive decline by avoiding these difficult driving situations [11][12][13][14], or by developing compensatory strategies (e.g.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of two cognitive training programs on the performance of older drivers with a cognitive self-assessment bias

Hay

Adam

Bocca

et al. 2016

Eur. Transp. Res. Rev.

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Purpose Depending on the calibration of their cognitive abilities, some older drivers (ODs) might stop driving prematurely (under-estimators, UEs) and others could expose themselves to risky situations (over-estimators, OEs). The aim of the study was to compare the effectiveness of two cognitive training (CT) programs intended for ODs presenting a cognitive calibration bias. We hypothesized that CT with feedback on performance can help ODs to correctly calibrate their abilities and consequently adapt their driving behavior. Method One hundred and six ODs (≥70 years) were assigned to two CT groups (with or without a driving simulator experience, DS). These interventions lasted about 36 h and were distributed over a 3-month period. ODs completed objective and subjective cognitive evaluations and an on-road driving evaluation before and after training. Results The first results on 67 participants (40 from the CT group, and 27 from the CT + DS group) showed an improvement of their visual processing speed, their divided attention and their selective attention after training. Participants from both groups also had an improved TRIP tactical sub-score (Test Ride for Investigating Practical fitness to drive), indicating a better driving behavioral adaptation. Finally, although both training programs seemed to be equally effective in correcting cognitive calibration bias, the results indicated that 21 UEs and 10 OEs were well calibrated and thus correctly self-assessed their cognitive abilities after training. Conclusion Both CT programs (with or without DS experience) seem to improve the visual attention of ODs. UEs appeared to be more susceptible than OEs to this training and were better calibrated after it.

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Driving Cessation and Health Trajectories in Older Adults

Cited by 233 publications

References 24 publications

Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists

Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists

Effects of hearing loss on traffic safety and mobility

Effectiveness of two cognitive training programs on the performance of older drivers with a cognitive self-assessment bias

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