Examining the association between age-related macular degeneration and motor vehicle collision involvement: a retrospective cohort study

McGwin, Gerald; Mitchell, Bradford; Searcey, Karen; Albert, Michael A.; Feist, Richard M.; Mason, John O.; Thomley, Martin L.; Owsley, Cynthia

doi:10.1136/bjophthalmol-2013-303601

Cited by 14 publications

(18 citation statements)

References 29 publications

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“…98 These and other studies concluded that AMD patients self-regulate by changing driving habits, for example, avoiding driving at night, in unfamiliar areas or over long distances 99100…”

Section: Resultsmentioning

confidence: 92%

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

et al. 2016

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ObjectivesTo review systematically the evidence of age-related macular degeneration (AMD) affecting real-world visual ability and quality of life (QoL). To explore trends in specific topics within this body of the literature.DesignSystematic review.MethodsA systematic literature search was carried out using MEDLINE, EMBASE, CINAHL, PsycINFO, PsychARTICLES and Health and Psychosocial Instruments for articles published up to January 2015 for studies including people diagnosed with AMD, assessing real-world visual ability or QoL as an outcome. Two researchers screened studies for eligibility. Details of eligible studies including study design, characteristics of study population and outcomes measured were recorded in a data extraction table. All included studies underwent quality appraisal using the Mixed Methods Appraisal Tool 2011 Version (MMAT).ResultsFrom 5284 studies, 123 were eligible for inclusion. A range of approaches were identified, including performance-based methods, quantitative and qualitative patient-reported outcome measures (PROMs). AMD negatively affects tasks including mobility, face recognition, perception of scenes, computer use, meal preparation, shopping, cleaning, watching TV, reading, driving and, in some cases, self-care. There is evidence for higher rates of depression among people with AMD than among community dwelling elderly. A number of adaptation strategies have been associated with AMD of varying duration. Much of the research fails to report the type of AMD studied (59% of included studies) or the duration of disease in participants (74%). Of those that do report type studied, the breakdown is as follows: wet AMD 20%, dry AMD 4% and both types 17%.ConclusionsThere are many publications highlighting the negative effects of AMD in various domains of life. Future research should focus on delivering some of this research knowledge into patient management and clinical trials and differentiating between the types of AMD.

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“…98 These and other studies concluded that AMD patients self-regulate by changing driving habits, for example, avoiding driving at night, in unfamiliar areas or over long distances 99100…”

Section: Resultsmentioning

confidence: 92%

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

et al. 2016

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“…Few studies have assessed the crash risk and driving performance of older drivers with AMD with inconclusive findings. Studies have failed to find a link between AMD and increased crash risk, 14 , 15 indeed, drivers with intermediate levels of AMD had significantly lower crash rates than those with normal vision, 15 which was suggested to arise from driver self-regulation. 12 , 13 Simulator studies of small numbers of drivers with AMD suggest impairments in some aspects of driving ability, including delayed braking times, slower speeds, and more lane crossings, compared with age-matched controls.…”

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confidence: 99%

Effects of Age-Related Macular Degeneration on Driving Performance

Wood

Black

Mallon

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PurposeTo explore differences in driving performance of older adults with age-related macular degeneration (AMD) and age-matched controls, and to identify the visual determinants of driving performance in this population.MethodsParticipants included 33 older drivers with AMD (mean age [M] = 76.6 ± 6.1 years; better eye Age-Related Eye Disease Study grades: early [61%] and intermediate [39%]) and 50 age-matched controls (M = 74.6 ± 5.0 years). Visual tests included visual acuity, contrast sensitivity, visual fields, and motion sensitivity. On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist (masked to drivers' visual status). Outcome measures included driving safety ratings (scale of 1–10, where higher values represented safer driving), types of driving behavior errors, locations at which errors were made, and number of critical errors (CE) requiring an instructor intervention.ResultsDrivers with AMD were rated as less safe than controls (4.8 vs. 6.2; P = 0.012); safety ratings were associated with AMD severity (early: 5.5 versus intermediate: 3.7), even after adjusting for age. Drivers with AMD had higher CE rates than controls (1.42 vs. 0.36, respectively; rate ratio 3.05, 95% confidence interval 1.47–6.36, P = 0.003) and exhibited more observation, lane keeping, and gap selection errors and made more errors at traffic light–controlled intersections (P < 0.05). Only motion sensitivity was significantly associated with driving safety in the AMD drivers (P = 0.005).ConclusionsDrivers with early and intermediate AMD can exhibit impairments in their driving performance, particularly during complex driving situations; motion sensitivity was most strongly associated with driving performance. These findings have important implications for assessing the driving ability of older drivers with visual impairment.

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“… 21 , 22 Contrary to default expectations, older drivers with intermediate AMD were found to have a reduced risk of collision involvement in one small study. 23 Also, self-regulatory driving practices may change at older age; 24 for example, drivers reduce their mileage as they age and avoid driving in the dark, as well as using routes well-known to them with the result that they have fewer accidents than their younger counterparts. 19 Additionally, men are more likely to be behind the steering wheel at an older age than females 25 who have a higher prevalence of AMD, thus distorting the conclusions drawn from the sex distribution of license holders.…”

Section: Resultsmentioning

confidence: 99%

Projected changes in age-related macular degeneration and driving license holders in Finland

Viitanen

Arjamaa

2014

OPTH

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PurposeThe aim of the study was to approximate the occurrence of all forms of age-related macular degeneration (AMD) of the retina among the driving license holders aged 80 or more, and to project the changes to 2030 in Finland. AMD, destroying the visual cells in the central part of the retina, is a common disease of older age: one out of three individuals aged 70 or older shows early signs of AMD progressing later to relentless loss of vision. This eye disease can be detected only by an ophthalmologist. In general, little is known about the prevalence of AMD among driving license holders aged 80 or older.MethodsAt first the prevalence of individuals with either drusen or AMD in Finland among those 80 or older was approximated. Then the number of license holders in this age group was extracted from the statistics of the Finnish Transport Safety Agency and Eurostat provided us with the demographical data. The changes were projected to 2030.ResultsIn Finland, with a population of 5.35 million, the number of those aged 80 or over will increase by 175,000 by 2030. The total number of individuals with either drusen or AMD will increase from 118,000 to 193,000 by the year 2030 and an increasing proportion of them will have a driving license. The proportion of women in 2012 having a driving license in the groups 60 or younger is about 45%, while in those aged 80 or older it is only 20%.ConclusionThe number of people aged 80 years or older will increase in Finland by 2030. The number of those in this age group having a driving license will increase more rapidly as the population ages because the proportion of women with a driving license will increase in this age group. As the prevalence of drusen and AMD among women aged 80 or over is higher than among men at comparable age, this means that AMD will increase even more rapidly among drivers in this age group.

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Examining the association between age-related macular degeneration and motor vehicle collision involvement: a retrospective cohort study

Cited by 14 publications

References 29 publications

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

Effects of Age-Related Macular Degeneration on Driving Performance

Projected changes in age-related macular degeneration and driving license holders in Finland

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