Are older drivers' on-road driving error rates related to functional performance and/or self-reported driving experiences?

Examining Coroners' Recommendations for Health and Safety Management of Ageing Heavy Vehicle Drivers: A STAMP Analysis

Recommendations were analysed from coronial cases involving ageing heavy vehicle drivers (≥55 years) and mapped onto a Systems Theoretic Accident Model and Processes (STAMP) control structure to identify the controllers and control actions influential in the heavy vehicle industry with regard to health and safety. A National Coronial Information System (NCIS) database search revealed 38 coroners' recommendations arising from 14 unique cases of ageing driver involvement. There were no ageing themes identified in the analysis of coroners' findings and recommendations. An examination of the STAMP control structure identified that the highest concentration of recommendations was in the level of regulation, the second most senior level of control, although safety constraints were advised for all five levels of the system. In regard to identifying themes of control flaws in the recommendations, the study found that "unidentified hazards" were the most common type of safety failure in the analysis of cases of ageing drivers, concentrated at the regulatory level, which indicates that additional risk identification methods by upper levels of control are needed. Therefore, a recommendation arising from the current study is that additional controls in safety intervention are necessitated in the upper and middle levels of the road freight transportation system; in particular, formalising health and safety education for organisational managers, with a focus on identifying ageing issues, would fill a gap in the system for managing ageing heavy vehicle drivers. In conclusion, this study has found that improving the health and safety of ageing heavy vehicle drivers necessitates additional safety constraints with a focus on formalised safety education for organisational managers, in addition to a means to detect emerging and unforeseen hazards in the road freight transportation industry.

An exploration of the role of driving experience on self-reported and real-world aberrant driving behaviors

A significant proportion of global road crashes are attributed to unsafe driving behaviors. The current study aimed to explore potential differences in driving behaviors across experienced and novice drivers using two separate approaches; a questionnaire study and an instrumented vehicle study (IVS). The analysis of 260 questionnaires and 1,372 traffic interactions within the IVS revelated that driving experience affects driving performance for different driving tasks. Factor analysis of the questionnaire data revealed the impact of driving errors, lapses, violations, and aggressive violations on the behavior of novice and experienced drivers. Behavioral models of novice and experienced drivers encountering other road users were determined using binary logistic regression. The results showed that novice drivers were more likely to engage in driving violations while experienced drivers were more likely to engage in aggressive violations. Unauthorized speeding, zigzag movements, using a mobile phone while driving, and unauthorized overtaking on roads were the most frequent driving violations by novice drivers. The most frequent aggressive violations by experienced drivers were tempting other drivers to create a race and chasing other drivers. These findings may be used as a framework to facilitate safer driving behaviors by reducing errors, lapses, violations and aggressive violations, and facilitating safety-promoting attitudes.

Comparison of older and middle-aged drivers' driving performance in a naturalistic setting

There is a concern in the public domain about driving safety among older drivers due the increase in age-associated medical conditions. It is not known how these medical changes impact driving performance and choice of driving environment. This study aimed to compare older drivers' (≥74 years) driving performance in a naturalistic setting to middle-aged drivers (35-64 years) on their chosen driving environment, and number, type and severity of errors. The effect of sex and perceived driving ability was also examined. Drivers' performance was studied using the electronic Driving Observation Schedule [eDOS]), a naturalistic observation approach. Fifty-three older (mean age = 80.6 years, 72% male) and 60 middle-aged (mean age = 50.0 years, 50% male) healthy drivers were recruited. Both groups made few driving errors that were mostly low-risk. Driving performance of older adults differed from middle-aged drivers; they drove on simpler routes (fewer intersections and lane changes) and made fewer errors. Findings are likely indicative of older drivers' use of adaptive strategies to maintain safe driving.

Assessment of cognitive screening tests as predictors of driving cessation: A prospective cohort study of a median 4-year follow-up

Background

Assessing fitness to drive and predicting driving cessation remains a challenge for primary care physicians using standard screening procedures. The objective of this study was to prospectively evaluate the properties of neuropsychological screening tests, including the Trail Making Test (TMT), Clock Drawing Test (CDT), Montreal Cognitive Assessment (MoCA), Useful Field of View (UFOV), and Timed Up and Go (TUG) test, in predicting driving cessation for health reasons in drivers older than 70 years of age.

Design and methods

This prospective cohort study, with a median follow-up of 4 years for drivers of 70 years old or older with an active driving license in Switzerland, included 441 participants from a driving refresher course dedicated to volunteer senior drivers. Cases were drivers reported in the national driving registry who lost their license following a health-related accident, who were reported as unfit to drive by their physician or voluntarily ceased driving for health reasons. Survival analysis was used to measure the hazard ratio of driving cessation by adjusting for age and sex and to evaluate the predictive value of combining 3 or more positive tests in predicting driving cessation during a 4-year follow-up.

Results

A total of 1738 person-years were followed-up in the cohort, with 19 (4.3%) having ceased driving for health reasons. We found that participants with a TMT-A < 54 sec and TMT-B < 150 sec at baseline had a significantly lower cumulative hazard of driving cessation in 4 years than those with slower performance (adjusted HR 3, 95% CI: 1.16–7.78, p = 0.023). Participants who performed a CDT ≥ 5 had a significantly lower cumulative hazard of driving cessation (adjusted HR 2.89, 95% CI: 1.01–7.71, p = 0.033). Similarly, an MoCA score ≥ 26, TUG test <12 sec or a UFOV of low risk showed a lower but not significant cumulative risk at a median follow-up of 4 years. When using tests as a battery, those with three or more positive tests out of five were 3.46 times more likely to cease driving (95% CI: 1.31–9.13, p = 0.012).

Conclusions

The CDT and the TMT may predict driving cessation in a statistically significant way, with a better performance than the UFOV and MoCA tests during a median 4-year follow-up. Combining tests may increase the predictability of driving cessation. Although our results are consistent with current evidence, they should be interpreted with precaution; more than 95% of the participants above the set threshold were able to continue driving for 4 years without any serious incident.

Personal and Clinical Factors Associated with Older Drivers' Self-Awareness of Driving Performance

Most older adults perceive themselves as good drivers; however, their perception may not be accurate, and could negatively affect their driving safety. This study examined the accuracy of older drivers' self-awareness of driving ability in their everyday driving environment by determining the concordance between the perceived (assessed by the Perceived Driving Ability [PDA] questionnaire) and actual (assessed by electronic Driving Observation Schedule [eDOS]) driving performance. One hundred and eight older drivers (male: 67.6%; age: mean = 80.6 years, standard deviation [SD] = 4.9 years) who participated in the study were classified into three groups: underestimation (19%), accurate estimation (29%), and overestimation (53%). Using the demographic and clinical functioning information collected in the Candrive annual assessments, an ordinal regression showed that two factors were related to the accuracy of self-awareness: older drivers with better visuo-motor processing speed measured by the Trail Making Test (TMT)-A and fewer self-reported comorbid conditions tended to overestimate their driving ability, and vice versa.

Self-reported violations, errors and lapses for older drivers: Measuring the change in frequency of aberrant driving behaviours across five time-points

The current study aimed to: 1. to confirm the 21-item, three-factor Driver Behaviour Questionnaire (DBQ) structure suggested by Koppel et al. (2018) within an independent sample of Canadian older drivers; 2. to examine whether the structure of the DBQ remained stable over a four-year period; 3. to conduct a latent growth analysis to determine whether older drivers' DBQ scores changed across time. Five hundred and sixty Canadian older drivers (males = 61.3%) from the Candrive/Ozcandrive longitudinal study completed the DBQ yearly for four years across five time-points that were approximately 12 months apart. In Year 1, the average age of the older drivers was 76.0 years (SD = 4.5 years; Range = 70-92 years). Findings from the study support the 21-item, three-factor DBQ structure suggested by Koppel and colleagues for an Australian sample of older drivers as being acceptable in an independent sample of Canadian older drivers. In addition, Canadian older drivers' responses to this version of the DBQ were stable across the five time-points. More specifically, there was very little change in older drivers' self-reported violations, and no significant change for self-reported errors or lapses. The findings from the current study add further support for this version of the DBQ as being a suitable tool for examining self-reported aberrant driving behaviours in older drivers. Future research should investigate the relationship between older drivers' self-reported aberrant driving behaviours and their performance on functional measures, their responses to other driving-related abilities and practice scales and/or questionnaires, as well their usual (or naturalistic) driving practices and/or performance on on-road driving tasks.

What is the relationship between self-reported aberrant driving behaviors, mindfulness, and self-reported crashes and infringements?

OBJECTIVES

This study investigated the relationship between self-reported aberrant driving behaviors, mindfulness, and self-reported crashes and infringements.

METHODS

Three hundred and eighteen participants (M = 46.0 years, SD = 13.7 years; female: 81.8%) completed an online survey that assessed aberrant driving behaviors, mindfulness (including regular mindfulness meditation [MM]), and self-reported crashes and infringements during the past 2 years. Structural equation modeling (SEM) was used to examine the relationship between self-reported aberrant driving behaviors and mindfulness simultaneously, as well as with participants' age and estimated kilometers driven over the past year.

RESULTS

The results of the SEM showed that mindfulness was negatively related to each self-reported aberrant driving behavior, with the strongest relationships being between mindfulness and driving-related lapses (-0.58) and errors (-0.46). Participants who practice MM had significantly fewer crashes in the past 2 years and reported significantly fewer driving-related violations and lapses compared to participants who did not practice MM (crashes: 9.3% vs. 18.8%, P < .05; violations: M = 6.66 [SD = 3.44] vs. M = 7.68 [SD = 4.53], P < .05; errors: M = 5.17 [SD = 3.44] vs. M = 6.19 [SD = 4.12], P < .05).

CONCLUSIONS

More research is needed to understand whether MM results in more mindful and attentive drivers or whether individuals who practice MM may have other traits or behaviors that are linked to improved safety.

The Driver Behaviour Questionnaire for older drivers: Do errors, violations and lapses change over time?

The aim of the current study was to examine how self-reported aberrant driving behaviours change across a three time-points in a group of older drivers. Two hundred and twenty-seven older drivers (males = 69.6%) from the Candrive/Ozcandrive longitudinal study completed the Driving Behaviour Questionnaire (DBQ) each yearacross three time-points (i.e., Year 1, Year 2, Year 3). At the third time-point, older drivers ranged in age from 77 to 96 years (M = 81.74 years; SD = 3.44 years). A longitudinal confirmatory factor analysis showed that a modified 21-item, 3-factor (errors, lapses and violations) DBQ was invariant across the time period, suggesting that the structure of the questionnaire was stable across each time-point. Further, multiple domain latent growth analysis on the resultant factors for errors, lapses and violations showed that the frequency of errors remained similar across the three-year period, while violations and lapses showed very marginal decreases in frequency. These changes were independent of the absolute number of these behaviours; Drivers with higher violations or lapses in Year one, showed similar decreases in frequency as those who self-reported lower frequencies of the behaviours. These results suggest that the DBQ is a reliable tool to measure older drivers' self-reported aberrant driving behaviours, and that these behaviours do not show much change across time. Future research should validate the self-reported responses from the DBQ with more objective measures such as those collected through naturalistic driving study (NDS) methodology or on-road driving tasks.