Pre-frailty associated with traffic crashes in Japanese community-dwelling older drivers

Possibility to Grasp the Older Drivers' Conditions from the Triennial Nationwide Survey of Japan for Elderly Welfare

The percentage of older drivers is increasing worldwide. Older adults are driving for their daily lives, including drivers who should not drive, "must-watch drivers", for health conditions, etc. The "Public Survey of Long-Term Care Prevention and Needs in Spheres of Daily Life (Needs Survey)", including the "Kihon Checklist (KCL)", is a triennial nationwide survey conducted by welfare administrations in Japan. The objective of this study was to demonstrate that the Needs Survey can capture situations (e.g., driving avoidance) of older drivers obtained by previous studies, many of which are one-time surveys. As for our methods, we administered a survey with a format of questions used in previous studies combined with KCL to all older adults in Tsurui Village, a rural community in Japan, obtained 393 responses, around half of them, and conducted a logistic regression analysis to estimate whether they were driving or not and a multiple regression analysis for the frequency of driving avoidance. The former analysis showed that KCL could detect must-watch drivers with relatively deteriorated health among not-so-old adults, adding to another one with relatively not-so-bad health among much older adults, and the latter analysis showed that the KCL scores could be an alternative to the self-rating of driving ability used in previous studies. In conclusion, KCL in the Needs Survey is recommended to be a valuable survey for regularly assessing the driving conditions of older drivers nationwide.

[Mobility, driving, and functional competence in older people-selected results from the Longitudinal Urban Cohort Ageing Study (LUCAS)]

Mobility is crucial for independent living in old age. Older people with reduced physical ability (frailty) begin to limit their personal range of activities to their immediate living environment and ultimately to their immediate home. Diseases of the musculoskeletal system as well as neurological, psychological, cognitive, sensory, and circulatory disorders can limit functional competence (ability to live independently).In the Longitudinal Urban Cohort Ageing Study (LUCAS), from which selected results are reported in this article, participants were categorized into different functional classes (Robust, postRobust, preFrail, Frail) using the LUCAS functional index. The results show that losses in functional competence were associated with impaired mobility and reduced car driving. Impaired mobility led to restricted radius of action.The aim of healthcare in old age is to preserve independence and quality of life as long as possible. Car driving is an important part of older peoples' activities of daily living. Therefore, primary care physicians should address car driving regularly because preventive measures to strengthen functional health also strengthen car driving ability in older persons.

Attitudes, Beliefs, and Current Practices Carried Out by Family Physicians in Spain Regarding the Prevention of Road Injuries in Older Adults: A Nationwide Cross-Sectional Study

Purpose

The activities related to the prevention of crash injuries in older adults (PCIOA) performed by Family Physicians (FPs) have been scarcely studied. Our aim was to estimate the frequency of PCIOA activities performed by FPs in Spain and its association with attitudes and beliefs regarding this health problem.

Methods

We conducted a cross-sectional study in a nationwide sample of 1888 FPs working in Primary Health Care Services, recruited from October 2016 to October 2018. Participants completed a validated, self-administered questionnaire. Study variables included three scores related to current practices (General Practices, General Advice and Health Advice), several scores related to attitudes (General, Drawbacks and Legal), demographic and workplace characteristics. To obtain the adjusted coefficients and their 95% confidence intervals, we applied mixed effects multi-level linear regression models and the likelihood-ratio test to compare multi-level and one-level models.

Results

The frequency of PCIOA activities reported by FPs in Spain was low. The General Practices Score was 0.22/1, the General Advice Score was 1.82/4, the Health Advice Score was 2.61/4, and the General Attitudes Score was 3.08/4. The importance given to road crashes in the elderly obtained 7.16/10, the role that FPs should play in the PCIOA obtained 6.73/10, and the current perceived role obtained 3.95/10. The General Attitudes Score and the importance that FPs give themselves in the PCIOA were associated with the three Current Practices Scores.

Conclusion

The frequency of activities related to the PCIOA that FPs usually carry out in Spain is far below desirable standards. The average level of attitudes and beliefs about the PCIOA of the FPs working in Spain seems adequate. The variables of the most pronounced FPs associated with the prevention of traffic accidents in older drivers were age over 50 years, female sex and foreign nationality.