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Kurita S, Doi T, Harada K, Morikawa M, Nishijima C, Fujii K, Kakita D, Shimada H. Subjective memory concerns and car collisions: A cross-sectional cohort study among older Japanese drivers. Heliyon 2024; 10:e33080. [PMID: 39021989 PMCID: PMC11253256 DOI: 10.1016/j.heliyon.2024.e33080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 07/20/2024] Open
Abstract
Background A previous study suggested older drivers with subjective memory concerns (SMC) had increased odds of experiencing car collisions, but whether SMC in different contexts and the number of SMC applicable items change this association is unknown. The aim of this study was to examine the association between SMC and car collisions among older drivers in Japan. Methods This cross-sectional study was conducted using data from a Japanese community-based cohort study. Participants were community-dwelling older adults aged ≥60 years. SMC was assessed using five questions: 1) "Do you feel you have more problems with memory than most?" 2) "Do you have any difficulty with your memory?" 3) "Do you forget where you have left things more than you used to?" 4) "Do you forget the names of close friends or relatives?" and 5) "Do other people find you forgetful?" Participants were asked about their experiences with car collisions during the previous two years. Results A total of 13,137 older drivers (72.1 ± 5.5 years old, and 43.6 % female) were analyzed. Cochran-Armitage trend test showed that as the number of SMC applicable items increased, the percentage of the experiences of car collisions significantly increased (6.8 %-15.8 %, P < 0.001). Logistic regression models showed each SMC question was associated with an increased odds ratio (OR) of car collisions (OR 1.26 to 1.71, all P < 0.001) after adjusting for confounding factors. As the number of SMC applicable items increased, the OR of car collisions significantly increased (OR 1.19 to 2.28, all P < 0.05, P for trend <0.001). Conclusions This cross-sectional study among community-dwelling older drivers in Japan suggested each SMC question and the number of applicable items were associated with car collisions. SMC may be a sign of increased risk of traffic incidents for older drivers.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- School of Psychology, Faculty of Science, The University of New South Wales, Sydney, Australia
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Daisuke Kakita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Yang J, Alshaikh E, Yu D, Kerwin T, Rundus C, Zhang F, Wrabel CG, Perry L, Lu ZL. Visual Function and Driving Performance Under Different Lighting Conditions in Older Drivers: Preliminary Results From an Observational Study. JMIR Form Res 2024; 8:e58465. [PMID: 38922681 PMCID: PMC11237778 DOI: 10.2196/58465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/04/2024] [Accepted: 05/04/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Age-related vision changes significantly contribute to fatal crashes at night among older drivers. However, the effects of lighting conditions on age-related vision changes and associated driving performance remain unclear. OBJECTIVE This pilot study examined the associations between visual function and driving performance assessed by a high-fidelity driving simulator among drivers 60 and older across 3 lighting conditions: daytime (photopic), nighttime (mesopic), and nighttime with glare. METHODS Active drivers aged 60 years or older participated in visual function assessments and simulated driving on a high-fidelity driving simulator. Visual acuity (VA), contrast sensitivity function (CSF), and visual field map (VFM) were measured using quantitative VA, quantitative CSF, and quantitative VFM procedures under photopic and mesopic conditions. VA and CSF were also obtained in the presence of glare in the mesopic condition. Two summary metrics, the area under the log CSF (AULCSF) and volume under the surface of VFM (VUSVFM), quantified CSF and VFM. Driving performance measures (average speed, SD of speed [SDspeed], SD of lane position (SDLP), and reaction time) were assessed under daytime, nighttime, and nighttime with glare conditions. Pearson correlations determined the associations between visual function and driving performance across the 3 lighting conditions. RESULTS Of the 20 drivers included, the average age was 70.3 years; 55% were male. Poor photopic VA was significantly correlated with greater SDspeed (r=0.26; P<.001) and greater SDLP (r=0.31; P<.001). Poor photopic AULCSF was correlated with greater SDLP (r=-0.22; P=.01). Poor mesopic VUSFVM was significantly correlated with slower average speed (r=-0.24; P=.007), larger SDspeed (r=-0.19; P=.04), greater SDLP (r=-0.22; P=.007), and longer reaction times (r=-0.22; P=.04) while driving at night. For functional vision in the mesopic condition with glare, poor VA was significantly correlated with longer reaction times (r=0.21; P=.046) while driving at night with glare; poor AULCSF was significantly correlated with slower speed (r=-0.32; P<.001), greater SDLP (r=-0.26; P=.001) and longer reaction times (r=-0.2; P=.04) while driving at night with glare. No other significant correlations were observed between visual function and driving performance under the same lighting conditions. CONCLUSIONS Visual functions differentially affect driving performance in different lighting conditions among older drivers, with more substantial impacts on driving during nighttime, especially in glare. Additional research with larger sample sizes is needed to confirm these results.
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Affiliation(s)
- Jingzhen Yang
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States
| | - Enas Alshaikh
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Deyue Yu
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Thomas Kerwin
- Driving Simulation Laboratory, The Ohio State University, Columbus, OH, United States
| | - Christopher Rundus
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Fangda Zhang
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Cameron G Wrabel
- Driving Simulation Laboratory, The Ohio State University, Columbus, OH, United States
| | - Landon Perry
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Zhong-Lin Lu
- Division of Arts and Sciences, NYU Shanghai, Shanghai, China
- Center for Neural Science and Department of Psychology, New York University, New York, NY, United States
- NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China
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Tsouvala A, Katsouri IG, Moraitou D, Papantoniou G, Sofologi M, Nikova A, Vlotinou P, Tsiakiri A, Tsolaki M. Metacognitive Awareness of Older Adult Drivers with Mild Cognitive Impairment: Relationships with Demographics, Subjective Evaluation of Cognition, and Driving Self-Efficacy. Behav Sci (Basel) 2024; 14:483. [PMID: 38920815 PMCID: PMC11200804 DOI: 10.3390/bs14060483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Self-regulation of driving is a means of maintaining one's driving identity. The purpose of this study was to investigate the extent to which older drivers with Mild Cognitive Impairment (MCI) are metacognitively aware of the requirements of specific demanding driving conditions and whether this awareness is linked to subjective assessments of cognition. (2) One hundred seventeen (117) older MCI drivers participated in a telephone survey in which they reported their metacognitive experiences in nine driving conditions, listed as an aim of self-regulation. The analyses included the participants' subjective cognitive assessments, both in terms of their cognitive state and their perceived driving self-efficacy. (3) The analyses pointed out a direct and negative effect of age on the formation of the metacognitive feeling of certainty. Furthermore, an indirect effect of sex through driving self-efficacy was established. This effect was negative in the case of the metacognitive feeling of difficulty and the estimation of effort and positive in the case of the metacognitive feeling of certainty. (4) This position points out the need to establish appropriate levels of the perceived self-efficacy of older drivers with MCI, and it raises issues when it moves to fictitious levels.
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Affiliation(s)
- Anastasia Tsouvala
- School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | | | - Despina Moraitou
- Laboratory of Psychology, School of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece; (D.M.); (M.T.)
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI—AUTh), 54124 Thessaloniki, Greece
| | - Georgia Papantoniou
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
| | - Maria Sofologi
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
| | | | - Pinelopi Vlotinou
- Department of Occupational Therapy, University of West Attica, 12243 Athens, Greece;
| | - Anna Tsiakiri
- Neurology Department, Democritus University of Thrace, 67100 Xanthi, Greece;
| | - Magdalini Tsolaki
- Laboratory of Psychology, School of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece; (D.M.); (M.T.)
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI—AUTh), 54124 Thessaloniki, Greece
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Chanmas G, Taveekitworachai P, Paliyawan P, Thawonmas R, Thawonmas R, Nukoolkit C, Dajpratham P. Driving scenarios and environmental settings in simulator-based driving assessment systems for stroke: a systematic review. Top Stroke Rehabil 2023; 30:872-880. [PMID: 36617424 DOI: 10.1080/10749357.2023.2165273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 01/02/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Driving simulators are effective tools to evaluate the driving abilities of patients with stroke. They can introduce various driving scenarios which will greatly benefit both the assessors and drivers. However, there is still no guidelines by which driving scenarios should be introduced in the driving assessment. OBJECTIVES We conducted a systematic review to examine the utilization of driving scenarios and environments in the simulator-based driving assessment for patients with stroke. METHODS A systematic review was conducted following PRISMA. We searched PubMed, Web of Science, ScienceDirect, ACM Digital Library, and IEEE Xplore Digital Library databases in January and June 2022 to identify eligible articles published since 2010. RESULTS Our searches identified 1,614 articles. We included 12 studies that applied driving simulators to assess the driving performance of patients with stroke. The driving scenarios were categorized into three categories - vehicle controls scenarios, hazard perception scenarios, and trajectory planning scenarios - based on a certain set of driving abilities. The most common driving scenarios are simple navigation (n = 8) and emergency stop (n = 8). The most frequently used driving area is urban (n = 9), and a variety of roads and traffic conditions were found in the included studies. Only 2 studies applied weather conditions, such as the clear and sunny condition or the windy condition. CONCLUSION It is recommended for future research to consider covering scenarios from the aforementioned three categories and further investigate the benefits of introducing complex weather conditions and localized traffic conditions in the driving assessment.
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Affiliation(s)
- Gunt Chanmas
- Graduate School of Information Science and Engineering, Ritsumeikan University, Shiga, Japan
| | | | - Pujana Paliyawan
- Ritsumeikan Center for Game Studies, Ritsumeikan University, Kyoto, Japan
| | - Ramita Thawonmas
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ruck Thawonmas
- College of Information Science and Engineering, Ritsumeikan University, Shiga, Japan
| | - Chakarida Nukoolkit
- School of Information Technology, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
| | - Piyapat Dajpratham
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Suntai Z, Kubanga K, Lidbe A, Adanu EK. Association between driving frequency and well-being among older adults. Aging Ment Health 2023; 27:2508-2514. [PMID: 37132430 DOI: 10.1080/13607863.2023.2207467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 04/14/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES Research on driving in older adulthood suggests that driving is a form of independence for older adults and is often associated with increased social capital and overall-being. However, few studies have examined whether the frequency of driving, and not driving alone, affects likelihood of having well-being among older adults. This study aimed to examine the association between frequency of driving and well-being among older adults, guided by the activity theory of aging. METHODS Data were drawn from the 2018 National Health and Aging Trends Study, a longitudinal panel survey of Medicare beneficiaries living in the United States. Bivariate analyses were conducted using Chi-square tests and the association between frequency of driving and well-being was tested with a multivariable logistic regression model. Well-being was determined by 11 items measuring positive and negative affect and asking participants if they agreed with certain statements about their lives. RESULTS After controlling for other factors that could influence well-being among older adults, results showed that those who drove every day were the most likely to have high well-being, followed by those who drove most days, those who drove some days, those who drove rarely, and those who never drove. DISCUSSION The study results indicate that as frequency of driving increases, the chance of having well-being increases among older adults. This supports the activity theory of aging and highlights the importance of productive aging.
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Affiliation(s)
- Zainab Suntai
- Diana R. Garland School of Social Work, Baylor University, Waco, TX, USA
| | - Kefentse Kubanga
- School of Social Work, University of Alabama, Tuscaloosa, AL, USA
| | - Abhay Lidbe
- Alabama Transportation Institute, University of Alabama, Tuscaloosa, AL, USA
| | - Emmanuel Kofi Adanu
- Alabama Transportation Institute, University of Alabama, Tuscaloosa, AL, USA
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Kurita S, Doi T, Harada K, Katayama O, Morikawa M, Nishijima C, Fujii K, Misu Y, Yamaguchi R, Von Fingerhut G, Kakita D, Shimada H. Motoric Cognitive Risk Syndrome and Traffic Incidents in Older Drivers in Japan. JAMA Netw Open 2023; 6:e2330475. [PMID: 37624598 PMCID: PMC10457720 DOI: 10.1001/jamanetworkopen.2023.30475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/13/2023] [Indexed: 08/26/2023] Open
Abstract
Importance To prevent motor vehicle collisions by older drivers, the increased risk of collisions should be considered early. Cognitive decline increases the risk of car collisions. Motoric cognitive risk syndrome (MCR), characterized by the presence of cognitive concerns and slow gait, can be assessed conveniently and is useful to assess the risk of dementia. Objective To examine the association between MCR assessment findings and car collisions among older drivers in Japan. Design, Setting, and Participants This cross-sectional study used data from a community-based cohort study, the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes, conducted in Japan from 2015 to 2018. Participants were community-dwelling older adults aged at least 65 years. Data were analyzed from February to March 2023. Exposure MCR was defined as having subjective memory concerns (SMC) and slow gait. Participants were classified into 4 groups: no SMC or slow gait, only SMC, only slow gait, and MCR. Main Outcomes and Measures Participants were asked about the experience of car collisions during the last 2 years and near-miss traffic incidents during the previous year through face-to-face interviews. Odds of experiencing a collision or near-miss traffic incident were assessed using logistic regression. Results Among a total of 12 475 participants, the mean (SD) age was 72.6 (5.2) years, and 7093 (56.9%) were male. The group with only SMC and the group with MCR showed a higher proportion of both car collisions and near-miss traffic incidents than the other groups (adjusted standardized residuals > 1.96; P < .001). Logistic regression analysis showed the only SMC and MCR groups had increased odds of car collisions (only SMC group: odds ratio [OR], 1.48; 95% CI, 1.27-1.72; MCR group: OR, 1.73; 95% CI, 1.39-2.16) and near-miss traffic incidents (only SMC group: OR, 2.07; 95% CI, 1.91-2.25; MCR group: OR, 2.13; 95% CI, 1.85-2.45) after adjusting for confounding factors. After stratifying MCR assessments by objective cognitive impairment, significant associations were still observed. In the only slow gait group, objective cognitive impairment was associated with increased odds of car collisions (OR, 1.96; 95% CI, 1.17-3.28). Conclusions and Relevance In this cross-sectional study of community-dwelling older drivers in Japan, SMC and MCR were associated with car collisions and near-miss traffic incidents independent from objective cognitive impairment. Future studies should examine the mechanism of these associations in more detail.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yuka Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ryo Yamaguchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
| | - Georg Von Fingerhut
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Daisuke Kakita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Makhoul K, Jankovic J. Driving Impairment in Movement Disorders. Mov Disord Clin Pract 2023; 10:369-381. [PMID: 36949799 PMCID: PMC10026316 DOI: 10.1002/mdc3.13676] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 01/29/2023] Open
Abstract
Background Driving may be adversely affected by any movement disorder, but has been mostly studied in Parkinson's disease (PD). Few studies have addressed driving impairment in patients with Huntington's disease (HD); driving in other movement disorders such as dystonia, blepharospasm and Tourette syndrome (TS) has not been adequately evaluated. Objectives The aim of this review is to summarize the findings of driving impairment in movement disorders and evaluate the usefulness of clinical tools in guiding clinicians whether to refer patients for driving assessment. Methods A review of literature was performed on PubMed and articles on driving and movement disorders were identified using a Boolean phrase. Results We were able to identify 66 articles that fulfilled the target subject: impairment of driving in PD, cervical dystonia, blepharospasm, HD and TS. We also included articles discussing the role of driving rehabilitation in patients with movement disorders. Conclusions Driving is often impaired in patients with PD and other movement disorders not only due to motor symptoms but also because of cognitive and behavioral co-morbidities. Certain screening tools may be helpful in guiding the clinician in referring the patients for driving assessment.
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Affiliation(s)
- Karim Makhoul
- Parkinson's Disease Center and Movement Disorders Clinic, Department of NeurologyBaylor College of MedicineHoustonTexasUSA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of NeurologyBaylor College of MedicineHoustonTexasUSA
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Santolino M, Céspedes L, Ayuso M. The Impact of Aging Drivers and Vehicles on the Injury Severity of Crash Victims. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17097. [PMID: 36554977 PMCID: PMC9778893 DOI: 10.3390/ijerph192417097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Against a general trend of increasing driver longevity, the injuries suffered by vehicle occupants in Spanish road traffic crashes are analyzed by the level of severity of their bodily injuries (BI). Generalized linear mixed models are applied to model the proportion of non-serious, serious, and fatal victims. The dependence between vehicles involved in the same crash is captured by including random effects. The effect of driver age and vehicle age and their interaction on the proportion of injured victims is analyzed. We find a nonlinear relationship between driver age and BI severity, with young and older drivers constituting the riskiest groups. In contrast, the expected severity of the crash increases linearly up to a vehicle age of 18 and remains constant thereafter at the highest level of BI severity. No interaction between the two variables is found. These results are especially relevant for countries such as Spain with increasing driver longevity and an aging car fleet.
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Affiliation(s)
- Miguel Santolino
- Department of Econometrics-Riskcenter-IREA, University of Barcelona, 08034 Barcelona, Spain
| | - Luis Céspedes
- Zurich Insurance and Riskcenter-IREA, 08034 Barcelona, Spain
| | - Mercedes Ayuso
- Department of Econometrics-Riskcenter-IREA, University of Barcelona, 08034 Barcelona, Spain
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9
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Joyce NR, Khan MA, Zullo AR, Pfeiffer MR, Metzger KB, Margolis SA, Ott BR, Curry AE. Distance From Home to Motor Vehicle Crash Location: Implications for License Restrictions Among Medically-At-Risk Older Drivers. J Aging Soc Policy 2022:1-15. [PMID: 36463560 PMCID: PMC10239525 DOI: 10.1080/08959420.2022.2145791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/11/2022] [Indexed: 12/07/2022]
Abstract
In 30 states, licensing agencies can restrict the distance from home that "medically-at-risk" drivers are permitted to drive. However, where older drivers crash relative to their home or how distance to crash varies by medical condition is unknown. Using geocoded crash locations and residential addresses linked to Medicare claims, we describe how the relationship between distance from home to crash varies by driver characteristics. We find that a majority of crashes occur within a few miles from home with little variation across driver demographics or medical conditions. Thus, distance restrictions may not reduce crash rates among older adults, and the tradeoff between safety and mobility warrants consideration.
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Affiliation(s)
- Nina R. Joyce
- Department of Epidemiology, Brown University School of Public Health
- Center for Gerontology and Health Care Research, Brown University School of Public Health
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia
| | - Marzan A. Khan
- Center for Gerontology and Health Care Research, Brown University School of Public Health
| | - Andrew R. Zullo
- Department of Epidemiology, Brown University School of Public Health
- Center for Gerontology and Health Care Research, Brown University School of Public Health
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia
- Department of Health Services Policy and Practice, Brown University School of Public Health
- Center of Innovation in Longterm Services and Supports, Providence Veterans Affairs Medical Center, Providence, Rhode Island
| | - Melissa R. Pfeiffer
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia
| | - Kristina B. Metzger
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia
| | - Seth A. Margolis
- Department of Neurology, Warren Alpert Medical School of Brown University
- Department of Psychiatry & Human Behavior, Brown University, Providence, Rhode Island
| | - Brian R. Ott
- Department of Neurology, Warren Alpert Medical School of Brown University
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Allison E. Curry
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia
- Division of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania
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10
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Gökçe E, Stojan R, Mack M, Bock O, Voelcker-Rehage C. Lifestyle Matters: Effects of Habitual Physical Activity on Driving Skills in Older Age. Brain Sci 2022; 12:608. [PMID: 35624995 PMCID: PMC9139606 DOI: 10.3390/brainsci12050608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Research on multitasking driving has suggested age-related deterioration in driving performance. It has been shown that physical and cognitive functioning, which are related to driving performance and decline with aging, are positively associated with physical activity behavior. This study aimed to explore whether driving performance decline becomes severe with advancing age and whether physical activity behavior modifies age-related deterioration in driving performance. A total of one hundred forty-one healthy adults were categorized into three groups based on their age; old-old (74.21 ± 2.33 years), young-old (66.53 ± 1.50 years), and young adults (23.25 ± 2.82 years). Participants completed a realistic multitasking driving task. Physical activity and cardiorespiratory fitness levels were evaluated. Older groups drove more slowly and laterally than young adults, and old-old adults drove slower than young-old ones across the whole driving course. Physical activity level did not interact with the aging effect on driving performance, whereas cardiovascular fitness interacted. Higher-fitness young-old and young adults drove faster than higher-fitness old-old adults. Higher-fitness old adults drove more laterally than higher-fitness young adults. The present study demonstrated a gradual decline in driving performance in old adults, and cardiorespiratory fitness interacted with the aging effect on driving performance. Future research on the interaction of aging and physical activity behavior on driving performance in different age groups is of great value and may help deepen our knowledge.
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Affiliation(s)
- Evrim Gökçe
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149 Münster, Germany; (R.S.); (M.M.)
- Sports Health Rehabilitation Laboratory, Ankara City Hospital, Ankara 06800, Turkey
| | - Robert Stojan
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149 Münster, Germany; (R.S.); (M.M.)
| | - Melanie Mack
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149 Münster, Germany; (R.S.); (M.M.)
| | - Otmar Bock
- Institute of Exercise Training and Sport Informatics, German Sport University, Am Sportpark Muengersdorf 6, 50927 Cologne, Germany;
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149 Münster, Germany; (R.S.); (M.M.)
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11
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Huang G, Pitts BJ. The effects of age and physical exercise on multimodal signal responses: Implications for semi-autonomous vehicle takeover requests. APPLIED ERGONOMICS 2022; 98:103595. [PMID: 34610491 DOI: 10.1016/j.apergo.2021.103595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 07/28/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
The present study examined whether the non-chronological age factor, engagement in physical exercise, affected responses to multimodal (combinations of visual, auditory, and/or tactile) signals differently between younger and older adults in complex environments. Forty-eight younger and older adults were divided into exercise and non-exercise groups, and rode in a simulated Level 3 autonomous vehicle under four different task conditions (baseline, video watching, headway estimation, and video-headway combination), while being asked to respond to various multimodal warning signals. Overall, bi- and trimodal warnings had faster response times for both age groups across driving conditions, but was more pronounced for older adults. Engagement in physical exercise was associated with smaller maximum braking force for younger participants only, and also corresponded to longer average fixation durations, compared to the non-exercise group. Findings from this research can help to guide decisions about the design of warning and information systems for semi-autonomous vehicles.
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Affiliation(s)
- Gaojian Huang
- Department of Industrial and Systems Engineering, San Jose State University, USA
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12
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Choi SW, Woo JH, Hyun SY, Jang JH, Choi WS. Factors associated with injury severity among users of powered mobility devices. Clin Exp Emerg Med 2021; 8:103-110. [PMID: 34237815 PMCID: PMC8273674 DOI: 10.15441/ceem.20.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/14/2020] [Indexed: 11/26/2022] Open
Abstract
Objective To examine the features of powered mobility device-related injuries and identify the predictors of injury severity in such settings. Methods Emergency Department-based Injury In-depth Surveillance data from 2011 to 2018 were used in this retrospective study. Participants were assigned to the mild/moderate and severe groups based on their excess mortality ratio–adjusted injury severity score and their general injury-related factors and injury outcome-related factors were compared. Results Of 407 patients, 298 (79.2%) were assigned to the mild/moderate group and 109 (26.8%) to the severe group. The severe group included a higher percentage of patients aged 70 years or older (43.0% vs. 59.6%, P=0.003), injuries incurred in the daytime (72.6% vs. 82.4%, P=0.044), injuries from traffic accidents and falls (P=0.042), head injuries (38.6% vs. 80.7%, P<0.001), torso injuries (16.8% vs. 32.1%, P=0.001), overall hospital admission (28.5% vs. 82.6%, P<0.001), intensive care unit admission (1.7% vs. 37.6%, P<0.001), death after admission (1.4% vs. 10.3%, P=0.034), and total mortality (0.7% vs. 9.2%, P<0.001). The odds ratios (ORs) for injury severity were as follows: age 70 years or older (OR, 2.124; 95% confidence interval [CI], 1.239–3.642), head injury (OR, 10.441; 95% CI, 5.465–19.950), and torso injury (OR, 4.858; 95% CI, 2.495–9.458). Conclusion The proportions of patients aged 70 years or older, head and torso injuries, injuries from traffic accidents and falls, and injuries in the daytime were higher in the severe group. Our results highlight the need for measures to address these factors to lower the incidence of severe injuries.
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Affiliation(s)
- Suk Won Choi
- Department of Emergency and Critical Care Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jae-Hyug Woo
- Department of Emergency and Critical Care Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Sung Youl Hyun
- Department of Traumatology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jae Ho Jang
- Department of Emergency and Critical Care Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Woo Sung Choi
- Department of Emergency and Critical Care Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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Tinella L, Lopez A, Caffò AO, Grattagliano I, Bosco A. Spatial Mental Transformation Skills Discriminate Fitness to Drive in Young and Old Adults. Front Psychol 2020; 11:604762. [PMID: 33343475 PMCID: PMC7745720 DOI: 10.3389/fpsyg.2020.604762] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/02/2020] [Indexed: 12/11/2022] Open
Abstract
Literature on driving research suggests a relationship between cognition and driving performance in older and younger drivers. There is little research on adults and driving, despite them being the largest age cohort behind the wheel. Among the cognitive domains, visuospatial abilities are expected to be highly predictive of driving skills and driving fitness. The relationship between specific spatial mental transformation skills (i.e., object and self-based ones) and driving performance has not yet been examined. The present study aimed to investigate the relationship between overall cognitive functioning, self and object-based spatial mental transformation skills, and driving performance in a sample of younger and older adult drivers. Participants were comprised of one hundred younger and 83 older adult Italian drivers. Participants completed a computerized driving test assessing traffic stress resilience, visual and motor reaction time, and the ability to obtain an overview of the traffic scenario (DT, vRT, mRT, and ATAV respectively in the Shufried®-Vienna Test System-DRIVESC). The Mental Rotation Test (MRT) and the Object Perspective Taking Test (OPT) were administered in order to assess object-based and self-based spatial mental transformation skills. The Montreal Cognitive Assessment Test (MoCA) was administered control for global cognitive functioning. The effects of education and gender were also controlled in the analysis. The results of the present study suggested that: (1) The effect of age, favoring younger participants, was found in DT, vRT, mRT, and ATAVT tests. (2) The effect of global cognitive functioning was found in DT and ATAV tests. (3) The effect of the spatial mental transformation tests was found in DT, vRT (MRT only), and ATAVT (OPT only) tests. Taken together, these results suggest the specific contribution of spatial mental transformation skills in the execution of complex behaviors connected to the fitness to drive. Prospectively, the results of the present study relating spatial mental transformation skills and driving processes may be a valuable source of knowledge for researchers dealing with the relationship between cognitive resources and navigation aids.
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Affiliation(s)
- Luigi Tinella
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Bari, Italy
| | - Antonella Lopez
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Bari, Italy
| | - Alessandro Oronzo Caffò
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Bari, Italy
| | - Ignazio Grattagliano
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Bari, Italy
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Bari, Italy
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Shen Y, Zahoor O, Tan X, Usama M, Brijs T. Assessing Fitness-To-Drive among Older Drivers: A Comparative Analysis of Potential Alternatives to on-Road Driving Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8886. [PMID: 33260453 PMCID: PMC7730871 DOI: 10.3390/ijerph17238886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 11/20/2022]
Abstract
To enable older drivers to maintain mobility without endangering public safety, it is necessary to develop more effective means of assessing their fitness-to-drive as alternatives to an on-road driving test. In this study, a functional ability test, simulated driving test, and on-road driving test were carried out for 136 older drivers. Influencing factors related to fitness-to-drive were selected based on the correlation between the outcome measure of each test and the pass/fail outcome of the on-road driving test. Four potential alternatives combining different tests were considered and three modeling techniques were compared when constructing the fitness-to-drive assessment model for the elderly. As a result, 92 participants completed all of the tests, of which 61 passed the on-road driving test and the remaining 31 failed. A total of seven influencing factors from all types of tests were selected. The best model was trained by the technique of gradient boosted machine using all of the seven factors, generating the highest accuracy of 92.8%, with sensitivity of 0.94 and specificity of 0.90. The proposed fitness-to-drive assessment method is considered an effective alternative to the on-road driving test, and the results offer a valuable reference for those unfit-to-drive older drivers to either adjust their driving behavior or cease driving.
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Affiliation(s)
- Yongjun Shen
- School of Transportation, Southeast University, Nanjing 211189, China; (O.Z.); (X.T.); (M.U.)
- Transportation Research Institute (IMOB), Hasselt University, 3500 Hasselt, Belgium;
| | - Onaira Zahoor
- School of Transportation, Southeast University, Nanjing 211189, China; (O.Z.); (X.T.); (M.U.)
| | - Xu Tan
- School of Transportation, Southeast University, Nanjing 211189, China; (O.Z.); (X.T.); (M.U.)
| | - Muhammad Usama
- School of Transportation, Southeast University, Nanjing 211189, China; (O.Z.); (X.T.); (M.U.)
| | - Tom Brijs
- Transportation Research Institute (IMOB), Hasselt University, 3500 Hasselt, Belgium;
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Falkenstein M, Karthaus M, Brüne-Cohrs U. Age-Related Diseases and Driving Safety. Geriatrics (Basel) 2020; 5:E80. [PMID: 33086572 PMCID: PMC7709672 DOI: 10.3390/geriatrics5040080] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 11/16/2022] Open
Abstract
Due to demographic changes, the number of older drivers is steadily increasing. Mobility is highly relevant for leading an independent life in the elderly. It largely depends on car driving, which is a complex task requiring a multitude of cognitive and motor skills vulnerable to age- related functional deterioration. The almost inevitable effects of senescence may be potentiated by age-related diseases, such as stroke or diabetes mellitus. Respective pharmacological treatment may cause side effects, additionally affecting driving safety. The present article reviews the impact of age-related diseases and drug treatment of these conditions on driving fitness in elderly drivers. In essence, we focus on diseases of the visual and auditory systems, diseases of the central nervous system (i.e., stroke, depression, dementia and mild cognitive disorder, and Parkinson's disease), sleep disorders, as well as cardiovascular diseases, diabetes mellitus, musculoskeletal disorders, and frailty. We will outline the role of functional tests and the assessment of driving behavior (by a driving simulator or in real traffic), as well as the clinical interview including questions about frequency of (near) accidents, etc. in the evaluation of driving fitness of the elderly. We also address the impact of polypharmacy on driving fitness and end up with recommendations for physicians caring for older patients.
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Affiliation(s)
- Michael Falkenstein
- Institute for Work Learning and Aging (ALA), Hiltroper Landwehr 136, 44805 Bochum, Germany
| | - Melanie Karthaus
- Leibniz Institute for Working Environment and Human Factors (IfADo), 44139 Dortmund, Germany;
| | - Ute Brüne-Cohrs
- LWL University Hospital, Clinic for Psychiatry, Psychotherapy and Preventive Medicine, 44791 Bochum, Germany;
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16
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Barber SJ. The Applied Implications of Age-Based Stereotype Threat for Older Adults. JOURNAL OF APPLIED RESEARCH IN MEMORY AND COGNITION 2020; 9:274-285. [PMID: 36032188 PMCID: PMC9415413 DOI: 10.1016/j.jarmac.2020.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Stereotype threat occurs when people feel concerned about the possibility of confirming, or being negatively judged by, a negative stereotype. This review highlights the applied implications of this phenomenon for older adults In clinical settings, older adults often feel that their physicians have negative expectations about their abilities because of their age. These feelings of age-based stereotype threat can increase older adults' subjective cognitive complaints and impair their performance on mental status examinations. Other research has shown that stereotype threat also adversely affects older adults' physical performance, motor learning, and driving performance. In workplace settings, older adults who experience stereotype threat also report lower job satisfaction, poorer work-related mental health, and greater intentions to resign or retire. Overall, this review provides evidence that the situational phenomenon of stereotype threat can affect older adults' performance in a variety of applied settings, and this can contribute to age differences in performance.
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Bellagamba D, Vionnet L, Margot-Cattin I, Vaucher P. Standardized on-road tests assessing fitness-to-drive in people with cognitive impairments: A systematic review. PLoS One 2020; 15:e0233125. [PMID: 32421733 PMCID: PMC7233547 DOI: 10.1371/journal.pone.0233125] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 04/28/2020] [Indexed: 11/18/2022] Open
Abstract
Objective The on-road assessment is the gold standard because of its ecological validity. Yet existing instruments are heterogeneous and little is known about their psychometric properties. This study identified existing on-road assessment instruments and extracted data on psychometric properties and usability in clinical settings. Method A systematic review identified studies evaluating standardized on-road evaluation instruments adapted for people with cognitive impairment. Published articles were searched on PubMed, CINHAL, PsycINFO, Web of Science, and ScienceDirect. Study quality and the level of evidence were assessed using the COSMIN checklist. The collected data were synthetized using a narrative approach. Usability was subjectively assessed for each instrument by extracting information on acceptability, access, cost, and training. Results The review identified 18 published studies between 1994 and 2016 that investigated 12 different on-road evaluation instruments: the Performance-Based Driving Evaluation, the Washington University Road Test, the New Haven, the Test Ride for Practical Fitness to Drive, the Rhode Island Road Test, the Sum of Manoeuvres Score, the Performance Analysis of Driving Ability, the Composite Driving Assessment Scale, the Nottingham Neurological Driving Assessment, the Driving Observation Schedule, the Record of Driving Errors, and the Western University’s On-road Assessment. Participants were mainly male (64%), between 48 and 80 years old, and had a broad variety of cognitive disorders. Most instruments showed reasonable psychometric values for internal consistency, criterion validity, and reliability. However, the level of evidence was poor to support any of the instruments given the low number of studies for each. Conclusion Despite the social and health consequences of decisions taken using these instruments, little is known about the value of a single evaluation and the ability of instruments to identify expected changes. None of the identified on-road evaluation instruments seem currently adapted for clinical settings targeting rehabilitation and occupational priorities rather than road security alone. Study registration PROSPERO registration number CRD42018103276.
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Affiliation(s)
- David Bellagamba
- Department of Occupational Therapy, School of Social Work & Health Sciences, HETSL, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Line Vionnet
- Department of Occupational Therapy, School of Social Work & Health Sciences, HETSL, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Isabel Margot-Cattin
- Department of Occupational Therapy, School of Social Work & Health Sciences, HETSL, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Paul Vaucher
- School of Health Sciences Fribourg, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland.,Unit of Traffic Medicine and Psychology, University Center for Legal Medicine, Lausanne University Hospital, Lausanne, Switzerland
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18
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Lambert AJ, Sharma T, Ryckman N. Accident Vulnerability and Vision for Action: A Pilot Investigation. Vision (Basel) 2020; 4:E26. [PMID: 32414049 PMCID: PMC7356849 DOI: 10.3390/vision4020026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/22/2020] [Accepted: 05/04/2020] [Indexed: 11/25/2022] Open
Abstract
Many accidents, such as those involving collisions or trips, appear to involve failures of vision, but the association between accident risk and vision as conventionally assessed is weak or absent. We addressed this conundrum by embracing the distinction inspired by neuroscientific research, between vision for perception and vision for action. A dual-process perspective predicts that accident vulnerability will be associated more strongly with vision for action than vision for perception. In this preliminary investigation, older and younger adults, with relatively high and relatively low self-reported accident vulnerability (Accident Proneness Questionnaire), completed three behavioural assessments targeting vision for perception (Freiburg Visual Acuity Test); vision for action (Vision for Action Test-VAT); and the ability to perform physical actions involving balance, walking and standing (Short Physical Performance Battery). Accident vulnerability was not associated with visual acuity or with performance of physical actions but was associated with VAT performance. VAT assesses the ability to link visual input with a specific action-launching a saccadic eye movement as rapidly as possible, in response to shapes presented in peripheral vision. The predictive relationship between VAT performance and accident vulnerability was independent of age, visual acuity and physical performance scores. Applied implications of these findings are considered.
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Affiliation(s)
- Anthony J. Lambert
- School of Psychology and Centre for Brain Research, University of Auckland, Auckland 1010, New Zealand; (T.S.); (N.R.)
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Martínez P, Contreras D, Moreno M. Safe mobility, socioeconomic inequalities, and aging: A 12-year multilevel interrupted time-series analysis of road traffic death rates in a Latin American country. PLoS One 2020; 15:e0224545. [PMID: 31910212 PMCID: PMC6946134 DOI: 10.1371/journal.pone.0224545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 10/16/2019] [Indexed: 11/18/2022] Open
Abstract
As the resources for road safety in developing countries are scarce and unevenly distributed, vulnerable road users -such as the elderly- may be particularly at risk of road traffic deaths. To date, the impact of road safety measures over the rate of road traffic deaths in older adults (60 years or older), considering the within-country socioeconomic inequalities, has not been explored in developing nations. This study takes the Chilean case as an example -with its 2005 traffic law reform as one of the road safety measures investigated-, in which open data available from official national sources for all its 13 regions over the 2002-2013 period were used for a multilevel interrupted time-series analysis. A statistically significant secular reduction of the rates of road traffic deaths in the elderly population was found (incidence rate ratio [IRR] 0.95, 95% confidence interval [CI] 0.91 to 0.99), but no evidence for a significant intercept or slope change after the traffic law reform was observed. Regions with the highest number of traffic offenses prosecuted in local police courts had lower rates of road traffic deaths in older adults (IRR 0.95, 95% CI 0.90 to 1.00), and those regions in the third (IRR 1.61, 95% CI 1.16 to 2.25) and the fifth (IRR 1.66, 95% CI 1.08 to 2.54) quintiles of socioeconomic deprivation had higher rates of road traffic deaths in the elderly. Such findings strongly support the conceptualization of the road safety of seniors in developing countries as a social equity issue, with implications for the design of traffic regulations and road environments.
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Affiliation(s)
- Pablo Martínez
- CITIAPS, Universidad de Santiago de Chile, Santiago, Chile
- Escuela de Psicología, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago, Chile
- Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Santiago, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (Imhay), Santiago, Chile
- * E-mail:
| | | | - Mónica Moreno
- CITIAPS, Universidad de Santiago de Chile, Santiago, Chile
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Furtado BMASM, Bonfim CVD, Fernandes CLEDA, Oliveira JA, Silva AGSD. Spatial analysis of traffic accidents involving older adults in a city in the northeast of Brazil. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.200105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to describe the epidemiological characteristics of traffic accidents involving older victims, responded to by the Mobile Emergency Service (or SAMU), and to analyze the spatial distribution of these events in the city of Olinda, Pernambuco, Brazil, from 2015 to 2018. Method: a composite cross-sectional study was performed, using SAMU service records as a data source. Descriptive statistics were applied, based on frequency distribution. For the mapping and detection of spatial clusters, the Kernel intensity estimator was used. Results: SAMU responded to 137 traffic accidents with older victims. The most affected age group were older adults aged 60 to 69 years (81; 59.1%), and there was a predominance of male victims (90; 65.7%). The day of the week when most accidents occurred was Wednesday (29; 21.25%), and the highest number of accidents occurred in the morning (46; 33.6%). As for the nature of the accident, accidents involving pedestrians (80; 58.4) predominated over collisions (57; 41.6%). The Kernel intensity estimator identified a significant focus in the Peixinhos neighborhood, with other foci distributed throughout the coastal area. Conclusion: the study identified the characteristics of older victims of traffic accidents and areas of greatest risk for their occurrence in the city studied. This information can be useful when planning environmental engineering measures to be carried out in the regions identified, in order to reduce the frequency of accidents and injuries.
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Abstract
Recent applications of eye tracking for diagnosis, prognosis and follow-up of therapy in age-related neurological or psychological deficits have been reviewed. The review is focused on active aging, neurodegeneration and cognitive impairments. The potential impacts and current limitations of using characterizing features of eye movements and pupillary responses (oculometrics) as objective biomarkers in the context of aging are discussed. A closer look into the findings, especially with respect to cognitive impairments, suggests that eye tracking is an invaluable technique to study hidden aspects of aging that have not been revealed using any other noninvasive tool. Future research should involve a wider variety of oculometrics, in addition to saccadic metrics and pupillary responses, including nonlinear and combinatorial features as well as blink- and fixation-related metrics to develop biomarkers to trace age-related irregularities associated with cognitive and neural deficits.
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Affiliation(s)
- Ramtin Z Marandi
- Department of Health Science & Technology, Aalborg University, Aalborg E 9220, Denmark
| | - Parisa Gazerani
- Department of Health Science & Technology, Aalborg University, Aalborg E 9220, Denmark
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22
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Chan ML, Wong Y, Ng R, Koh GCH. Medical conditions and driving fitness of older Singaporean taxi drivers. Occup Med (Lond) 2019; 69:211-214. [PMID: 30937427 DOI: 10.1093/occmed/kqz025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Taxi driving has been associated with the risk of various diseases (e.g. cardiovascular disease, hypertension, diabetes, hyperlipaemia, back pain). Little is known about the relationship between health conditions and driving fitness of older taxi drivers who continue to work. AIMS To investigate the (i) prevalence of medical conditions and (ii) relationship between age and medical conditions, with on-road driving tests in the relicensing process of older taxi drivers aged ≥70 years, prior to the mandatory retirement age of 75 years. METHODS We analysed retrospectively all relicensing records (N = 855) of taxi drivers aged 70, 73 and 74 years that were submitted from April 2014 to April 2015. RESULTS All passed their medical fitness screening. Ninety-eight per cent passed their driving tests. Thirty-one per cent, 36% and 24% reported none, one and two medical conditions, respectively. These included hypertension (56%), eye disease (25%; cataracts 19%), diabetes (24%), corrected hearing impairment (14%), hyperlipaemia (12%) and heart disease (9%). Deafness (P < 0.001) was associated with older age. No past medical condition affected driving outcome. CONCLUSION Older Singaporean taxi drivers were healthy and generally competent drivers. Early effective preventive health screening and modifiable lifestyle intervention are recommended in older taxi drivers.
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Affiliation(s)
- M-L Chan
- Department of Occupational Therapy, Tan Tock Seng Hospital, Singapore
| | - Y Wong
- Singapore Clinical Research Institute, Singapore
| | - R Ng
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore
| | - G C-H Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Nouchi R, Kobayashi A, Nouchi H, Kawashima R. Newly Developed TV-Based Cognitive Training Games Improve Car Driving Skills, Cognitive Functions, and Mood in Healthy Older Adults: Evidence From a Randomized Controlled Trial. Front Aging Neurosci 2019; 11:99. [PMID: 31133842 PMCID: PMC6513888 DOI: 10.3389/fnagi.2019.00099] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/10/2019] [Indexed: 01/26/2023] Open
Abstract
Background: Cognitive training in a laboratory improves car driving skills of older car drivers. However, it remains unclear whether other types of cognitive training at home have beneficial effects on driving skills. Using our developed cognitive training games that can be played on a television with a set-top box in a person's home, we investigated the effects of a 6-week cognitive training program on driving skills, which included on-road evaluation (primary outcome), and cognitive functions and emotional states (secondary outcome) in older people. Methods: In this double-blinded randomized control trial (RCT), 60 older licensed drivers were randomly assigned into one of the two groups: a cognitive training game for car driving (CTCD) group and an active control cognitive training game (ACT) group. Participants in the CTCD group played the CTCD (processing speed, dual attention, and speed prediction) for 20 min in five sessions per week for 6 weeks. Participants in the ACT group played the ACT (selecting the larger number; selecting a number from largest to smallest; play a game of rock, article, scissors) for 20 min in five sessions per week for 6 weeks. We measured driving skills, various cognitive functions, and emotional states before and after the 6-week intervention period. Results: Our main results showed that compared to the ACT group, the CTCD group demonstrated improved driving skills (adjusted p = 0.034). Moreover, the CTCD group demonstrated improved inhibition (stroop, adjusted p = 0.042: reverse Stroop, adjusted p = 0.043) and processing speed performance symbol search (SS), adjusted p = 0.049; digit symbol coding (adjusted p = 0.047), compared to the ACT group. The CTCD group scored higher on vigor-activity mood (adjusted p = 0.041) as measured using the Profile of Mood State. Discussion: This randomized controlled trial provides scientific evidence for the benefits of the 6-week CTCD program on driving skills and cognitive functions, such as processing speed, inhibition, and vigor-activity mood, in healthy older people. Our results suggest that cognitive training is useful to improve the driving skills of older adults. Trial registration: This trial was registered at The University Hospital Medical Information Network Clinical Trials Registry (UMIN 000029769). Registered 31 October 2017, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034010.
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Affiliation(s)
- Rui Nouchi
- Department of Cognitive Health Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
- Smart Aging Research Center (S.A.R.C.), Tohoku University, Sendai, Japan
| | - Akiko Kobayashi
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Haruka Nouchi
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- Smart Aging Research Center (S.A.R.C.), Tohoku University, Sendai, Japan
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
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24
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Strogatz D, Mielenz TJ, Johnson AK, Baker IR, Robinson M, Mebust SP, Andrews HF, Betz ME, Eby DW, Johnson RM, Jones VC, Leu CS, Molnar LJ, Rebok GW, Li G. Importance of Driving and Potential Impact of Driving Cessation for Rural and Urban Older Adults. J Rural Health 2019; 36:88-93. [PMID: 31022317 DOI: 10.1111/jrh.12369] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Analyses compared older drivers from urban, suburban, and rural areas on perceived importance of continuing to drive and potential impact that driving cessation would have on what they want and need to do. METHODS The AAA LongROAD Study is a prospective study of driving behaviors, patterns, and outcomes of older adults. A cohort of 2,990 women and men 65-79 years of age was recruited during 2015-2017 from health systems or primary care practices near 5 study sites in different parts of the United States. Participants were classified as living in urban, surburban, or rural areas and were asked to rate the importance of driving and potential impact of driving cessation. Logistic regression models adjusted for sociodemographic and driving-related characteristics. FINDINGS The percentages of older drivers rating driving as "completely important" were 76.9%, 79.0%, and 83.8% for urban, suburban, and rural drivers, respectively (P = .009). The rural drivers were also most likely to indicate driving cessation would have a high impact on what they want or need to do (P < .001). After adjustment for sociodemographic and driving-related characteristics, there was a 2-fold difference for rural versus urban older drivers in odds that driving cessation would have a high impact on what they need to do (OR = 2.03; 95% CI: 1.60-2.58). CONCLUSIONS Older drivers from rural areas were more likely to rate driving as highly important and the prospect of driving cessation as very impactful. Strategies to enhance both the ability to drive safely and the accessibility of alternative sources of transportation may be especially important for older rural adults.
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Affiliation(s)
| | - Thelma J Mielenz
- Mailman School of Public Health, Columbia University, New York, New York.,Center for Injury Epidemiology and Prevention, Columbia University, New York, New York
| | | | - Ida R Baker
- Bassett Research Institute, Cooperstown, New York
| | | | | | - Howard F Andrews
- Mailman School of Public Health, Columbia University, New York, New York.,Columbia University College of Physicians and Surgeons, New York, New York
| | - Marian E Betz
- School of Medicine, University of Colorado, Aurora, Colorado
| | - David W Eby
- University of Michigan Transportation Research Institute, Ann Arbor, Michigan.,Center for Advancing Transportation Leadership and Safety, University of Michigan, Ann Arbor, Michigan
| | - Renee M Johnson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Vanya C Jones
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Cheng Shiun Leu
- Mailman School of Public Health, Columbia University, New York, New York
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, Ann Arbor, Michigan.,Center for Advancing Transportation Leadership and Safety, University of Michigan, Ann Arbor, Michigan
| | - George W Rebok
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Guohua Li
- Mailman School of Public Health, Columbia University, New York, New York.,Center for Injury Epidemiology and Prevention, Columbia University, New York, New York.,Columbia University College of Physicians and Surgeons, New York, New York
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25
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Azami-Aghdash S, Aghaei MH, Sadeghi-Bazarghani H. Epidemiology of Road Traffic Injuries among Elderly People; A Systematic Review and Meta-Analysis. Bull Emerg Trauma 2018; 6:279-291. [PMID: 30402515 PMCID: PMC6215074 DOI: 10.29252/beat-060403] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To systematically review the epidemiological patterns and interventions for prevention of road traffic injuries (RTIs) among elderly. Methods: Searching keywords including: accident, trauma, road injury, road traffic injuries, aging, old, elder, strategy, intervention, road traffic crash prevention and traffic accident in databases including, Google scholar, SID, IranMedex, PubMed and Scopus. English and non-Persian articles, articles presented in congresses, articles that considered elderly people to have age under than 60 years were excluded. The reporting quality of articles was assessed by two experts using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) check list. Results: RTIs compromised 23.6% of total injuries among elderly. The most frequent injuries were about car accidents (51.4%). Pedestrian injuries composed 48.1% of the RTIs. Head and neck (32.1%) were most injured body parts. There was a significant difference between elderly and non-elderly people in terms of RTIs associated mortality (Odd=2.57 [1.2-5.4 CI 95%]). Overall 25 main domains of intervention and 73 subordinate domains were extracted in five categories (human, road and environment, tools and cars, medical, legal and political issues). Conclusion: According to the notable prevalence and fatality of RTIs, lack of sufficient studies and valid evidence of the present study can provide an appropriate evidence for better interventions for RTIs prevention among elderly.
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Affiliation(s)
- Saber Azami-Aghdash
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mir Hossein Aghaei
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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26
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Zou X, Yue WL, Vu HL. Visualization and analysis of mapping knowledge domain of road safety studies. ACCIDENT; ANALYSIS AND PREVENTION 2018; 118:131-145. [PMID: 29958121 DOI: 10.1016/j.aap.2018.06.010] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/12/2018] [Accepted: 06/15/2018] [Indexed: 06/08/2023]
Abstract
Mapping knowledge domain (MKD) is an important application of visualization technology in Bibliometrics, which has been extensively applied in psychology, medicine, and information science. In this paper we conduct a systematic analysis of the development trend on road safety studies based on the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) articles published between 2000 and 2018 using the MKD software tools VOSviewer and Sci2 Tool. Based on our analysis, we first present the annual numbers of articles, origin countries, main research organizations and groups as well as the source journals on road safety studies. We then report the collaborations among the main research organizations and groups using co-authorship analysis. Furthermore, we adopt the document co-citation analysis, keywords co-occurrence analysis, and burst detection analysis to visually explore the knowledge bases, topic distribution, research fronts and research trends on road safety studies. The proposed approach based on the visualized analysis of MKD can be used to establish a reference information and research basis for the application and development of methods in the domain of road safety studies. In particular, our results show that the knowledge bases (classical documents) of road safety studies in the last two decades have focused on five major areas of "Crash Frequency Data Analysis", "Driver Behavior Questionnaire", "Safety in Numbers for Walkers and Bicyclists", "Road Traffic Injury and Prevention", and "Driving Speed and Road Crashes". Among the research topics, the five dominant clusters are "Causation and Injury Severity Analysis of Road Accidents", "Epidemiologic Study and Prevention of Road Traffic Injury", "Intelligent Transportation System and Active Safety", "Young drivers' driving behavior and psychology", and "Older drivers' psychological and physiological characteristics". Finally, the burst keywords in research trends include Cycling, Intelligent Transportation Systems, and Distraction.
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Affiliation(s)
- Xin Zou
- School of Natural and Built Environments, University of South Australia, Mawson Lakes, SA, 5095, Australia.
| | - Wen Long Yue
- Australian Road Research Board, Port Melbourne, VIC, 3207, Australia
| | - Hai Le Vu
- Institute of Transport Studies, Monash University, Clayton, VIC, 3800, Australia
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27
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Kepecs DM, Glick L, Silver SA, Yuen DA. Does Chronic Kidney Disease-Induced Cognitive Impairment Affect Driving Safety? Can J Kidney Health Dis 2018; 5:2054358118777133. [PMID: 29977582 PMCID: PMC6024330 DOI: 10.1177/2054358118777133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/03/2017] [Indexed: 11/16/2022] Open
Abstract
PURPOSE OF REVIEW One of the principal mechanisms by which illness can affect driving safety is by impairing cognition. Nevertheless, despite the substantial evidence demonstrating cognitive impairment in chronic kidney disease (CKD), little is known about the effects of CKD on driving safety. OBJECTIVE Investigate the current national medical guidelines and research literature with respect to CKD and driving safety. SOURCES OF INFORMATION Medline, CINAHL, PEDro, Scopus as of August 2017. The most up to date national driving guidelines and available information provided by the provincial and territorial ministries of transportation across Canada. FINDINGS Fives studies of driving fitness in patients with CKD have been published with minimal data available for patients at early stages of the disease. Amongst these studies, only two come from an era when modern end stage renal disease therapies were routinely provided. The first study demonstrated that 40% of 186 surveyed patients on hemodialysis felt uncomfortable driving and that 1/3 of patients were involved in motor vehicle collisions (MVC) since starting dialysis. Of the patients who felt comfortable driving, more than 75% were found to be at increased driving risk. The second study reported that 15% of patients on hemodialysis were involved in MVCs over a three year span and that the "Am I A Safe Driver" assessment tool by the American Medical Association may not capture all patients at high driving risk. Despite these alarming numbers, national guidelines place few driving restrictions on this patient population and only 3 of 11 available provincial or territorial driving forms include kidney disease as a category that physicians should consider when assessing medical fitness to drive. LIMITATIONS Our review is limited by the lack of randomized control studies evaluating the effects of CKD on driving safety. IMPLICATIONS Our review demonstrates that driving safety in this patient population remains poorly understood. The limited evidence that does exist, however, suggests that these patients are at substantial risk for unsafe driving. Future research is necessary to determine the impact of CKD-associated cognitive impairment on driving risk, and to parse out the contributions of CKD and its various treatments to driving impairment.
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Affiliation(s)
- David M. Kepecs
- Keenan Research Centre for Biomedical Science of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Lauren Glick
- Keenan Research Centre for Biomedical Science of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Samuel A. Silver
- Division of Nephrology, Queen’s University, Kingston, Ontario, Canada
| | - Darren A. Yuen
- Keenan Research Centre for Biomedical Science of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
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28
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Stout SH, Babulal GM, Ma C, Carr DB, Head DM, Grant EA, Williams MM, Holtzman DM, Fagan AM, Morris JC, Roe CM. Driving cessation over a 24-year period: Dementia severity and cerebrospinal fluid biomarkers. Alzheimers Dement 2018; 14:610-616. [PMID: 29328928 PMCID: PMC5938126 DOI: 10.1016/j.jalz.2017.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 09/25/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION With 36 million older adult U.S. drivers, safety is a critical concern, particularly among those with dementia. It is unclear at what stage of Alzheimer's disease (AD) older adults stop driving and whether preclinical AD affects driving cessation. METHODS Time to driving cessation was examined based on Clinical Dementia Rating (CDR) and AD cerebrospinal fluid biomarkers. 1795 older adults followed up to 24 years received CDR ratings. A subset (591) had cerebrospinal fluid biomarker measurements and was followed up to 17 years. Differences in CDR and biomarker groups as predictors of time to driving cessation were analyzed using Kaplan-Meier curves and Cox proportional models. RESULTS Higher CDR scores and more abnormal biomarker measurements predicted a shorter time to driving cessation. DISCUSSION Higher levels of AD biomarkers, including among individuals with preclinical AD, lead to earlier driving cessation. Negative functional outcomes of preclinical AD show a nonbenign phase of the disease.
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Affiliation(s)
- Sarah H Stout
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Ganesh M Babulal
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chunyu Ma
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - David B Carr
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA; The Rehabilitation Institute of St. Louis, St. Louis, MO, USA
| | - Denise M Head
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychology and Brain Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Elizabeth A Grant
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | | | - David M Holtzman
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Anne M Fagan
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Department of Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA; Department of Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Catherine M Roe
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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29
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Molnar LJ, Eby DW, Bogard SE, LeBlanc DJ, Zakrajsek JS. Using naturalistic driving data to better understand the driving exposure and patterns of older drivers. TRAFFIC INJURY PREVENTION 2018; 19:S83-S88. [PMID: 29584495 DOI: 10.1080/15389588.2017.1379601] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 09/11/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aging of the population in the United States and elsewhere has brought increasing attention to the issue of safe driving and mobility among older adults. The overall objective of this research was to use naturalistic data collection to better understand driving exposure and driving patterns, 2 important contributors to crash risk. METHODS Data came from a study conducted at the University of Michigan Transportation Research Institute as part of the Integrated Vehicle-Based Safety System (IVBSS) program. A total of 108 randomly sampled drivers took part, with the sample stratified by age and sex. The age groups examined were 20 to 30 (younger), 40 to 50 (middle-aged), and 60 to 70 years old (older). Sixteen late-model Honda Accords were used as research vehicles and were driven by participants as their personal vehicles over the study period. Roughly the first 2 weeks of vehicle use comprised the baseline driving period, during which the IVBSS technologies were turned off (i.e., no warnings were presented to the drivers) but all onboard data were collected. For this article, only data from the baseline period were analyzed to limit any confounding effects that the safety technology may have had on driving behavior. RESULTS Results indicated that when looking at age independent of sex, older drivers (age 60-70) took fewer trips, drove fewer minutes, were less likely to drive at night, and had fewer high decelerations and speeding events than the youngest age group (20-30). They were also less likely to drive during peak morning traffic and on high-speed roads than their middle-age counterparts (40-50). Across all age groups, there were few differences by sex, with the exception that females drove fewer miles and fewer minutes and had fewer high decelerations than males. When both age and sex were taken into account, it was often the group of females age 60-70 that appeared to account for many of the age and sex differences found in driving exposure and patterns. CONCLUSIONS Future research in this area would benefit from larger scale and longitudinal study designs so that changes in driving exposure and patterns over time among large samples of drivers could be examined.
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Affiliation(s)
- Lisa J Molnar
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - David W Eby
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - Scott E Bogard
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - David J LeBlanc
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - Jennifer S Zakrajsek
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
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30
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A decade of road traffic fatalities among the elderly in north-West Iran. BMC Public Health 2018; 18:111. [PMID: 29310628 PMCID: PMC5759218 DOI: 10.1186/s12889-017-4976-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/05/2017] [Indexed: 11/23/2022] Open
Abstract
Background Iran has a uniquely catastrophic status for road traffic injury incidence and fatality. The elderly account for a substantial number of the hospitalizations and fatalities due to traffic injuries. The aim of this study was to investigate the crash mechanisms and medical outcomes of traffic fatalities among the elderly in East Azerbaijan province of Iran during the period 2006–2016. Methods A total of 9435 fatalities registered in East Azerbaijan forensic medicine database, Iran, during 2006–2016, were investigated. Of these, 1357 were elderly persons (age > 65). Both victim- and crash-related variables were compared for the elderly and other age groups. Bivariate and multivariate analysis methods were applied using Stata statistical software package version 13. Results Of the 9435 fatalities, 1357 victims (14.4%) were elderly persons. The mean age of the elderly traffic fatalities was 75.3(SD = 6.2) years. About 78% of the elderly versus 80% of those in other age groups were males. A decreasing trend of fatal traffic accidents was observed over the study period both for the elderly and other age groups. The elderly were nearly seven times more likely to die as a pedestrian compared to other age groups. By exclusively analyzing pedestrians, it was found that motorcycles were responsible for pedestrian deaths in 9.1% of the fatalities while this figure was 5.5% for pedestrians in other age groups killed in a traffic accident (P < 0.05). About 56% (N = 761) of the elderly died in hospital which was higher than the proportion for other age groups (39%). Ambulance was the main vehicle for transferring the injured victims in four-fifths of the cases both for the elderly and other age groups. Although, in the present study, head injuries were the most common type of injury regardless of the age group, the elderly had a lower percentage of head injuries and a higher percentage of injuries to the torso, pelvis and limbs compared to younger victims. Conclusions Pedestrian inner-city crashes in East Azerbaijan province of Iran are a major cause of road injury fatalities among the elderly and should be considered as a priority in road safety interventions.
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Deng H, Chen W, Kuang S, Zhang T. Distinct Aging Effects on Motion Repulsion and Surround Suppression in Humans. Front Aging Neurosci 2017; 9:363. [PMID: 29163143 PMCID: PMC5673999 DOI: 10.3389/fnagi.2017.00363] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 10/23/2017] [Indexed: 12/27/2022] Open
Abstract
Elderly exhibit accumulating deficits in visual motion perception, which is critical for humans to interact with their environment. Previous studies have suggested that aging generally reduces neuronal inhibition in the visual system. Here, we investigated how aging affects the local intra-cortical inhibition using a motion direction discrimination task based on the motion repulsion phenomenon. Motion repulsion refers to the phenomenon by which observers overestimate the perceived angle when two superimposed dot patterns are moving at an acute angle. The misperception has been interpreted as local mutual inhibition between nearby direction-tuned neurons within the same cortical area. We found that elderly exhibited much stronger motion repulsion than young adults. We then compared this effect to how aging affects the global inter-cortical inhibition by adopting the surround suppression paradigm previously used by Betts et al. (2005). We found that elderly showed less change in the discrimination threshold when the size of a high-contrast drifting Gabor was increased, indicating reduced surround suppression compared to young adults. Our results indicate that aging may not always lead to a decrease of neuronal inhibition in the visual system. These distinct effects of aging on inhibitory functions might be one of the reasons that elderly people often exhibit deficits of motion perception in a real-world situation.
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Affiliation(s)
- Hu Deng
- State Key Laboratory of Brain and Cognitive Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Weiying Chen
- State Key Laboratory of Brain and Cognitive Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Shenbing Kuang
- State Key Laboratory of Brain and Cognitive Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Tao Zhang
- State Key Laboratory of Brain and Cognitive Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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32
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Molnar LJ, Eby DW. Implications of advanced vehicle technologies for older drivers. ACCIDENT; ANALYSIS AND PREVENTION 2017; 106:457-459. [PMID: 28689933 DOI: 10.1016/j.aap.2017.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Advances are being made in vehicle technologies that may help older adults compensate for some of the declines in abilities associated with aging. These advances hold promise for increasing vehicle safety, reducing injuries, and making the driving task more comfortable. However, important research gaps remain with regard to how various advanced technologies impact the safety of older drivers, as well as older drivers' perceptions about these technologies. This special issue contains seven original contributions that address these issues. Specific topics include the: congruence of design guidelines with the needs and abilities of older drivers, transfer of control between automated and manual driving, use of in-vehicle monitoring technology, motivations for technology use and assigned meanings, technology valuation, and effects on driving behavior.
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Affiliation(s)
- Lisa J Molnar
- University of Michigan Transportation Research Institute, Center for Advancing Transportation Leadership and Safety, 2901 Baxter Road, Ann Arbor, MI, 48109-2150, United States.
| | - David W Eby
- University of Michigan Transportation Research Institute, Center for Advancing Transportation Leadership and Safety, 2901 Baxter Road, Ann Arbor, MI, 48109-2150, United States
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33
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Heaton K, McManus BJ, Mumbower R, Vance DE. A Pilot Study of Sleep, Work Practices, Visual Processing Speed, and 5-Year Motor Vehicle Crash Risk Among Truck Drivers. Workplace Health Saf 2017. [PMID: 28621204 DOI: 10.1177/2165079917704448] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this pilot study was to explore the relationships between sleep, work practices, speed of processing, and 5-year motor vehicle crash risk among a group of older truck drivers. Anthropometric, demographic, and psychological data were recorded, along with health, sleep, and work histories from a sample of 23 truck drivers. Results from this pilot study suggest that physical fatigue may play a role in processing speed. Future studies should be designed with adequate power and include objective measures of sleep and repeated measures over time to determine 5-year MVC rates. Implications for occupational health nursing research, practice, and education are presented.
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Affiliation(s)
- Karen Heaton
- 1 University of Alabama at Birmingham School of Nursing
| | | | | | - David E Vance
- 1 University of Alabama at Birmingham School of Nursing
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Maillot P, Dommes A, Dang NT, Vienne F. Training the elderly in pedestrian safety: Transfer effect between two virtual reality simulation devices. ACCIDENT; ANALYSIS AND PREVENTION 2017; 99:161-170. [PMID: 27898369 DOI: 10.1016/j.aap.2016.11.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 09/30/2016] [Accepted: 11/19/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES A virtual-reality training program has been developed to help older pedestrians make safer street-crossing decisions in two-way traffic situations. The aim was to develop a small-scale affordable and transportable simulation device that allowed transferring effects to a full-scale device involving actual walking. METHODS 20 younger adults and 40 older participants first participated in a pre-test phase to assess their street crossings using both full-scale and small-scale simulation devices. Then, a trained older group (20 participants) completed two 1.5-h training sessions with the small-scale device, whereas an older control group received no training (19 participants). Thereafter, the 39 older trained and untrained participants took part in a 1.5-h post-test phase again with both devices. RESULTS Pre-test phase results suggested significant differences between both devices in the group of older participants only. Unlike younger participants, older participants accepted more often to cross and had more collisions on the small-scale simulation device than on the full-scale one. Post-test phase results showed that training older participants on the small-scale device allowed a significant global decrease in the percentage of accepted crossings and collisions on both simulation devices. But specific improvements regarding the way participants took into account the speed of approaching cars and vehicles in the far lane were notable only on the full-scale simulation device. DISCUSSION The findings suggest that the small-scale simulation device triggers a greater number of unsafe decisions compared to a full-scale one that allows actual crossings. But findings reveal that such a small-scale simulation device could be a good means to improve the safety of street-crossing decisions and behaviors among older pedestrians, suggesting a transfer of learning effect between the two simulation devices, from training people with a miniature device to measuring their specific progress with a full-scale one.
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Affiliation(s)
- Pauline Maillot
- Paris Descartes University, Sorbonne Paris Cité, Laboratory TEC EA 3625, Paris, France; The French Institute of Science and Technology for Transport, Development and Networks, Laboratory for Road Operations, Perception, Simulators and Simulations, Versailles, France.
| | - Aurélie Dommes
- The French Institute of Science and Technology for Transport, Development and Networks, Laboratory for Road Operations, Perception, Simulators and Simulations, Versailles, France
| | - Nguyen-Thong Dang
- The French Institute of Science and Technology for Transport, Development and Networks, Laboratory for Road Operations, Perception, Simulators and Simulations, Versailles, France
| | - Fabrice Vienne
- The French Institute of Science and Technology for Transport, Development and Networks, Laboratory for Road Operations, Perception, Simulators and Simulations, Versailles, France
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35
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Tournier I, Dommes A, Cavallo V. Review of safety and mobility issues among older pedestrians. ACCIDENT; ANALYSIS AND PREVENTION 2016; 91:24-35. [PMID: 26950033 DOI: 10.1016/j.aap.2016.02.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 02/09/2016] [Accepted: 02/29/2016] [Indexed: 06/05/2023]
Abstract
Although old people make up an extremely vulnerable road-user group, older pedestrians' difficulties have been studied less extensively than those of older drivers, and more knowledge of this issue is still required. The present paper reviews current knowledge of older-adult problems with the main components of pedestrian activity, i.e., walking and obstacle negotiation, wayfinding, and road crossing. Compared to younger ones, old pedestrians exhibit declining walking skills, with a walking speed decrease, less stable balance, less efficient wayfinding strategies, and a greater number of unsafe road crossing behaviors. These difficulties are linked to age-related changes in sensorial, cognitive, physical, and self-perception abilities. It is now known that visual impairment, physical frailty, and attention deficits have a major negative impact on older pedestrians' safety and mobility, whereas the roles of self-evaluation and self-regulation are still poorly understood. All these elements must be taken into consideration, not only in developing effective safety interventions targeting older pedestrians, but also in designing roads and cars. Recent initiatives are presented here and some recommendations are proposed.
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Affiliation(s)
- Isabelle Tournier
- INSIDE, University of Luxembourg, 11 porte des sciences, L-4366 Esch-sur-Alzette, Luxembourg; LEPSIS, IFSTTAR, 25 allée des Marronniers, F-78000 Versailles, France.
| | - Aurélie Dommes
- LEPSIS, IFSTTAR, 25 allée des Marronniers, F-78000 Versailles, France
| | - Viola Cavallo
- LEPSIS, IFSTTAR, 25 allée des Marronniers, F-78000 Versailles, France
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Smith GA, Porter MM, Cull AW, Mazer BL, Myers AM, Naglie G, Bédard M, Tuokko HA, Vrkljan BH, Gélinas I, Marshall SC, Rapoport MJ. Seasonal and Weather Effects on Older Drivers' Trip Distances. Can J Aging 2016; 35:1-10. [PMID: 27045699 DOI: 10.1017/s0714980816000040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The purpose of this study was to determine if season or weather affected the objectively measured trip distances of older drivers (≥ 70 years; n = 279) at seven Canadian sites. During winter, for all trips taken, trip distance was 7 per cent shorter when controlling for site and whether the trip occurred during the day. In addition, for trips taken within city limits, trip distance was 1 per cent shorter during winter and 5 per cent longer during rain when compared to no precipitation when controlling for weather (or season respectively), time of day, and site. At night, trip distance was about 30 per cent longer when controlling for season and site (and weather), contrary to expectations. Together, these results suggest that older Canadian drivers alter their trip distances based on season, weather conditions, and time of day, although not always in the expected direction.
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Affiliation(s)
- Glenys A Smith
- Health,Leisure and Human Performance Research Institute,Faculty of Kinesiology and Recreation Management,University of Manitoba
| | - Michelle M Porter
- Health,Leisure and Human Performance Research Institute,Faculty of Kinesiology and Recreation Management,University of Manitoba
| | - Andrew W Cull
- Health,Leisure and Human Performance Research Institute,Faculty of Kinesiology and Recreation Management,University of Manitoba
| | - Barbara L Mazer
- School of Physical and Occupational Therapy,McGill University,and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal;Jewish Rehabilitation Hospital
| | - Anita M Myers
- School of Public Health and Health Systems,University of Waterloo
| | - Gary Naglie
- Department of Medicine and Rotman Research Institute,Baycrest Health Sciences;Department of Research,Toronto Rehabilitation Institute,University Health Network;Department of Medicine and Institute of Health Policy,Management and Evaluation,University of Toronto
| | - Michel Bédard
- Centre for Research on Safe Driving and Department of Health Sciences,Lakehead University
| | - Holly A Tuokko
- Centre on Aging and Department of Psychology,University of Victoria
| | - Brenda H Vrkljan
- Occupational Therapy,School of Rehabilitation Science,McMaster University
| | - Isabelle Gélinas
- School of Physical and Occupational Therapy,McGill University,and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal;Jewish Rehabilitation Hospital
| | - Shawn C Marshall
- Ottawa Hospital Research Institute;Department of Medicine,University of Ottawa
| | - Mark J Rapoport
- Department of Psychiatry,University of Toronto,and Sunnybrook Health Sciences Centre
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Almeida MHMD, Caromano FA, Ribeiro SS, Batista MPP. Programa de orientação com ênfase em práticas de autocuidado para motoristas idosos. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2016. [DOI: 10.1590/1809-98232016019.140192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo: Apresentar resultados de um programa de orientação com ênfase em práticas de autocuidado para motoristas idosos, bem como descrever dificuldades pessoais e desafios ambientais identificados por seus participantes em relação à direção veicular. Método: Pesquisa-intervenção junto a motoristas idosos realizada mediante entrevistas individuais, programa de orientação e uma sessão de grupo focal. Resultados: Participaram 13 idosos com idade entre 62 e 82 anos. Sete (54,0%) referiram dificuldades para dirigir, dos quais cinco (71,4%) mencionaram dificuldades decorrentes da interação com o ambiente; três (42,9%), apontaram dificuldade emocional e três (42,9%) referiram, em conjunto, dificuldades físicas, sensoriais e/ou cognitivas. Na sessão de grupo focal os idosos refletiram sobre fatores que incidem sobre o ato de dirigir abordados durante o programa, referindo terem ampliado práticas de autocuidado para seu enfrentamento. Um maior número de participantes passou a identificar influência dos déficits de atenção e de questões emocionais na direção veicular. Quanto às condições relativas ao ambiente físico e social, fizeram críticas ao crescimento desordenado do trânsito, mencionaram preocupação com outros motoristas e apontaram deficiência dos mecanismos de educação, fiscalização e punição às infrações de trânsito. Discutiram também mudanças para favorecer a mobilidade dos pedestres, condição também vivenciada por motoristas. Conclusão: Os idosos explicitaram a importância das orientações, colocando como fundamental a discussão, entre profissionais e idosos, de práticas abrangentes que equacionem a multiplicidade de fatores que incidam sobre o ato de dirigir, sempre com o objetivo de manter a direção segura pelo maior tempo possível.
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38
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Challenges of Older Drivers’ Adoption of Advanced Driver Assistance Systems and Autonomous Vehicles. HUMAN ASPECTS OF IT FOR THE AGED POPULATION. HEALTHY AND ACTIVE AGING 2016. [DOI: 10.1007/978-3-319-39949-2_41] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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39
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Piersma D, de Waard D, Davidse R, Tucha O, Brouwer W. Car drivers with dementia: Different complications due to different etiologies? TRAFFIC INJURY PREVENTION 2015; 17:9-23. [PMID: 25874501 DOI: 10.1080/15389588.2015.1038786] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Older drivers with dementia are an at-risk group for unsafe driving. However, dementia refers to various etiologies and the question is whether dementias of different etiology have similar effects on driving ability. METHODS The literature on the effects of dementia of various etiologies on driving ability is reviewed. Studies addressing dementia etiologies and driving were identified through PubMed, PsychINFO, and Google Scholar. RESULTS AND CONCLUSIONS Early symptoms and prognoses differ between dementias of different etiology. Therefore, different etiologies may represent different likelihoods with regard to fitness to drive. Moreover, dementia etiologies could indicate the type of driving problems that can be expected to occur. However, there is a great lack of data and knowledge about the effects of almost all etiologies of dementia on driving. One could hypothesize that patients with Alzheimer's disease may well suffer from strategic difficulties such as finding a route, whereas patients with frontotemporal dementia are more inclined to make tactical-level errors because of impaired hazard perception. Patients with other dementia etiologies involving motor symptoms may suffer from problems on the operational level. Still, the effects of various etiologies of dementias on driving have thus far not been studied thoroughly. For the detection of driving difficulties in patients with dementia, structured interviews with patients but also their family members appear crucial. Neuropsychological assessment could support the identification of cognitive impairments. The impact of such impairments on driving could also be investigated in a driving simulator. In a driving simulator, strengths and weaknesses in driving behavior can be observed. With this knowledge, patients can be advised appropriately about their fitness to drive and options for support in driving (e.g., compensation techniques, car adaptations). However, as long as no valid, reliable, and widely accepted test battery is available for the assessment of fitness to drive, costly on-road test rides are inevitable. The development of a fitness-to-drive test battery for patients with dementia could provide an alternative for these on-road test rides, on condition that differences between dementia etiologies are taken into consideration.
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Affiliation(s)
- Dafne Piersma
- a Clinical and Developmental Neuropsychology, University of Groningen , Groningen , The Netherlands
| | - Dick de Waard
- a Clinical and Developmental Neuropsychology, University of Groningen , Groningen , The Netherlands
| | - Ragnhild Davidse
- b SWOV Institute for Road Safety Research , The Hague , The Netherlands
| | - Oliver Tucha
- a Clinical and Developmental Neuropsychology, University of Groningen , Groningen , The Netherlands
| | - Wiebo Brouwer
- a Clinical and Developmental Neuropsychology, University of Groningen , Groningen , The Netherlands
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40
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Arai A, Arai Y. Self-assessed driving behaviors associated with age among middle-aged and older adults in Japan. Arch Gerontol Geriatr 2014; 60:39-44. [PMID: 25465504 DOI: 10.1016/j.archger.2014.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 10/28/2014] [Accepted: 10/30/2014] [Indexed: 10/24/2022]
Abstract
With the increasing number of older drivers, road traffic safety is an urgent public health issue. It is not easy for older drivers or their relatives to detect early signs of dangerous driving behaviors. We examine the types of driving behavior that increase in frequency with age. We surveyed people aged 40 and over among the general public in Japan using a self-administered questionnaire on sociodemographic factors, driving status, frequency of driving, 12-items on physical symptoms possibly related to driving performance, and 28-items on driving behaviors. Multiple logistic regression models were used to estimate the odds ratios (OR) of occurrence of each of the 28 driving behaviors for a 5-year increase in age. Significant associations with a 5-year increase in age after adjusting for confounding factors were found for the following directly unsafe driving behaviors: (1) little or no sign of attempts to avoid dangerous situations (OR for a 5-year increase in age=1.38, 95% CI: 1.18-1.63); (2) lack of attention to other people and cars (1.33, 1.12-1.60); (3) improper maneuvering around curves (1.33, 1.09-1.65); and (4) improper or no turn signals (1.33, 1.06-1.69). Information about these driving behaviors should be given to drivers and their stakeholders and used to caution participants when implementing educational programs for older drivers. Self-assessment of driving ability in older drivers provides useful information to raise awareness of their driving performance.
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Affiliation(s)
- Asuna Arai
- Department of Gerontological Policy, National Center for Geriatrics and Gerontology (NCGG), 35 Gengo, Morioka-cho, Obu, Aichi 474-8511, Japan; Department of Health Care Policy, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
| | - Yumiko Arai
- Department of Gerontological Policy, National Center for Geriatrics and Gerontology (NCGG), 35 Gengo, Morioka-cho, Obu, Aichi 474-8511, Japan.
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