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Nguyen H, Di Tanna GL, Coxon K, Brown J, Ren K, Ramke J, Burton MJ, Gordon I, Zhang JH, Furtado J, Mdala S, Kitema GF, Keay L. Associations between vision impairment and vision-related interventions on crash risk and driving cessation: systematic review and meta-analysis. BMJ Open 2023; 13:e065210. [PMID: 37567751 PMCID: PMC10423787 DOI: 10.1136/bmjopen-2022-065210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES To systematically investigate the associations between vision impairment and risk of motor vehicle crash (MVC) involvement, and evaluate vision-related interventions to reduce MVCs. DESIGN Medline (Ovid), EMBASE and Global Health electronic databases were systematically searched from inception to March 2022 for observational and interventional English-language studies. Screening, data extraction and appraisals using the Joanna Briggs Institute appraisal tools were completed by two reviewers independently. Where appropriate, measures of association were converted into risk ratios (RRs) or ORs for meta-analysis. PARTICIPANTS Drivers of four-wheeled vehicles of all ages with no cognitive declines. PRIMARY AND SECONDARY OUTCOMES MVC involvement (primary) and driving cessation (secondary). RESULTS 101 studies (n=778 052) were included after full-text review. 57 studies only involved older drivers (≥65 years) and 85 were in high-income settings. Heterogeneity in the data meant that most meta-analyses were underpowered as only 25 studies, further split into different groups of eye diseases and measures of vision, could be meta-analysed. The limited evidence from the meta-analyses suggests that visual field defects (four studies; RR 1.51 (95% CI 1.23, 1.85); p<0.001; I2=46.79%), and contrast sensitivity (two studies; RR 1.40 (95% CI 1.08, 1.80); p=0.01, I2=0.11%) and visual acuity loss (five studies; RR 1.21 (95% CI 1.02, 1.43); p=0.03, I2=28.49%) may increase crash risk. The results are more inconclusive for available evidence for associations of glaucoma (five studies, RR 1.27 (95% CI 0.67, 2.42); p=0.47; I2=93.48%) and cataract (two studies RR 1.15 (95% CI 0.97, 1.36); p=0.11; I2=3.96%) with crashes. Driving cessation may also be linked with glaucoma (two studies; RR 1.62 (95% CI 1.20, 2.19); p<0.001, I2=22.45%), age-related macular degeneration (AMD) (three studies; RR 2.21 (95% CI 1.47, 3.31); p<0.001, I2=75.11%) and reduced contrast sensitivity (three studies; RR 1.30 (95% CI 1.05, 1.61); p=0.02; I2=63.19%). Cataract surgery halved MVC risk (three studies; RR 0.55 (95% CI 0.34, 0.92); p=0.02; I2=97.10). Ranibizumab injections (four randomised controlled trials) prolonged driving in persons with AMD. CONCLUSION Impaired vision identified through a variety of measures is associated with both increased MVC involvement and cessation. Cataract surgery can reduce MVC risk. Despite literature being highly heterogeneous, this review shows that detection of vision problems and appropriate treatment are critical to road safety. PROSPERO REGISTRATION NUMBER CRD42020172153.
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Affiliation(s)
- Helen Nguyen
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Gian Luca Di Tanna
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Kristy Coxon
- School of Health Sciences, and the Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
| | - Julie Brown
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Kerrie Ren
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Justine H Zhang
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - João Furtado
- Division of Ophthalmology, Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil
| | - Shaffi Mdala
- Ophthalmology Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Gatera Fiston Kitema
- Ophthalmology Department, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
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Mohaqeqi Kamal SH, Abolfathi Momtaz Y, Basakha M, Ahmadi S, Karimi SE, Omidi Oskouei A, Zanjari N, SoleimanvandiAzar N. Barriers and facilitators of driving status among older persons. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09431-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ang BH, Oxley JA, Chen WS, Yap KK, Song KP, Lee SWH. To reduce or to cease: A systematic review and meta-analysis of quantitative studies on self-regulation of driving. JOURNAL OF SAFETY RESEARCH 2019; 70:243-251. [PMID: 31848001 DOI: 10.1016/j.jsr.2019.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/07/2019] [Accepted: 07/10/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The ability to remain safe behind the wheels can become arduous with aging, yet important for sustaining local travel needs. This review aimed to explore safe mobility issues involving older adults and gain a broad understanding of older drivers' self-regulatory driving practices and motivators behind such behavioral changes, including strategies adopted to reduce or cease driving while maintaining safe mobility. METHODS A systematic literature search was performed on 11 online databases for quantitative studies describing self-regulation of driving amongst older adults aged 60 years and above from database inception until December 2018. Data were described narratively and, where possible, data were pooled using random-effects meta-analysis. RESULTS Of the 1556 studies identified, 54 studies met the inclusion criteria and 46 studies were included in the meta-analyses. All included studies examined car drivers only. Older adults who were single or female were found to be at higher odds of driving cessation. Physical fitness, mental health, social influence, and support systems received by older adults were important driving forces influencing mobility and adjustments made in their travel patterns. CONCLUSIONS Driving self-regulation amongst older adults is a multifaceted decision, impacting mobility and mental health. Therefore, future interventions and support systems should not only create opportunities for retaining mobility for those who have ceased driving, but also promote better psychological and social well-being for regulators and for those who are transitioning from driving to non-driving status. Practical applications: (a) Engage and educate older adults about self-regulation, including strategies that can be adopted and non-car mobility options available. (b) Expand the research focus to explore potential interactions of factors facilitating or hindering the transition process to develop a more comprehensive framework of self-regulation. (c) Encourage ongoing research to formulate, monitor, and evaluate the effectiveness of policies and interventions implemented. (d) Expand the research horizon to explore and understand the perspectives of older adults from developing countries.
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Affiliation(s)
- Boon Hong Ang
- School of Science, Monash University Malaysia, Malaysia
| | | | - Won Sun Chen
- School of Health Science, Swinburne University of Technology, Australia
| | - Khai Khun Yap
- School of Science, Monash University Malaysia, Malaysia
| | | | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Malaysia; Gerontology Laboratory, Global Asia in the 21(st) Century (GA21) Platform, Monash University Malaysia, Malaysia; School of Pharmacy, Taylor's University, Malaysia.
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Ang BH, Jennifer O, Chen WS, Lee SWH. Factors and challenges of driving reduction and cessation: A systematic review and meta-synthesis of qualitative studies on self-regulation. JOURNAL OF SAFETY RESEARCH 2019; 69:101-108. [PMID: 31235220 DOI: 10.1016/j.jsr.2019.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 01/23/2019] [Accepted: 03/06/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Older adults are at a greater risk of injury and death in a motor-vehicle accident. While the ability to drive safely can be challenging with aging, the concept of self-regulation and associated support system have attracted more attention in recent years, especially in developed countries. This review describes the mechanism and summarizes the potential factors that influenced self-regulation of driving amongst older adults to provide new insights into a broader framework for transportation and safe mobility. METHODS We systematically searched 12 online databases for qualitative studies exploring the experiences of older adults aged 60 years and above on their decision to self-regulate their driving. Thematic synthesis was performed to identify elements influencing driving reduction and cessation. The confidence profile of each findings from the meta-synthesis was appraised using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) tool. RESULTS A total of 17 studies representing views of 712 older adults from four countries were included. Three major themes were identified with each representing a transition phase that can either facilitate or hinder older drivers from ceasing completely or reducing their driving, when transitioning from pre-decision phase to post-cessation phase. CONCLUSIONS Our findings suggest that there is a mismatch between the current traffic collation prevention measures, such as age-specific mandatory license renewal system and travel needs of older adults. As such, it is time for the authorities, researchers, and public from various fields and perspectives to collaborate, sustain, and improve safety and mobility in older adults. Practical applications: Adequate regulations and guidelines from the medical community and legal authorities are warranted to assist older adults and caregivers. Social support (e.g., feedback, assurance, or transportation support) from family members, friends, and healthcare professionals are crucial for a smooth transition. Provision of alternative transportations in rural areas are needed and future interventions should focus on engaging and educating older adults to consider alternative transportation modes for mobility. Age-specific mandatory license renewal procedure can be useful in screening for at-risk groups.
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Affiliation(s)
- Boon Hong Ang
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Oxley Jennifer
- Monash University Accident Research Centre (MUARC), Monash University, Melbourne, Australia
| | - Won Sun Chen
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; School of Pharmacy, Taylor's University, Subang Jaya, Selangor, Malaysia; Gerontechnology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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Makizako H, Shimada H, Hotta R, Doi T, Tsutsumimoto K, Nakakubo S, Makino K. Associations of Near-Miss Traffic Incidents with Attention and Executive Function among Older Japanese Drivers. Gerontology 2018; 64:495-502. [DOI: 10.1159/000486547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 12/30/2017] [Indexed: 11/19/2022] Open
Abstract
Background: Attention and executive function may play an important role in ensuring safe driving as they involve paying attention to complex information and making an instantaneous judgment during driving. We hypothesized that poor performance in attention and executive function may increase the risk of near-miss incidents among older drivers. Objective: The aim of this study was to examine associations of current experience of near-miss traffic incidents with attention and executive function among older Japanese drivers. Methods: The study included 3,421 general older drivers (mean age: 71.7 ± 4.9 years; 56.3% men) with a valid driver’s license who were currently driving at least once per week and who had participated in a community-based cohort study between February 2015 and August 2016. The participants were asked about their experiences of near-miss traffic incidents in 10 situations that had almost happened during driving in the previous year. Results: Of the 3,421 older drivers, 1,840 (53.8%) had experienced near-miss incidents during driving in the previous year at least once. Male sex (OR 1.46, 95% CI 1.27–1.69) and high driving frequency (OR 1.11, 95% CI 1.07–1.15) were significantly associated with the current experience of near-miss traffic incidents when the overall data were analyzed. In young-old drivers aged 65–74 years, poor performance in attention as assessed by the Trail Making Test-part A (OR 1.45, 95% CI 1.05–2.00) was significantly associated with near-miss traffic incidents. Conclusion: Male sex, high driving frequency, and poor performance in attention (in young-old drivers) were associated with near-miss traffic incidents. Improvement in attention may play a role in decreasing the risk of traffic accidents among older drivers.
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Reliability and validity of the English and Malay versions of the Driving and Riding Questionnaire: a pilot study amongst older car drivers and motorcycle riders. Public Health 2017; 155:8-16. [PMID: 29274898 DOI: 10.1016/j.puhe.2017.11.003] [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] [Received: 04/07/2017] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study aimed to examine the reliability and validity of the English and Malay versions of the Driving and Riding Questionnaire. STUDY DESIGN An observational study with a mix-method approach by utilising both questionnaire and short debriefing interviews. METHODS Forward and backward translations of the original questionnaire were performed. The translated questionnaire was assessed for clarity by a multidisciplinary research team, translators, and several Malay native speakers. A total of 24 subjects participated in the pilot study. Reliability (Cronbach's alpha) and validity (content validity) of the original and translated questionnaires were examined. RESULTS The English and Malay versions of the Driving and Riding Questionnaire were found to be reliable tools in measuring driving behaviours amongst older drivers and riders, with Cronbach's alpha of 0.9158 and 0.8919, respectively. For content validity, the questionnaires were critically reviewed in terms of relevance, clarity, simplicity, and ambiguity. The feedback obtained from participants addressed various aspects of the questionnaire related to the improvement of wordings used and inclusion of visual guide to enhance the understanding of the items in the questionnaire. This feedback was incorporated into the final versions of the English and Malay questionnaires. CONCLUSION The findings of this study demonstrated both the English and Malay versions of the Driving and Riding Questionnaire to be valid and reliable.
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Hill LL, Laughlin GA, Bettencourt R, Barrett-Connor E. Associations Between Health and Driving in an Older Adult Cohort in Rancho Bernardo. J Aging Health 2016; 29:1367-1387. [PMID: 27492614 DOI: 10.1177/0898264316661828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to identify the associations between health and health care utilization with driving patterns in a cohort of older adults. METHOD In 2012, a total of 1,826 surviving participants in the Rancho Bernardo cohort were sent a health and driving pattern survey; 1,277 were returned. RESULTS The majority of the respondents (1,151, 91%) were still driving. Older age, female sex, hospitalizations, emergency department (ED) visits and physical therapy visits, neurological disease, depression, limited vision, and limited hearing were associated with non-driving status. A total of 809 (71%) of drivers reported no citations or crashes in the last 5 years. DISCUSSION The vast majority of older drivers in this cohort continued to drive, and did so safely. Health care utilization, medications, medical conditions, and self-assessment of health were associated with non-driving status. Prospective studies are needed to clarify the temporal relationships between these factors.
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Affiliation(s)
- Linda L Hill
- 1 University of California, San Diego, La Jolla, USA
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Kwon M, Huisingh C, Rhodes LA, McGwin G, Wood JM, Owsley C. Association between Glaucoma and At-fault Motor Vehicle Collision Involvement among Older Drivers: A Population-based Study. Ophthalmology 2016; 123:109-16. [PMID: 26459997 PMCID: PMC4695303 DOI: 10.1016/j.ophtha.2015.08.043] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/26/2015] [Accepted: 08/31/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To examine the association between glaucoma and motor vehicle collision (MVC) involvement among older drivers, including the role of visual field impairment that may underlie any association found. DESIGN A retrospective, population-based study. PARTICIPANTS A sample of 2000 licensed drivers aged ≥70 years who reside in north central Alabama. METHODS At-fault MVC involvement over the 5 years before enrollment was obtained from state records. Three aspects of visual function were measured: habitual binocular distance visual acuity, binocular contrast sensitivity (CS), and the binocular driving visual field constructed from combining the monocular visual fields of each eye. Poisson regression was used to calculate crude and adjusted rate ratios (RRs) and 95% confidence intervals (CIs). MAIN OUTCOMES MEASURES At-fault MVC involvement over the 5 years before enrollment. RESULTS Drivers with glaucoma (n = 206) had a 1.65 times higher MVC rate (95% CI, 1.20-2.28; P = 0.002) compared with those without glaucoma after adjusting for age, and mental status. Among those with glaucoma, drivers with severe visual field loss had higher MVC rates (RR, 2.11; 95% CI, 1.09-4.09; P = 0.027), whereas no association was found among those with impaired visual acuity and CS. When the visual field was subdivided into 6 regions (upper, lower, left, and right visual fields; horizontal and vertical meridians), we found that impairment in the left, upper, or lower visual field was associated with higher MVC rates, and an impaired left visual field showed the highest RR (3.16; P = 0.001) compared with other regions. However, no association was found in deficits in the right side or along the horizontal or vertical meridian. CONCLUSIONS A population-based study suggests that older drivers with glaucoma are more likely to have a history of at-fault MVC involvement than those without glaucoma. Impairment in the driving visual field in drivers with glaucoma seems to have an independent association with at-fault MVC involvement, whereas visual acuity and CS impairments do not.
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Affiliation(s)
- MiYoung Kwon
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Carrie Huisingh
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lindsay A Rhodes
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gerald McGwin
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Joanne M Wood
- School of Optometry and Vision Science and Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Cynthia Owsley
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Choi NG, DiNitto DM. Depressive Symptoms Among Older Adults Who Do Not Drive: Association With Mobility Resources and Perceived Transportation Barriers. THE GERONTOLOGIST 2015; 56:432-43. [PMID: 25601389 DOI: 10.1093/geront/gnu116] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 10/22/2014] [Indexed: 11/12/2022] Open
Abstract
PURPOSE OF THE STUDY To examine alternative means of mobility that nondriving older adults rely on and their impact on well-being. DESIGN AND METHODS Data from the 2011 (T1, N = 6,680) and 2012 (T2, N = 5,413) interview waves of the National Health and Aging Trends Study were used to examine sample characteristics by driving status, use of alternative mobility resources, and perceived transportation-related barriers among ex-drivers and nondrivers, and their association with depressive symptoms. RESULTS A majority of nondrivers relied on their informal support system and/or paid assistance to drive them to places. About half reported walking/using a wheelchair or scooter. A significant proportion of never drivers also used public transportation and van/shuttle services, whereas a smaller proportion of ex-drivers used them. Nondrivers who walked for transport had lower depressive symptoms than those who did not walk at either T1 or T2, and perception of transportation barriers to visiting friends/family was associated with higher depressive symptoms at T1 only. IMPLICATIONS Older adults' mobility needs should be met through increasing walkability, public and paratransit transportation, supplemental senior transportation, and increasing informal caregivers-transportation providers' ability to aid older adults.
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Affiliation(s)
- Namkee G Choi
- School of Social Work, The University of Texas at Austin.
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Characterizing functional complaints in patients seeking outpatient low-vision services in the United States. Ophthalmology 2014; 121:1655-62.e1. [PMID: 24768243 DOI: 10.1016/j.ophtha.2014.02.030] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 02/27/2014] [Accepted: 02/27/2014] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To characterize functional complaints of new low-vision rehabilitation patients. DESIGN Prospective observational study. PARTICIPANTS The Low Vision Rehabilitation Outcomes Study recruited 819 patients between 2008 and 2011 from 28 clinical centers in the United States. METHODS New patients referred for low-vision rehabilitation were asked, "What are your chief complaints about your vision?" before their appointment. Full patient statements were transcribed as free text. Two methods assessed whether statements indicated difficulty in each of 13 functional categories: (1) assessment by 2 masked clinicians reading the statement, and (2) a computerized search of the text for specific words or word fragments. Logistic regression models were used to predict the influence of age, gender, and visual acuity on the likelihood of reporting a complaint in each functional category. MAIN OUTCOME MEASURES Prevalence and risk factors for patient concerns within various functional categories. RESULTS Reading was the most common functional complaint (66.4% of patients). Other functional difficulties expressed by at least 10% of patients included driving (27.8%), using visual assistive equipment (17.5%), mobility (16.3%), performing in-home activities (15.1%), lighting and glare (11.7%), and facial recognition and social interactions (10.3%). Good agreement was noted between the masked clinician graders and the computerized algorithm for categorization of functional complaints (median κ of 0.84 across the 13 categories). Multivariate logistic regression models demonstrated that the likelihood of reading difficulties increased mildly with age (odds ratio, 1.4 per 10-year increment in age; 95% confidence interval, 1.3-1.6), but did not differ with visual acuity (P = 0.09). Additionally, men were more likely to report driving difficulties and difficulties related to lighting, whereas women were more likely to report difficulty with either in-home activities or facial recognition or social interaction (P<0.05 for all). Mobility concerns, defined as walking difficulty and out-of-home activities, showed no relationship to gender, age, or visual acuity. CONCLUSIONS Reading was the most commonly reported difficulty, regardless of the patient's diagnosis. Neither visual acuity nor gender were predictive of reading concerns, although, age showed a small effect. Addressing reading rehabilitation should be a cornerstone of low-vision therapy.
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Abstract
Objective: This study aims to identify social, psychological, and biomedical risk factors for current and future driving cessation in older adults. Method: Data from six waves (1998-2008) of the Health and Retirement Study (HRS) were pooled. Participants aged 65 and above were included in the study ( N = 17,349). Results: Multivariate logistic regression models to identify risk factors for current and future driving cessation were consistent (age, gender, education, race, marital status, income, cognitive function, limits in activities of daily living and instrumental activities of daily living, vision, health, diabetes, stroke, arthritis, and hip fracture). Only one variable, falls, was associated with future driving cessation (odds ratio [OR] = 0.92; confidence interval [CI] = [0.85, 1.0]), but not current driving cessation. Discussion: Older age, female gender, and minority race were risk factors for current and future cessation. Adults with arthritis were more likely to keep driving compared with those without arthritis.
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Affiliation(s)
| | - Chae Man Lee
- The University of Massachusetts Boston, Boston USA
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