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Liang D, Lau N, Antin JF. Modeling of older adults' driving exposure and avoidance using objective driving data in a naturalistic driving study. ACCIDENT; ANALYSIS AND PREVENTION 2022; 174:106728. [PMID: 35689967 DOI: 10.1016/j.aap.2022.106728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 05/13/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Older adults in the United States rely heavily on driving their own vehicles to commute to work, shop for groceries, and access public services. To effectively help older adults maintain mobility and independence,we need to better understand how thecognitive, visual functioning, and health declines influence their tendency to self-restrict their driving. The objective of this study is to develop a causal model to examine the effects of age, gender, household status (specifically living alone), physical, cognitive, visual abilities, and health status on older adults' driving mobility in terms of driving exposure and avoidance. Driving exposure was measured by actual driving data, whereas driving avoidance was assessed by both self-report data and actual driving exposure to challenging situations. Structural equation modeling was used to analyze data collectedin the Second Strategic Highway Research Program Naturalistic Driving Study for establishing relationships between the selected factors and mobility. The structural equation model included a total of794 participants aged 65 and over (367 or 46.22%femalesand 427 or 53.78% males). Results indicate that poorer health is associated with less driving exposure; deteriorating cognitive and physical capabilities are associated with more self-reported driving avoidance and less actual driving in challenging situations; visual function is associated with self-reported avoidance; living alone is associated with higher driving exposure in general as well as in challenging situations; self-reported driving avoidance of challenging situations has a negative association with actual driving in those same situations. The final model could be applied to predict older adults' mobility changes according to their age, gender, household status, as well as their visual, physical, cognitive and health status.
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Affiliation(s)
- Dan Liang
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24060, United States.
| | - Nathan Lau
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24060, United States.
| | - Jonathan F Antin
- Virginia Tech Transportation Institute, Blacksburg, VA 24060, United States.
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White J, Hambisa MT, Cavenagh D, Dolja-Gore X, Byles J. Understanding the relationship between eye disease and driving in very old Australian women: a longitudinal thematic evaluation. BMC Ophthalmol 2022; 22:277. [PMID: 35751055 PMCID: PMC9233390 DOI: 10.1186/s12886-022-02506-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background Over recent decades an increasing number of adults will retain their driver’s licenses well into their later years. The aim of this study was to understand and explore the experience of driving and driving cessation in very old Australian women with self-reported eye disease. Methods An interpretative qualitative study. Participants were from the Australian Longitudinal Study on Women’s Health (cohort born in 1921–26), a sample broadly representative of similarly aged Australian women. Responses to open-ended questions were analysed using an inductive thematic approach, employing a process of constant comparison. Results Qualitative data were from 216 older women with eye disease who made 2199 comments about driving, aged between 70 and 90 years depending on the timing of their comments. Themes included: (1) Access to treatment for eye disease promotes driving independence and quality of life; (2) Driving with restrictions for eye disease enables community engagement and (3) Driving cessation due to poor vision leads to significant lifestyle changes. Conclusions Key findings highlighted driving cessation, or reduction, is often attributed to deterioration in vision. The consequence is dependence on others for transport, typically children and friends. Access to successful treatment for eye disease allowed older women to continue driving. We posit that occupational therapists can play an essential role in promote driving confidence and ability as women age. Trial registration: Not applicable.
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Affiliation(s)
- Jennifer White
- Centre for Women's Health Research, College of Health Medicine and Wellbeing, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.
| | - Mitiku Teshome Hambisa
- Centre for Women's Health Research, College of Health Medicine and Wellbeing, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Dominic Cavenagh
- Centre for Women's Health Research, College of Health Medicine and Wellbeing, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Xenia Dolja-Gore
- Centre for Women's Health Research, College of Health Medicine and Wellbeing, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Julie Byles
- Centre for Women's Health Research, College of Health Medicine and Wellbeing, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
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Sheppard WEA, McCarrick D, Wilkie RM, Baraas RC, Coats RO. A Systematic Review of the Effects of Second-Eye Cataract Surgery on Motor Function. FRONTIERS IN AGING 2022; 3:866823. [PMID: 35821847 PMCID: PMC9261376 DOI: 10.3389/fragi.2022.866823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022]
Abstract
Cataract removal surgery is one of the most commonly performed surgical procedure in developed countries. The financial and staff resource cost that first-eye cataract surgery incurs, leads to restricted access to second-eye cataract surgery (SES) in some areas, including the United Kingdom. These restrictions have been imposed despite a lack of knowledge about the impact of not performing SES on visuo-motor function. To this end, a systematic literature review was carried out, with the aim of synthesising our present understanding of the effects of SES on motor function. Key terms were searched across four databases, PsycINFO, Medline, Web of Science, and CINAHL. Of the screened studies (K = 499) 13 met the eligibility criteria. The homogeneity between participants, study-design and outcome measures across these studies was not sufficient for meta-analyses and a narrative synthesis was carried out. The evidence from objective sources indicates a positive effect of SES on both mobility and fall rates, however, when considering self-report measures, the reduction in falls associated with SES becomes negligible. The evidence for any positive effect of SES on driving is also mixed, whereby SES was associated with improvements in simulated driving performance but was not associated with changes in driving behaviours measured through in vehicle monitoring. Self-report measures of driving performance also returned inconsistent results. Whilst SES appears to be associated with a general trend towards improved motor function, more evidence is needed to reach any firm conclusions and to best advise policy regarding access to SES in an ageing population. Systematic Review Registration:https://osf.io/7hne6/, identifier INPLASY2020100042.
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Speed management across road environments of varying complexities and self-regulation behaviors in drivers with cataract. Sci Rep 2022; 12:6951. [PMID: 35484276 PMCID: PMC9051061 DOI: 10.1038/s41598-022-10952-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/15/2022] [Indexed: 11/08/2022] Open
Abstract
Evidence suggests that drivers with cataract self-regulate their driving, but there is a lack of objective information. This study compared speed behavior in older drivers with and without cataract and how the parameter is influenced by road traffic complexity and driver characteristics. The study included 15 drivers with cataract and a control group of 20 drivers. Visual status was assessed using visual acuity, contrast sensitivity, and intraocular straylight. Speed management was studied using a driving simulator. Driving difficulty and self-regulation patterns were evaluated by means of the Driver Habits Questionnaire (DHQ). The cataract group showed a significant decrease in visual function in all the parameters evaluated (p < 0.05). These drivers tended to drive at lower speeds than the control group. Road characteristics, gender, and intraocular straylight in the better eye were identified as significant predictors of speed management. Drivers with cataract experience greater driving difficulty, particularly when driving at night (p < 0.05). Drivers with cataract reduce their driving speed more than older drivers without visual impairment. The straylight parameter may be a good indicator of each driver's subjective perception of their own visual ability to drive. This work helps shed light on the mechanisms through which age-related visual impairment influences driving behavior.
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Aggressive Driving Behaviours in Cannabis Users. The Influence of Consumer Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083911. [PMID: 33917856 PMCID: PMC8068208 DOI: 10.3390/ijerph18083911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/30/2022]
Abstract
This study analysed dangerous driving behaviours in twenty young occasional cannabis users through objective and self-reported data, studying the relationship between the two aspects. Visual function was assessed in a baseline session and after smoking cannabis, as well as speed-related behaviour in a driving simulator. The participants responded to questionnaires on sociodemographic factors, their consumption profile, and the incidence of dangerous behaviours (Dula Dangerous Driving Index; DDDI). After cannabis use, the results revealed a significant deterioration in visual function. In terms of speed management, they showed significantly greater acceleration force in the two different sections of the route, and they drove significantly faster. Our correlations indicate that males and heavier users display more risky speed management. Likewise, the heavier cannabis users admitted to increased dangerous driving behaviour, and an accident in the preceding year was associated with a trend towards aggressive driving behaviour according to the DDDI questionnaire. The findings of this study suggest that cannabis users adopt dangerous behaviours when driving, despite the effect this drug has on certain important functions, such as vision. The results suggest a need for awareness-raising and information campaigns.
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Abstract
Safe driving demands the coordination of multiple sensory and cognitive functions, such as vision and attention. Patients with neurologic or ophthalmic disease are exposed to selective pathophysiologic insults to driving-critical systems, placing them at a higher risk for unsafe driving and restricted driving privileges. Here, we evaluate how vision and attention contribute to unsafe driving across different patient populations. In ophthalmic disease, we focus on macular degeneration, glaucoma, diabetic retinopathy, and cataract; in neurologic disease, we focus on Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Unsafe driving is generally associated with impaired vision and attention in ophthalmic and neurologic patients, respectively. Furthermore, patients with ophthalmic disease experience some degree of impairment in attention. Similarly, patients with neurologic disease experience some degree of impairment in vision. While numerous studies have demonstrated a relationship between impaired vision and unsafe driving in neurologic disease, there remains a dearth of knowledge regarding the relationship between impaired attention and unsafe driving in ophthalmic disease. In summary, this chapter confirms-and offers opportunities for future research into-the contribution of vision and attention to safe driving.
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Affiliation(s)
- David E Anderson
- Department of Ophthalmology & Visual Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Deepta A Ghate
- Department of Ophthalmology & Visual Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Matthew Rizzo
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States.
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Derhy D, Lithfous S, Speeg C, Gaucher D, Despres O, Dufour A, Bourcier T, Sauer A. Driving Skills Tested on Simulator After Strabismus Surgery: A Prospective Study. Transl Vis Sci Technol 2020; 9:36. [PMID: 32855882 PMCID: PMC7422777 DOI: 10.1167/tvst.9.8.36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/10/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose The sense of vision is responsible for 90% of the information obtained by the motorist. Improvement in binocular visual acuity (VA) and visual field (VF) achieved after strabismus surgery could have beneficial effects on driving. Our study sought to identify functional improvements (VA and VF) and improvements in driving ability following strabismus surgery. Methods In a prospective cohort study, the following parameters are analyzed before and 3 months after strabismus surgery: simulated driving performance (including eye movements and actions on vehicle control), binocular VA, binocular VF, and self-confidence during driving. Results Twenty patients participated in the study. The mean preoperative logMAR binocular VA and stereopsis do not significantly differ from the postoperative. The mean Esterman VF score increases from 91.3 (±17.2) preoperatively to 96.9 (±13.9) postoperatively (P = 0.045). The mean self-confidence directed at driving scores decreases from 20.5 (±10.3) points before surgery to 11.0 (±6.0) points after surgery (P < 0.001). The distance at which the road signs are identified is significantly higher after surgery. The average speed of the vehicle and the speed near the targets (30 m) increase significantly after strabismus surgery. A significant decrease in ocular movements near targets is also observed. The number of brake pedal depressions and the rate of brake pedal depressions slightly decrease after surgery. Conclusions This study demonstrates the potential beneficial effects of strabismus surgery on driving ability, with significant improvements in self-confidence during driving, VF, and driving on a simulator. Translational Relevance This was the first study to use a driving simulator in strabismus.
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Affiliation(s)
- Dan Derhy
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Ségolène Lithfous
- CI2N, Centre d'Investigations Neurocognitives & Neurophysiologiques UMS 3489 CNRS / UdS . Strasbourg, France
| | - Claude Speeg
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - David Gaucher
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Olivier Despres
- CI2N, Centre d'Investigations Neurocognitives & Neurophysiologiques UMS 3489 CNRS / UdS . Strasbourg, France
| | - André Dufour
- CI2N, Centre d'Investigations Neurocognitives & Neurophysiologiques UMS 3489 CNRS / UdS . Strasbourg, France
| | - Tristan Bourcier
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Arnaud Sauer
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
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Webber KJ, Fylan F, Wood JM, Elliott DB. Experiences following cataract surgery - patient perspectives. Ophthalmic Physiol Opt 2020; 40:540-548. [PMID: 32654259 DOI: 10.1111/opo.12709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/20/2020] [Accepted: 05/19/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Most patients report being highly satisfied with the outcome of cataract surgery but there are variable reports regarding the impact of cataract surgery on some real-world activities, such as fall rates. We hypothesised that adaptations to changed refractive correction and visual function may cause difficulties in undertaking everyday activities for some patients and used a series of focus groups to explore this issue. METHOD Qualitative methods were used to explore patients' experiences of their vision following cataract surgery, including adaptation to vision changes and their post-surgical spectacle prescription. Twenty-six participants took part in five focus groups (Mean age = 68.2 ± 11.4 years), and the data were analysed using thematic analysis. RESULTS We identified three themes. 'Changes to Vision' explores participants' adaptation following cataract surgery. While several had problems with tasks relying on binocular vision, few found them bothersome and they resolved following second eye surgery. Participants described a trial and error approach to solving these problems rather than applying solutions suggested by their eyecare professionals. 'Prescription Restrictions' describes the long-term vision problems that pre-surgery myopic patients experienced as a consequence of becoming emmetropic following surgery and thus needing spectacles for reading and other close work activities, which they did not need before surgery. Very few reported that they had the information or time to make a decision regarding their post-operative correction. 'Information Needs' describes participant's responses to the post-surgical information they were given, and the unmet information need regarding when they can drive following surgery. CONCLUSION The findings highlight the need for clinicians to provide information on adaptation effects, assist patients to select the refractive outcome that best suits their lifestyle, and provide clear advice about when patients can start driving again. Patients need to be provided with better guidance from clinicians and prescribing guidelines for clinicians would be beneficial, particularly for the period between first- and second-eye surgery.
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Affiliation(s)
- Kathryn J Webber
- School of Optometry and Vision Science, University of Bradford, West Yorkshire, UK
| | - Fiona Fylan
- Leeds Sustainability Institute, Leeds Beckett University, Leeds, UK
| | - Joanne M Wood
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - David B Elliott
- School of Optometry and Vision Science, University of Bradford, West Yorkshire, UK
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2015 Glenn A. Fry Award Lecture: Driving toward a New Vision: Understanding the Role of Vision in Driving. Optom Vis Sci 2019; 96:626-636. [DOI: 10.1097/opx.0000000000001421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Manda S, Castle R, Hwang AD, Peli E. IMPACT OF HEADLIGHT GLARE ON PEDESTRIAN DETECTION WITH UNILATERAL CATARACT. PROCEEDINGS OF THE ... INTERNATIONAL DRIVING SYMPOSIUM ON HUMAN FACTORS IN DRIVER ASSESSMENT, TRAINING, AND VEHICLE DESIGN 2019; 2019:36-42. [PMID: 31423491 PMCID: PMC6698325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Detecting pedestrians while driving at night is difficult, and is further impeded by oncoming headlight glare (HLG). Cataracts increase intraocular light scattering, making the task even more challenging. We used a within-subjects repeated measures design to determine the impact of HLG on driving with unilateral cataract. Pedestrian detection performance of six young normal vision (NV) subjects was measured with clear lens glasses and with simulated unilateral cataract (0.8 Bangerter foil) glasses. The subjects drove night-time scenarios in a driving simulator with and without custom simulated headlight glare. With simulated unilateral cataracts, pedestrian detection rates decreased and response times increased with oncoming HLG. We verified these effects with six patients who already underwent cataract surgery for one eye and were scheduled to get cataract surgery in the other eye. We measured their performance before and after the second cataract surgery. The results were similar to those obtained with the simulated unilateral cataract, confirming that a negative impact of HLG persists with untreated cataract in one eye.
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Affiliation(s)
- Sailaja Manda
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Rachel Castle
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Alex D Hwang
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Eli Peli
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Meuleners LB, Feng YR, Fraser M, Brameld K, Chow K. Impact of first and second eye cataract surgery on physical activity: a prospective study. BMJ Open 2019; 9:e024491. [PMID: 30898810 PMCID: PMC6475349 DOI: 10.1136/bmjopen-2018-024491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To investigate the impact of first eye and second eye cataract surgery on the level of physical activity undertaken by older adults with bilateral cataract. DESIGN Prospective cohort study. SETTING Three public ophthalmology clinics in Western Australia. PARTICIPANTS Fifty-five older adults with bilateral cataract aged 55+ years, awaiting first eye cataract surgery. OUTCOME MEASURES The primary outcome measure was participation in moderate leisure-time physical activity. The secondary outcomes were participation in walking, gardening and vigorous leisure-time physical activity. Participants completed a researcher-administered questionnaire, containing the Active Australia Survey and visual tests before first eye cataract surgery, after first eye surgery and after second eye surgery. A Generalised Estimating Equation linear regression model was undertaken to analyse the change in moderate leisure-time physical activity participation before first eye surgery, after first eye surgery and after second eye surgery, after accounting for relevant confounders. RESULTS Participants spent significantly less time per week (20 min) on moderate leisure-time physical activity before first eye cataract surgery compared with after first eye surgery (p=0.04) after accounting for confounders. After second eye cataract surgery, participants spent significantly more time per week (32 min) on moderate physical activity compared with after first eye surgery (p=0.02). There were no significant changes in walking, gardening and vigorous physical activity throughout the cataract surgery process. CONCLUSION First and second eye cataract surgery each independently increased participation in moderate leisure-time physical activity. This provides a rationale for timely first and second eye cataract surgery for bilateral cataract patients, even when they have relatively good vision.
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Affiliation(s)
- Lynn B Meuleners
- Curtin-Monash Accident Research Centre, Curtin University, Perth, Western Australia, Australia
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Meuleners LB, Brameld K, Fraser ML, Chow K. The impact of first- and second-eye cataract surgery on motor vehicle crashes and associated costs. Age Ageing 2019; 48:128-133. [PMID: 30265273 DOI: 10.1093/ageing/afy156] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/12/2018] [Indexed: 11/15/2022] Open
Abstract
Objective to evaluate the association between first- and second-eye cataract surgery and motor vehicle crashes for older drivers and the associated costs to the community. Design retrospective population-based cohort study. Subjects a total of 2,849 drivers aged 60 years and older who had undergone both first- and second-eye cataract surgery were involved in 3,113 motor vehicle crashes as drivers during the study period. Methods de-identified data were obtained using the Western Australian Data Linkage System from 1 January 2003 to 31 December 2015. Poisson regression analysis based on Generalised Estimating Equations was undertaken to compare the frequency of crashes in the year before first eye cataract surgery, between first and second eye surgery and 1 year after second eye surgery. Results first eye cataract surgery was associated with a significant 61% reduction in crash frequency (P < 0.001) and second eye surgery was associated with a significant 23% reduction in crashes (P < 0.001), compared to the year before first eye cataract surgery after accounting for age, gender, marital status, accessibility, socio-economic status, driving exposure and comorbidities. The estimated cost savings from the reduction in crashes in the year after second eye cataract surgery compared to the year before first eye cataract surgery was $14.9 million. Conclusions first- and second-eye cataract surgery were associated with a significant reduction in motor vehicle crashes, with first eye surgery having the greatest impact. These results provide encouragement for the timely provision of first- and second-eye cataract surgery for older drivers.
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Affiliation(s)
- Lynn B Meuleners
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, Perth, Western Australia, Australia
| | - Kate Brameld
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, Perth, Western Australia, Australia
| | - Michelle L Fraser
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, Perth, Western Australia, Australia
| | - Kyle Chow
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, Perth, Western Australia, Australia
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