ObjectivesTo assess crash risk and driving habits associated with chronic medical conditions among drivers entering old age.DesignProspective cohort study.SettingFrench cohort GAZEL.Participants12 460 drivers in the analysis of road traffic crash, among whom 11 670 completed the follow-up period (2007–2014). We assessed driving cessation among 11 633 participants over the same period, and mileage and driving avoidance among the 4973 participants who returned a road safety questionnaire in 2015.Main outcome measuresYearly occurrence of at least one road crash as a driver; time to driving cessation; mileage; driving avoidance: at night, with bad weather, in heavy traffic, with glare conditions, over long distances.ResultsSeveral potentially risky conditions (angina, myocardial infarction, coronary disease; stroke; nephritic colic, urinary stones; glaucoma) were associated with lower mileage and/or driving avoidance and did not increase crash risk. Neither driving avoidance nor lower mileage was found for other conditions associated with an increased crash risk: hearing difficulties (adjusted OR 1.19, 95% CI 1.06 to 1.34); joint disorders (1.17, 95% CI 1.06 to 1.30). Depression, anxietyandstress was associated with an increased crash risk (1.23, 95% CI 1.01 to 1.49) despite increased driving avoidance. Parkinson’s disease was associated with driving cessation (adjusted HR 32.61, 95% CI 14.21 to 65.17).ConclusionsDepending on their condition, and probably on the associated risk perception, drivers entering old age report diverse driving habits. For example, hearing difficulties is a frequent condition, rarely considered a threat to road safety, and nonetheless associated with an increased crash risk.
The number of elderly drivers is rapidly increasing. Older people have an increased frailty and an associated increase in injury susceptibility. Furthermore, driver’s conditions are important factors when assessing fitness to safe driving. The ageing of the population therefore leads to the question of the contribution of chronic medical factors to road traffic crashes involvement among elderly drivers.The GAZEL cohort includes past employees of the electricity and gas French company, who volunteered to participate in a multi-purpose health-related research cohort. Since 1989, participants have been followed up using administrative data and yearly self-administered questionnaires.The study sample consisted in 13 891 participants who were active drivers during the period 2007–2015. Data on road traffic crashes, relevant confounders (age, alcohol consumption, family status and gender) and medical conditions were collected. We will fit a generalized estimating equations model (GEE) after multiple imputation in order to identify medical conditions which are associated with increased odds of road traffic crashes involvement among elderly drivers.To date, this is the largest study of its kind of people aged 60 years or over in France. Prevention could benefit from the evaluation of fitness to drive according to the status of these conditions. However, our study suggests a better understanding of the driving behavior adaptation among older drivers is necessary to apply sensible policies.
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