Association of Physical Function With Driving Space and Crashes Among Older Adults

Abstract

Background and Objectives Balancing both driver mobility and safety is important for the well-being of older adults. However, research on the association of physical function with these 2 driving outcomes has yielded inconsistent findings. This study examined whether physical functioning of older drivers, as measured by the Short Physical Performance Battery (SPPB), is associated with either driving space or crash involvement. Methods Using cross-sectional data of active drivers aged 65–79 years from the AAA Longitudinal Research on Aging Drivers (LongROAD) study (n = 2,990), we used multivariate log-binomial and logistic regressions to estimate the associations of the SPPB with either self-reported restricted driving space in the prior 3 months or any crashes in the past year. Interaction with gender was assessed using likelihood ratio tests. Results After adjustment, older drivers with higher SPPB scores (higher physical functioning) had lower prevalence of restricted driving space (8–10 vs. 0–7, prevalence ratio [PR] = 0.88, 95% confidence interval [CI]: 0.78–0.99; 11–12 vs. 0–7, PR = 0.78, 95% CI: 0.61–0.99). Fair (8–10), but not good (11–12), scores were significantly associated with reduced crash involvement (8–10 vs. 0–7, odds ratio [OR] = 0.71, 95% CI: 0.60–0.84). Gender was not a significant effect modifier. Discussion and Implications This study provides evidence that higher physical functioning is associated with better driving mobility and safety and that the SPPB may be useful for identifying at-risk drivers. Further research is needed to understand physical functioning’s longitudinal effects and the SPPB’s role in older driver intervention programs.

Associations of Frailty Status with Low-Mileage Driving and Driving Cessation in a Cohort of Older Drivers

“…Given previous research, the finding that those with higher levels of the frailty phenotype are more likely to be classified as low-mileage drivers implies that measures of the frailty phenotype may also be used to identify older adults who are more likely to be involved in car crashes. This implication is supported by previous research on the AAA LongROAD cohort by Man et al (2020), which found that being classified as nonfrail was protective against having a self-reported crash rate of one or more crashes in the previous year [29]. If true, this means interventions that aim to reduce the prevalence of frailty may be successful in helping older adults increase their driving exposure [30,31], decrease their overall crash rate, and maintain their driving independence by delaying driving cessation.…”

“…Depression was scored using the Patient-Reported Outcomes Measurement Information System (PROMIS) instruments, with higher scores indicative of more severe depression [20]. Cognitive health was assessed by performance on immediate and delayed word recall tasks, which are designed to test episodic and working memory, with higher scores indicative of better cognitive health [21,22]. To measure driving importance, participants were asked "How important is it that you continue driving?".…”

“…To measure driving importance, participants were asked "How important is it that you continue driving?". Responses ranged from 1 (not at all) to 7 (completely), and were divided into three categories: 1 to 5, 6, and 7 [22]. Age at baseline was categorized as 65-69, 70-74, and 75-79; gender was treated as a binary variable including male and female; highest level of education attained was categorized as high school or less, some college, bachelor's degree, and advanced degree; marital status was categorized as married/living with partner, separated/divorced/never married, and widowed; self-reported vision was categorized as poor to good, very good, and excellent; depression was dichotomized at a T score value of 55; and cognitive health was dichotomized at the median [22,23].…”

Falls in older patients with cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology review paper

“…Notably, the Short Physical Performance Battery (SPPB), a tool that includes static and dynamic balance, gait speed, and repeated chair stands [48] is not included in the mentioned reviews. SPPB scores are predictive of community-dwelling older adults who are at risk for falls [49,50], who might suffer from higher all-cause mortality [51], as well as at-risk drivers who are likely to be in motor vehicle accidents [52]. The SPPB may be a very useful tool for outpatient oncology nurses in identifying older patients who are at risk for falls.…”

Age-Related Diseases and Driving Safety

“…Pre-frail participants had 30% higher odds of reporting involvement in a crash in the prior year than non-frail participants after adjusting for several confounding factors [198]. In a recent Japanese study [199], 349 older drivers were classified in a (pre-)frail and a robust group. Pre-frailty/frailty was associated with more nearmiss traffic incidents compared to robustness.…”