Chronic medical conditions and their association with crash risk and changes in driving habits: a prospective study of the GAZEL cohort

Abstract

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.

Prescribed anti‐glaucoma medication consumption and road traffic crash

“…A great array of studies has also documented that in older drivers glaucoma is associated with driving avoidance, lower density driving and driving mileage, and less driving in challenging situations (such as at night, on the highway, etc.) 6,19,23 . Reduced driving exposure and increased apparent self‐regulatory practices were also exhibited by the elderly with vision deficits, such as older drivers aged 70 years or over with contrast sensitivity impairment 45 .…”

“…44 A great array of studies has also documented that in older drivers glaucoma is associated with driving avoidance, lower density driving and driving mileage, and less driving in challenging situations (such as at night, on the highway, etc.). 6,19,23 Reduced driving exposure and increased apparent self-regulatory practices were also exhibited by the elderly with vision deficits, such as older drivers aged 70 years or over with contrast sensitivity impairment. 45 Since driving self-restriction was associated with a reduced prevalence of vehicle collision in male drivers with glaucoma, 44 individuals with glaucoma should be aware of their medical conditions and self-regulate in driving to mitigate potential traffic crash risks.…”

“…13,[16][17][18] Both findings from the real-world and simulation studies yield conflicts. For example, one French cohort study indicated that glaucoma did not increase crash risk, 19 whereas other studies reported drivers with glaucoma are more prone to traffic crash involvement than those without glaucoma in both the real-world and simulation studies. 13,18,[20][21][22] The areas and degrees of visual field impairment probably play a key role here but no study was able so far to characterize it.…”

“…It should be noted that a consistency observed among most studies is that individuals with glaucoma are more likely to self-regulate and restrict their driving, especially in highly demanding situations. 6,17,19,23 However, the simulation studies were not capable of reflecting the selfregulation behaviors on driving that people imposed.…”

Velocidade da Marcha e Força de Preensão Manual: Indicadores das Condições Físicas de Idosos Submetidos à Avaliação para Habilitação Veicular

“…; glaucoma) foram associadas com menor quilometragem e/ou evitar dirigir e não aumentaram o risco de acidente. Depressão, ansiedade e estresse foram associados a maior risco de acidente (1,23, IC 95% 1,01-1,49)(Naredo Turrado et al, 2021). O evento acidente de trânsito foi reportado por uma parcela pequena dos participantes.…”