Differences in Driving Outcomes Among Cognitively Normal African American and Caucasian Older Adults

Babulal, Ganesh M.; Stout, Sarah H.; Williams, Monique; Rajasekar, Ganesh; Harmon, Annie C.; Vivoda, Jonathon M.; Zuelsdorff, Megan; Benzinger, Tammie L.S.; Morris, John C.; Ances, Beau M.; Roe, Catherine M.

doi:10.1007/s40615-019-00655-z

Cited by 4 publications

(9 citation statements)

References 53 publications

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“…Other research among persons of all ages also indicates that African-Americans 14 are more likely to exhibit some of these COVID-19 prevention strategies such as mask waring. Additionally, African Americans also had a lower proportion of days driving during the later part of the year, which is in line with findings from before the COVID-19 pandemic showing African Americans face a greater risk of driving decline compared to whites (Babulal et al, 2020). A potential explanation for this trend might be that because African Americans experience a disproportionate burden in morbidity and mortality from the COVID-19 virus, (Andrasfay & Goldman, 2021) they are especially aware of the disabling and deadly effects of COVID-19 and are therefore more likely to take precautionary measures such as masking and cleaning.…”

Section: Gender and Race Differences In Pandemic-related Behaviorssupporting

confidence: 86%

Driving, Social Distancing, Protective, and Coping Behaviors of Older Adults Before and During COVID-19

Roe¹,

Bayat

Hicks

et al. 2022

J Appl Gerontol

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A thorough understanding of individual characteristics of older adults during the COVID-19 pandemic is critical for managing the ongoing pandemic course and planning for the future pandemics. Here, we explore the impact of the COVID-19 pandemic on driving, social distancing, protective, and coping behaviors of older adults. This study reports data on participants aged above 65 whose driving behaviors are being monitored using Global Positioning System (GPS) devices. Participants completed a COVID-19 survey in May 2020. We found that older adults decreased their number of days driving, number of trips per day, as well as average driving speed, and had fewer speeding incidents following COVID-19 onset. We also show that female and African American older adults engaged in more positive coping and cleaning behaviors, and had greater decreases in the number of days driving during the pandemic. The findings highlight the importance of considering older adults’ individual characteristics for an equitable response to the COVID-19 pandemic.

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Section: Gender and Race Differences In Pandemic-related Behaviorssupporting

confidence: 86%

Driving, Social Distancing, Protective, and Coping Behaviors of Older Adults Before and During COVID-19

Roe¹,

Bayat

Hicks

et al. 2022

J Appl Gerontol

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“…Additionally, bias may have existed in terms of overconfidence in driving abilities and could have attributed to the perceived driving difficulty in risky driving situations. Naturalistic studies that rely on non-obtrusive recordings of driver behavior and patterns could remedy this potential limitation as seen in Babulal et al (2020) who found evidence of mobility decline using both measurement methods.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to one other recent study (Babulal et al (2020), we expanded this prior work by examining more subtle variations in driving mobility captured by driving space, driving exposure, and difficulty driving. Like Babulal et al (2020), we found that Black older adults reported more restricted driving space compared to White older adults. However, Babulal et al (2020) also found race differences in driving exposure and driving difficulty and used naturalistic driving methodology to validate self-reported findings that showed Black older adults in that sample had a faster rate of change in driving exposure metrics when compared to White older adults.…”

Section: Discussionmentioning

confidence: 99%

Social and Neighborhood Context Moderates the Associations Between Processing Speed and Driving Mobility: A 10-year Analysis of the ACTIVE Study

Pope,

Wheeler,

Bell

et al. 2023

J Aging Health

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Objectives: Processing speed is essential to functional independence in later life, such as driving a vehicle. Few studies have examined processing speed and driving mobility in the context of racial differences and social determinants of health (SDoH). This study characterized the longitudinal association between processing speed and driving mobility, and how it varied by race and SDoH. Methods: Using data from the control arm of the Advanced Cognitive Training in Vital Elderly study ( n = 581, 24.5% Black), multilevel models examined longitudinal associations between processing speed and driving mobility outcomes (driving space, exposure, and difficulty). Race and SDoH moderations were explored. Results: Decline in processing speed measures was associated with increased self-reported driving difficulty, but only for older adults with below-average to average scores for neighborhood and built environments and social community context SDoH domains. Discussion: Findings emphasize the influence of physical and social environmental characteristics on processing speed and driving mobility.

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“…Drivers 65 years and older who are racialized as Black have a higher risk of driving reduction, mobility restriction, and driving cessation compared to their non-Hispanic White counterparts. 19,20 Given the projected growth of the aging population, number of crashes and injuries among older drivers, and risk of polypharmacy and multimorbidity, driving ability and safety remain top public health priorities.…”

Section: Introductionmentioning

confidence: 99%

“…Among systematic meta-analyses in older adult samples, poorer driving performance was consistently identified for specific medical conditions (eg, dementia, Parkinson disease, and stroke). Drivers 65 years and older who are racialized as Black have a higher risk of driving reduction, mobility restriction, and driving cessation compared to their non-Hispanic White counterparts . Given the projected growth of the aging population, number of crashes and injuries among older drivers, and risk of polypharmacy and multimorbidity, driving ability and safety remain top public health priorities.…”

Section: Introductionmentioning

confidence: 99%

Medication and Road Test Performance Among Cognitively Healthy Older Adults

Carr,

Beyene,

Doherty

et al. 2023

JAMA Netw Open

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ImportanceOlder adults are increasingly prescribed medications that have adverse effects. Prior studies have found a higher risk of motor vehicle crashes to be associated with certain medication use.ObjectiveTo determine whether specific medication classes were associated with performance decline as assessed by a standardized road test in a community sample of cognitively healthy older adults, to evaluate additional associations of poor road test performance with comorbid medical conditions and demographic characteristics, and to test the hypothesis that specific medication classes (ie, antidepressants, benzodiazepines, sedatives or hypnotics, anticholinergics, antihistamines, and nonsteroidal anti-inflammatory drugs or acetaminophen) would be associated with an increase in risk of impaired driving performance over time.Design, Setting, and ParticipantsThis was a prospective cohort study of 198 cognitively healthy adults 65 years and older with a valid driver’s license who were followed up annually, with rolling enrollment. Data were collected from participants in St Louis, Missouri, and neighboring Illinois who were enrolled in the Knight Alzheimer’s Disease Research Center. Data were collected from August 28, 2012, to March 14, 2023, and analyzed from April 1 to 25, 2023. Participants with healthy cognition, defined as a Clinical Dementia Rating score of 0 at baseline and subsequent visits, who had available clinical, neuropsychological, road tests, and self-reported medication data were included.ExposurePotentially driver-impairing medication use.Main Outcomes and MeasuresThe primary outcome measure was performance on the Washington University Road Test (pass or marginal/fail). Multivariable Cox proportional hazards models were used to evaluate associations between potentially driver-impairing medication use and road test performance.ResultsOf the 198 included adults (mean [SD] baseline age, 72.6 [4.6] years; 87 female [43.9%]), 70 (35%) received a marginal/fail rating on the road test over a mean (SD) follow-up of 5.70 (2.45) years. Any use of antidepressants (adjusted hazard ratio [aHR], 2.68; 95% CI, 1.69-4.71), serotonin and norepinephrine reuptake inhibitors (aHR, 2.68; 95% CI, 1.54-4.64), sedatives or hypnotics (aHR, 2.70; 95% CI, 1.40-5.19), or nonsteroidal anti-inflammatory drugs (aHR, 2.72; 95% CI, 1.31-5.63) was associated with an increase in risk of receiving a marginal/fail rating on the road test compared with control individuals. Conversely, participants taking lipid-lowering agents had a lower risk of receiving a marginal/fail rating compared to control individuals. There were no statistically significant associations found between anticholinergic or antihistamines and poor performance.Conclusions and RelevanceIn this prospective cohort study, specific medication classes were associated with an increase in risk of poor road test performance over time. Clinicians should consider this information and counsel patients accordingly when prescribing these medications.

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Differences in Driving Outcomes Among Cognitively Normal African American and Caucasian Older Adults

Cited by 4 publications

References 53 publications

Driving, Social Distancing, Protective, and Coping Behaviors of Older Adults Before and During COVID-19

Driving, Social Distancing, Protective, and Coping Behaviors of Older Adults Before and During COVID-19

Social and Neighborhood Context Moderates the Associations Between Processing Speed and Driving Mobility: A 10-year Analysis of the ACTIVE Study

Medication and Road Test Performance Among Cognitively Healthy Older Adults

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