Frailty phenotype and self-reported crashes and driving space: Baseline AAA LongROAD

Man, Cora; Ng, Linda S.; Molnar, Lisa J.; Eby, David W.; Ryan, Lindsay H.; DiGuiseppi, Carolyn; Strogatz, David; Betz, Marian E.; Hill, Linda; Guralnik, Jack M.; Crowe, Christopher L; Li, Guohua; Mielenz, Thelma J.

doi:10.1016/j.jth.2019.100626

Cited by 7 publications

(8 citation statements)

References 49 publications

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“…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.…”

Section: Discussionmentioning

confidence: 53%

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

et al. 2020

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The US older adult population is projected to considerably increase in the future, and continued driving mobility is important for health aspects in populations with fewer transportation alternatives. This study evaluated whether frailty is associated with low-mileage driving (<1865 miles per year) and driving cessation among older adults. Baseline demographics and health data were collected for 2990 older drivers via in-person assessments and questionnaires, with 2964 reporting baseline frailty data. Multivariable log-binomial regression models were used to evaluate the association between baseline frailty status and low-mileage driving. Multivariable Cox proportional hazards regression were used to evaluate the association between baseline frailty status and driving cessation. For every unit increase in frailty, the estimated adjusted risk of driving fewer than 1865 miles/year increased by 138% (adjusted risk ratio: 2.38, 95% CI: 1.63-3.46). Relative to older drivers who were not frail, the adjusted hazard ratios of driving cessation were 4.15 (95% CI: 1.89-9.10) for those classified as prefrail and 6.08 (95% CI: 1.36-27.26) for those classified as frail. Frailty is positively associated with low-mileage driving status and driving cessation in a dose-response fashion. Public health interventions that reduce frailty, such as physical activity, may help older drivers maintain safe and independent mobility.

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Section: Discussionmentioning

confidence: 53%

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

et al. 2020

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“…Driving frequency was self-reported miles driven per week. This variables was included because driving status is associated with social isolation (3,8,22).…”

Section: Methodsmentioning

confidence: 99%

Rate of Social Isolation by Geographic Location Among Older Adults: AAA LongROAD Study

Lynch

Mielenz

et al. 2021

Front. Public Health

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Introduction: Social isolation is a modifiable risk factor for negative health outcomes among older adults. This work assessed the relationship between geography (i.e., urban vs. non-urban residence) and social isolation in a cohort of older drivers.Methods: The AAA LongROAD cohort with 2,989 older adult drivers from across the country were included. Social isolation was measured at baseline and at two subsequent annual follow-ups using PROMIS v2.0 Social Isolation 4a. The effect of geographic location with social isolation was assessed through with multivariable regression using a generalized estimating equation model.Results: The rate of social isolation in urban areas was 21% lower (adjusted RR 0.79, 95% CI 0.46, 1.36) compared to non-urban areas after adjusting for covariates, though not significant.Discussion: Social isolation is a predictor of poor health outcomes and geographic considerations have been lacking in the literature. The panel data in this analysis provides more evidence for causality though the under-representation of non-urban areas potentially reduces the power for the results.Conclusions: It is important to understand the needs and risk of social isolation in various geographic settings to ensure resources and interventions are appropriately modified for a greater public health impact.

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“…It is defined as "a clinical state in which there is an increase in an individual's vulnerability for developing increased dependency and/or mortality when exposed to a stressor" [196]. One commonly used frailty measure is the frailty phenotype created and validated by Fried and colleagues, which provides a standardized measure based on the assessment of five criteria: unintentional weight loss, weakness, exhaustion, slowness, and low physical activity [197]. An older person is classified as frail when three or more of these five components are present; prefrailty is classified when one or two components exist.…”

Section: Frailtymentioning

confidence: 99%

“…An older person is classified as frail when three or more of these five components are present; prefrailty is classified when one or two components exist. Frailty among older adults is associated with an increased risk of adverse health outcomes, such as falls, incident disability, hospitalization, and crash-related injury or death [197]. In the LongROAD study, the association of frailty with reduced driving space and involvement in motor vehicle crashes was studied.…”

Section: Frailtymentioning

confidence: 99%

“…In the LongROAD study, the association of frailty with reduced driving space and involvement in motor vehicle crashes was studied. 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.…”

Section: Frailtymentioning

confidence: 99%

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Age-Related Diseases and Driving Safety

Falkenstein¹,

Karthaus

Brüne-Cohrs

2020

Geriatrics

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Due to demographic changes, the number of older drivers is steadily increasing. Mobility is highly relevant for leading an independent life in the elderly. It largely depends on car driving, which is a complex task requiring a multitude of cognitive and motor skills vulnerable to age- related functional deterioration. The almost inevitable effects of senescence may be potentiated by age-related diseases, such as stroke or diabetes mellitus. Respective pharmacological treatment may cause side effects, additionally affecting driving safety. The present article reviews the impact of age-related diseases and drug treatment of these conditions on driving fitness in elderly drivers. In essence, we focus on diseases of the visual and auditory systems, diseases of the central nervous system (i.e., stroke, depression, dementia and mild cognitive disorder, and Parkinson’s disease), sleep disorders, as well as cardiovascular diseases, diabetes mellitus, musculoskeletal disorders, and frailty. We will outline the role of functional tests and the assessment of driving behavior (by a driving simulator or in real traffic), as well as the clinical interview including questions about frequency of (near) accidents, etc. in the evaluation of driving fitness of the elderly. We also address the impact of polypharmacy on driving fitness and end up with recommendations for physicians caring for older patients.

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Frailty phenotype and self-reported crashes and driving space: Baseline AAA LongROAD

Cited by 7 publications

References 49 publications

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

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

Rate of Social Isolation by Geographic Location Among Older Adults: AAA LongROAD Study

Age-Related Diseases and Driving Safety

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