Ten Years Down the Road: Predictors of Driving Cessation

Edwards, Jerri D.; Bart, Edward; O’Connor, Melissa; Cissell, Gayla

doi:10.1093/geront/gnp127

Cited by 85 publications

(75 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reduced speed of visual processing/attention (measured with UFOV score) was an independent risk factor in line with studies of driving cessation in aging. 29,30 The UPDRS-ADL score (risk factor for "ex-driver" status in a crosssectional study 31 ) and the daily total levodopa equivalent amount were independent risk factors of future driving cessation in the multivariate model suggesting that these measures better predict future functional impairment compared to the motor UPDRS score in the medicated ("on") phase.…”

Section: Discussionmentioning

confidence: 99%

Real-life driving outcomes in Parkinson disease

Uç¹,

Rizzo

Johnson³

et al. 2011

Neurology

View full text Add to dashboard Cite

Objective: To determine the incidence of and risk factors for driving outcomes in drivers with Parkinson disease (PD). Methods:In a prospective cohort study, we ascertained the time until driving cessation, a crash, or a traffic citation using self-report and state Department of Transportation records in 106 licensed, active drivers with PD and 130 controls.Results: Drivers with PD stopped driving earlier than controls, hazard ratio (95% confidence interval) ϭ 7.09 (3.66-13.75), p Ͻ 0.001. Cumulative incidence of driving cessation at 2 years after baseline was 17.6% (11.5%-26.5%) for PD and 3.1% (1.2%-8.1%) for controls. No significant differences between groups on times to first crash or citation were detected. However, the number of observed crashes was low. Cox proportional hazards models showed that significant baseline risk factors for driving cessation in PD were older age, preference to be driven by somebody else, positive crash history, use of compensatory strategies, low driving exposure, impairments in visual perception (especially visual processing speed and attention) and cognitive abilities, parkinsonism (especially activities of daily living score and total daily dose of antiparkinsonian medications), and higher error counts on a road test. Within PD, crashes were associated with poorer postural stability and history of driving citations, and citations were associated with younger age and road errors at baseline. Conclusions:Drivers with PD are at a higher risk of driving cessation than elderly control drivers. A battery evaluating motor and nonmotor aspects of PD, driving record, and performance can be useful in assessing future driving outcomes in PD. Neurology Cognitive, visual, and motor impairments in Parkinson disease (PD) can affect driving performance on standardized road tests 1-11 and driving simulator experiments. 12-16 Cross-sectional or retrospective surveys show higher rates of driving cessation in PD, 17-21 which may lead to greater inactivity, social isolation, depression, and caregiver burden. 22,23 Driving simulation studies have shown increased crash rates in PD 13,16 and retrospective surveys have suggested increased crashes in drivers with PD. 17,19 However, real-life driving outcomes in PD have not been determined in prospective, controlled PD cohort studies. 21This study examines the real-life outcomes in a PD driver cohort, whose baseline features, experimental road test, and driving simulator performance were reported previously. 1,5,6,8,16 The main outcome measures in this study were time to driving cessation, time to first crash, and time to first citation. We hypothesized that the incidence of unfavorable real-life driving outcomes in drivers with PD would be higher than in neurologically normal control drivers,

show abstract

Section: Discussionmentioning

confidence: 99%

Real-life driving outcomes in Parkinson disease

Uç¹,

Rizzo

Johnson³

et al. 2011

Neurology

View full text Add to dashboard Cite

show abstract

“…Just over one half (140 of 263, 53 per cent) of the current drivers reported that they felt that their cataract had affected their driving, including reduced confidence (53), reduced number of hours or distance driven (41), reduced speed compared to traffic flow (26), dependency on someone else to drive around (eight), avoidance of driving in rain (36), at night (85), in traffic (15), unfamiliar areas (28) or long distances (20), specific visual disturbances (36) including blur, glare, refractive change and other miscellaneous impacts (nine). Total weekly driving exposure varied greatly among participants.…”

Section: Self-reported Driving Difficulty and Exposurementioning

confidence: 99%

Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists

Keay

Palagyi

et al. 2016

Clinical and Experimental Optometry

View full text Add to dashboard Cite

Background: Although cataract surgery can restore sight, lengthy waiting times are common in public hospitals in Australia. We investigated the driving status of older people during their surgical waiting period. Methods: Baseline, cross-sectional data from two prospective cohort studies of patients aged 50 years and older on Australian public hospital cataract surgery waiting lists were analysed. Participants underwent assessment of vision and completed the Driving Habits Questionnaire. The vision status was compared between current drivers and former drivers. Results: Participants (n = 442) were on average 73 ± 8 years of age and approximately half were women (229/442, 52 per cent). Habitual vision was 6/12 +2 on average (0.26 ± 0.21 logMAR).There were 263 (60 per cent) current drivers, 110 (25 per cent) former drivers and 69 participants (16 per cent) who had never driven. Among the current drivers, 82/263 (31 per cent) failed visual acuity requirements for an unconditional drivers' license (6/12 acuity with one or both eyes). The former drivers had worse visual acuity than the current drivers (between group difference 0.12 ± 0.20 logMAR, p < 0.0001) and worse contrast sensitivity (between group difference À0.14 ± 0.22 log units, p < 0.0001). Both high contrast visual acuity and contrast sensitivity were independently associated with still driving. More than half (140/263, 53 per cent) of the drivers believed that their cataract had affected their driving and 23 current drivers (nine per cent) reported a crash in the last 12 months. Conclusion:We report on the level of visual impairment among older drivers waiting for cataract surgery. Approximately one-third did not meet the required visual acuity standard for driving and hence would require further ophthalmic assessment and a conditional license to continue to drive. Approximately one-quarter of the surgical candidates were no longer driving and this was associated with greater visual impairment. These findings support a need for timely and appropriately prioritised access to cataract surgical services.

show abstract

“…Calculations were based on cognitive impairment as the exposure variable of primary interest, as cognitive impairment is consistently reported to be a strong predictor of crash involvement and driving cessation in older adults (Edwards et al 2010). The incidence of mild cognitive impairment in older adults is about 5 per 100 person-years (Wouters et al 2010), the incidence of crashes in older adult drivers is about 5 per 100 person-years (Staplin et al 2003), and the risk ratio of crash involvement associated with mild cognitive impairment is reported to be 4.2 (Wadley et al 2009).…”

Section: Sample Size Estimation and Statistical Analysismentioning

confidence: 99%

Longitudinal Research on Aging Drivers (Longroad): Study Design and Methods

2017

Innovation in Aging

View full text Add to dashboard Cite

Background: As an important indicator of mobility, driving confers a host of social and health benefits to older adults. Despite the importance of safe mobility as the population ages, longitudinal data are lacking about the natural history and determinants of driving safety in older adults. Methods: The Longitudinal Research on Aging Drivers (LongROAD) project is a multisite prospective cohort study designed to generate empirical data for understanding the role of medical, behavioral, environmental and technological factors in driving safety during the process of aging. Results: A total of 2990 active drivers aged 65-79 years at baseline have been recruited through primary care clinics or health care systems in five study sites located in California, Colorado, Maryland, Michigan, and New York. Consented participants were assessed at baseline with standardized research protocols and instruments, including vehicle inspection, functional performance tests, and "brown-bag review" of medications. The primary vehicle of each participant was instrumented with a small data collection device that records detailed driving data whenever the vehicle is operating and detects when a participant is driving. Annual follow-up is being conducted for up to three years with a telephone questionnaire at 12 and 36 months and in-person assessment at 24 months. Medical records are reviewed annually to collect information on clinical diagnoses and healthcare utilization. Driving records, including crashes and violations, are collected annually from state motor vehicle departments. Pilot testing was conducted on 56 volunteers

show abstract

Ten Years Down the Road: Predictors of Driving Cessation

Cited by 85 publications

References 41 publications

Real-life driving outcomes in Parkinson disease

Real-life driving outcomes in Parkinson disease

Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists

Longitudinal Research on Aging Drivers (Longroad): Study Design and Methods

Contact Info

Product

Resources

About