Epidemiology of Elderly Driving Safety

Epidemiology of Elderly Driving Safety

Annotated Bibliography

Ball, K., Edwards, JD, Ross, LA, and McGwin, G. (2010) Cognitive Training Decreases Motor Vehicle Collision Involvement of Older Drivers. The American Geriatrics Society. Journal Compilation. 58:2107-2113.

The work of Ball, Edwards, Ross and McGwin (2010) reports a randomized, controlled, multisite, single-blind clinical trial in a community of seniors in four cities in the United States including Birmingham, Alabama; Baltimore, Maryland, Indianapolis, Indiana, and State College, Pennsylvania. The mean age of drivers in the study was 73.1 years of age with 18.6% of the drivers being African-American. The intervention reported in this study was that of cognitive training for memory, reasoning and speed of processing. Measures used were stated-recorded MVC involvement up to six years following study enrollment. The results reported by the study include that the interventions employed resulted in a 50% decrease (per person-mile) of "at-fault MVCs than the control group." (p.2107) This study concludes that cognitive speed-of-processing and reasoning training were effective in lower at-fault motor vehicle collision rates among older drivers. This study demonstrates the value of cognitive training in older drivers to lower the rates of motor vehicle collisions in this age group.

II. Bauza, G. (2008) High Mortality in Elderly Drivers is Associated with Distinct Injury Patterns: Analysis of 187,869 Injured Drivers. Journal of Trauma. 2008.

The work of Bauza (2008) reports that while there has been a significant increase in the use of seatbelts in the United States stated at 85%, there have been in excess of 6 million motor vehicle collisions (MVCs) stated for 2004 resulting in approximately 40,000 deaths otherwise stated equally "one death every 12 minutes." (p. 304) Bauza reports that fatality rates while declining after the age of 25 "jump to 18.0 per 100,000 in those 65 or older and account for 14% of all traffic fatalities, despite the fact that elderly drivers are likely to be spending the least amount of time driving." (2008, p. 304) Bauza (2008) reports a study in which the Institutional Review Board at Boston University Medical Center obtained records of injured drivers between October 2001 and February 2005. 187,869 records met the inclusion criteria for the study and the study sampling is reported at 15,755 drivers who were injured and who were 70 years of age or older. The study reports that despite similar use of safety belts that elderly drivers experienced the worst outcomes and had a greater likelihood of being admitted to Intensive Care with the longest stays in the ICU and in the hospital. Elderly were less likely to be discharged directly to their home following release from the hospital and the mortality rates for individuals ages 70 and above is reported to be 17.1% compared to only 2.6% among younger adults. Specific injuries is cited for the higher rates of mortality including concussion, intracranial hemorrhage, facture of vertebral column, spinal cord injury, injuries of thoracic cavity, fracture of the clavicle, scapula or humerus, neck or femur fracture and ankle fracture. The value of this study is in the information provided concerning the outcomes of elderly following motor vehicle collisions.

III. Kulikov, E. (2011) The Social and Policy Predictors of Driving Mobility Among Older Adults. Journal of Aging & Social Policy. 23:1-18, 2011. Taylor and Francis Group, LLC. Routledge.

The work of Kulikov (2011) reports a study that was designed for the purpose of identifying the affect of the requirements of state drivers license on the driving mobility of individuals 70 years of age or older. The sampling included 8.638 elderly men and women and involved data used from four waves of the AHEAD survey conducted by the Institute for Social Research at the University of Michigan. The four waves are stated to include 1993, 1995, 1998, and 2000. The study is reported to be constructed in findings in previous research that demonstrated that "in person license renewals reduced fatality rates among the oldest drivers and that mandatory vision testing adjusted for the driver's license renewal period, was associated with a lower fatal crash risk for older drivers." (Kulikov, 2011, p. 14) The report is stated to demonstrate that the renewal requirements for state drivers license "made a significant different in the driving mobility of older Americans." (Kulikov, 2011, p.14)

IV. Munro, CA, et al. (2010) Predictors of Lane-Change Errors in Older Drivers. JAGS 58:457-242, 2010. The American Geriatrics Society.

The work of Munro (2010) examines predictors of errors in changing lanes on the part of older drivers. Research is reported to show that older drivers have other than attention related to driving outcomes. Visuospatial skills are stated to be linked to on-road measures of driving in patients with dementia. Older age and performance are reported in a study of predictors and failure of a standardized road test to be the primary indicators. Stated as the most surprising of all findings was the auditory rather than visual attention was the best prediction of lane-change failure. Drivers in rural areas are not as likely to execute proper changes of lanes. Limitations of the study include that the sampling was comprised of drivers 67 years of age and older and cannot be generalized. In addition, a restricted range of visual status as well as health status and cognition results in restrictions on which predictions may be based. As well, the study was limited by the participant's knowledge that their driving was being monitored and made it likely that the participants drove more carefully than they usually would if not being monitored.

V. O'Connor, MG, et al. (2010) The 4Cs (Crash History, Family Concerns, Clinical Condition, and Cognitive Functions): A Screening Tool for the Evaluation of the At-Risk Driver. JAGS 58:1104-1108. 2010. The American Geriatrics Society.