Older drivers who experience falls may be at a higher risk for car crashes

As we age, our ability to drive may help us live independently, shop for ourselves, and maintain social connections. Although car crash rates are low among older adults and are declining, older adults do still have higher rates of fatal crashes. Falls, which are a common and preventable cause of injury among older adults, may lower our ability to drive safely.

15 sept 2017--Experts believe that falls are related to driving in four ways:

• They can cause physical injury that limits mobility (our ability to move) and interferes with driving performance.
• Falling can increase the fear of falling, which leads to a reduction in physical activity . Reduced physical activity can weaken our physical strength, which also could reduce fitness for driving.
• Falls can affect an older adult's mental well-being, making them more fearful and leading to changes in driving behaviors.
• Falls and difficulty driving may be caused by common factors, such as vision problems.

A research team created a study to see whether falls were related to driving risks and behaviors among older adults. Their study was published in the Journal of the American Geriatrics Society.
To test their theory that falls are related to car crashes, crash-related injuries, and changes in driving performance, the researchers reviewed 15 studies of driving behavior among older adults involving nearly 47,000 people.
The researchers learned that older adults who had fallen were 40 percent more likely to experience a car crash after their fall than older adults who had not fallen.
Based on estimates of car crashes involving older drivers and older adults who fall, falls—or the things that cause falls and crashes—accounted for more than 177,000 additional car crashes each year.
Researchers also learned that falls may be an independent factor impairing an older adult's ability to drive safely, suggesting that some motor vehicle crashes might be caused by the falls themselves - regardless of the driver's underlying health and functioning.
The researchers suggested that taking steps to reduce the conditions that contribute to both falls and car crashes could reduce the occurrence of both. Some strategies for doing so include:

• Cataract surgery (a type of eye surgery that helps address cloudy vision)
• Exercise to improve physical and mental well-being
• Efforts to improve mental function

The researchers also suggested that for older adults who fall, post-fall rehabilitation might help improve functional ability and enable them to drive more safely.

More information: Kenneth A. Scott et al, Associations Between Falls and Driving Outcomes in Older Adults: Systematic Review and Meta-Analysis, Journal of the American Geriatrics Society (2017). DOI: 10.1111/jgs.15047


Provided by American Geriatrics Society

New guide from AGS, NHTSA a green light to promoting safe driving for older adults

A newly updated guide from the American Geriatrics Society (AGS) and the National Highway Traffic Safety Administration (NHTSA) is putting healthcare professionals on the road to success for assessing and counseling older drivers. With older adults accounting for 10 percent of all people injured in traffic crashes annually and 17 percent of annual traffic fatalities, the Clinician's Guide to Assessing and Counseling Older Drivers (3rd Edition) translates research findings and public health initiatives into practical, person-centered advice for safely navigating the open road.

17 feb 2016--"For all of us, but for Baby Boomers especially, driving is more than just a national pastime and a means for transportation. It's a reflection of independence, mobility, and freedom," explains Alice Pomidor, MD, MPH, AGSF, chair of the editorial board that developed the AGS-NHTSA guide. "The main goal of this guide is to help healthcare professionals promote health, independence, and quality of life by preventing crashes and injuries."
Added Nancy E. Lundebjerg, MPA, AGS CEO: "This guide reflects the fact that many individuals play a role in older adult well-being, and that expert-authored tools, tips, and recommendations can help all healthcare professionals support high-quality, person-centered care in a key focus area: driver safety."
Reviewed and edited by an interprofessional board of physicians, nurses, social workers, occupational therapists, and pharmacists, the updated guide walks through key issues, opportunities, and challenges faced by older drivers, theirhealthcare professionals, and their caregivers. Areas of emphasis include:

• Determining when an older person may be at an increased risk for unsafe driving. The AGS-NHTSA guide highlights certain "red lights" that clinicians should look for, such as impaired vision or hearing.
• Recognizing medical conditions, functional deficits, and medications that may affect driver safety. Increased longevity in the U.S. population coupled with the number of health conditions older adults manage mean that many older individuals may outlive their ability to drive safely.
• Understanding how to screen and assess functional abilities for driving. Motor skills, sensory perception, vision, and cognition are all important to driving. However, they may not be equally important for a particular older adult: one area of function may warrant greater attention than another on a case-by-case basis.
• Advising older adults about transitioning from driving. Proactively screening frail older adults for driving safety means knowing when to make strategic recommendations and planning for driving retirement beforehand.
• Considering ethical and legal issues affecting older drivers. Laws, regulations, and policies on driving vary not only by state but also by local jurisdiction.
• Meeting the future transportation needs of older adults. Coordination among clinicians, licensing agencies, and relevant state/community entities can help older adults and caregivers become aware of resources once independent driving is no longer an option.

More information: The full guide and collateral tools will be available on GeriatricsCareOnline.org, the online home for AGS resources. Public education materials also will be released by the Health in Aging Foundation onHealthinAging.org.


Provided by American Geriatrics Society

Elderly Tend to Drive Slower to Make Up for Reaction Time

13 mar 2011-- One reason that elderly people tend to be slower drivers than younger people is because they have a narrower field of vision and have more difficulty seeing pedestrians, according to a new study.

Israeli researchers tested experienced elderly and non-elderly drivers, and compared the differences between them in reaction times and when pedestrians were perceived as hazards.

Driving simulator tests showed that the elderly drivers noticed pedestrians half as often as younger drivers and also took longer to respond to hazardous situations involving pedestrians.

The elderly drivers reduced their driving speed by almost 20 percent in order to give themselves more time to respond to hazards and dangers, said the team at Ben-Gurion University of the Negev.

The study was released online in advance of publication in an upcoming print issue of the journal Accident Analysis and Prevention.

"These findings strengthen the notion that elderly drivers, shown to have a narrower useful field of view, may also be limited in their ability to detect hazards, particularly when outside the center of their view," Tal Oron-Gilad, of the department of industrial engineering, said in a university news release.

She added that "authorities should be aware of these limitations and increase elderly drivers' awareness of pedestrians by posting traffic signs or dedicated lane marks that inform them of potential upcoming hazards."

More information

The U.S. Centers for Disease Control and Prevention

Report: Older Drivers in Fewer Deadly Crashes

16 jan 2009--As the baby boomer generation ages, the elderly are becoming a bigger segment of the driving population. And while some are racing around town like the "little old lady from Pasadena," a growing number seem to be becoming more cautious.

Contrary to expectations, older drivers are involved in fewer fatal collisions now than in decades past, perhaps because they're limiting their time on the road, two new Insurance Institute for Highway Safety studies report. Safer cars may be helping, too.

"The findings are a welcome surprise," said Anne McCartt, Institute senior vice president for research, and an author of the new studies. "No matter how we looked at the fatal crash data for this age group - whether by miles driven, licensed drivers, or population - the fatal crash involvement rates for drivers 70 and older declined, and did so at a faster pace than the rates for drivers 35-54 years old."

The study, which looked at driving trends over the years 1997 to 2006, found a 21 percent decline in crash deaths among drivers 70 and older, even as the number of licensed drivers in the age group climbed from 18 million to 20 million.

If the fatal crash involvement rate for older drivers had instead mirrored the trend among younger ones, nearly 7,000 additional older drivers would have been in fatal crashes during the study period.

Compared with drivers ages 20 to 69, fewer people 70 and older are licensed to drive, and they tend to drive fewer miles per outing. But older drivers also hang on to their licenses longer now and drive more miles.

In the past, crash risk tended to increase with age because of physical, cognitive and visual declines associated with aging. Risk of fatality in a crash also increases for the elderly because their bodies are generally more fragile.

The researchers say they can't single out a particular reason for the decline in elderly fatal crash rates, though they suggest that safer cars, more physically-fit seniors and self-limiting of driving could play a part.

One of the Institute studies surveyed drivers 65 and older in three states who were renewing their licenses. It found that drivers over 80 were more than twice as likely to limit their own driving than 65- to 69-year-olds. Of those, 74 percent cited medical conditions such as diabetes or arthritis as limiting factors, and 69 percent cited memory impairments.

• Video: Why We Age
• Interactive Map Shows Deadliest U.S. Roads
• Do People Really Die of Old Age?

• Original Story: Report: Older Drivers in Fewer Deadly Crashes

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Vision problems prompt older drivers to put down the keys

Rockville, MD, 07 jan 2009 — With 30 million drivers in the US aged 65 and over, we count on older Americans to recognize when they can no longer drive safely and decide that it's time to stay off the road. A new study finds that a decrease in vision function is a key factor in bringing about this decision.

The Salisbury Eye Evaluation and Driving Study (SEEDS) (http://www.iovs.org/cgi/content/full/50/1/107), conducted by researchers affiliated with Johns Hopkins University, looked at changes in vision, cognition and the general health status of more than 1,200 licensed drivers aged 67-87 in Salisbury, MD, a community with limited public transportation. SEEDS is unique, in that the researchers performed comprehensive tests of both vision and cognitive function.

The results, recently published in the peer-reviewed journal Investigative Ophthalmology & Visual Science (www.iovs.org), reveal that after a year, 1.5 percent of the drivers had given up driving, and another 3.4 percent had restricted their driving. The most common predictors of stopping or decreasing driving were slow visual scanning, psychomotor speed and poor visuo-constructional skills, as well as reduced contrast sensitivity. (These skills are necessary to help drivers be aware of and respond to other cars, road conditions and road signs. Contrast sensitivity is the ability to detect detail in shades of gray; it is necessary for driving in poor weather and low lighting.)

"These skills are important for safe and confident driving where objects are moving at rapid speeds in relation to each other, and timely and accurate judgments are required," the researchers stated.

The study, which was in part supported by the National Institute of Aging, also found that women were four times more likely than men to stop or restrict their driving. In addition, drivers who had higher depression scores on the initial test were more likely to have given up or restricted their driving after a year. Previous studies have examined depression as an effect of giving up driving, not as a predictor.

"Older drivers are the fastest growing sector of all licensed drivers in the US," noted researcher Lisa Keay, PhD. "The decision to stop or limit driving to one's own neighborhood has major implications for personal independence — but it is an important way to maintain the safety of older drivers and those who share the road.

"As a society, we would like to think that when a driver recognizes that his or her functions related to vision or cognition are declining, they make that crucial decision. My colleagues and I found it reassuring that in this group, that appeared to be the case."

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ARVO is the largest eye and vision research organization in the world. Members include more than 12,500 eye and vision researchers from over 73 countries. The Association encourages and assists research, training, publication and dissemination of knowledge in vision and ophthalmology. The ARVO Foundation for Eye Research exists to provide continuing education and stable support for original and innovative vision research, particularly research with translational impact that fosters collaboration between clinicians and basic scientists. The Foundation also supports training for new vision research scientists around the world. For more information, visit www.arvo.org.