The impact of advanced age on driving safety in older adults with medical conditions

Moon Sanghee (1) , Maud Ranchet (2) , Abiodun Emmanuel Akinwuntan (1) , Mark Tant (3) , David Carr (4) , Mukaila Raji (5) , Hannes Devos (1)

1 Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS
2 IFSTTAR/TS2/LESCOT - Laboratoire Ergonomie et Sciences Cognitives pour les Transports
3 Center for Evaluation of Fitness to Drive and Car Adaptations, VIAS Institute, Brussels, Belgium
4 Department of Medicine and Neurology, Washington University in St. Louis, St. Louis, MO
5 Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX

Background: Adults aged 85 and older, often referred to as the oldest-old, are the fastest growing segment of the population. The rapidly increasing number of older adults with chronic and multiple medical conditions poses challenges regarding their driving safety. Objective: To investigate the effect of advanced age on driving safety in drivers with medical conditions. Methods: We categorized 3,425 drivers with pre-existing medical conditions into four age groups: middle-aged (55-64, n = 1,386), young-old (65-74, n = 1,013), old-old (75-84, n = 803), or oldest-old (85+, n = 223). All underwent a formal driving evaluation. The outcome measures included fitness-to-drive recommendation by the referring physician, comprehensive fitness-to-drive decision from an official driving evaluation center, history of motor vehicle crashes (MVCs), and history of traffic violations. Results: The oldest-old reported more cardiopulmonary and visual conditions, but reported less neurological conditions than the old-old. Compared with the middle-aged, the oldest-old were more likely to be considered unfit-to-drive by the referring physicians (odds ratio (OR) = 4.47, 95% confidence interval (CI) 2.20-9.10) and by the official driving evaluation center (OR = 2.74, 95% CI 1.87-4.03). The oldest-old reported more MVCs (OR = 2.79, 95% CI 1.88-4.12) compared to the middle-aged. Conclusion: Advanced age adversely affected driving safety outcomes. The oldest-old are a unique age group with common medical conditions known to interfere with safe driving. Driving safety strategies should particularly target the oldest-old since they are the fastest growing group and their increased frailty is associated with severe or fatal injuries due to MVCs.

Mots clés: OLDEST-OLD; DRIVING SAFETY; FITNESS-TO-DRIVE; MOTOR VEHICLE CRASH

Mots clés: CONDUCTEUR AGE; SECURITE ROUTIERE

Domaines: Psychologie et comportements; Santé

Moon Sanghee, Maud Ranchet, Abiodun Emmanuel Akinwuntan, Mark Tant, David Carr, et al.. The impact of advanced age on driving safety in older adults with medical conditions. Gerontology, 2018, 22 p. ⟨hal-01701463v1⟩