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164 EMFShould Miss Daisy Be Driving? Factors Associated With Adverse Driving Events Among Older Drivers

2011; Elsevier BV; Volume: 58; Issue: 4 Linguagem: Inglês

10.1016/j.annemergmed.2011.06.192

1097-6760

Marian E. Betz, Robert S. Schwartz, Morgan Valley, Steven R. Lowenstein,

Older Adults Driving Studies

By 2025, 25% of United States drivers will be over age 65. Some of these older drivers are at higher risk of motor vehicle crashes (MVCs), but there is no brief screening tool to predict crash risk accurately. As the first step in the development of such a tool, we sought to identify demographic, health and driving-related characteristics associated with adverse driving experiences (ADEs: MVCs and police stops) among older drivers. Older (65+ years) patients visiting the emergency department and geriatric clinic at a university hospital completed a confidential, pilot-tested survey and 3-month telephone follow-up. Non-English speaking patients, those with critical illness or significant cognitive impairment and those who had not driven in the past 30 days were excluded. We used logistic regression to identify demographic, health and driving-related factors associated with an ADE in the past year and at 3 months. Variables with statistically significant or strong (OR>2) relationships in bivariate analysis were included simultaneously in the final model. The response rate was 50% (N=230) and 77% (n=178) completed the 3-month telephone follow-up. The median age was 76 (range: 65-93). Almost all (97%) lived in a private residence. Most drove daily or almost daily but reported restricting their driving in certain conditions (Table), and 16% (95CI 11-20) reported an ADE in the past year. Of those with an ADE, 39% (95%CI 23-57) had a MVC, 44% (95%CI 28-62) a police stop, and 17% (95%CI 6-33) both. In multivariate logistic regression, 5 factors were associated with an ADE in the past year: avoiding driving alone (OR 34.17; 95%CI 1.81-646.71); driving daily or almost everyday (OR 14.33; 95%CI 01.76-116.37); having someone else recommend driving cessation (OR 7.13; 95%CI 0.86-59.09); ever experiencing vision problems while driving (OR 3.22; 95%CI 0.79-13.21); and ever being confused while driving (OR 2.29; 95%CI 1.06-4.96). After 3 months, 5% (95%CI 2-9) of contacted drivers had stopped driving and 5% (95%CI 2-9) had experienced an ADE. Only 1 driver characteristic (avoiding driving alone) was associated with an ADE at 3-months (OR 20.13; 95%CI 1.15-351.87).Tabled 1 Adverse driving events among older drivers are somewhat common. Certain reported driving behaviors and experiences--notably, avoiding driving alone--are associated with a recent ADE and possibly with a future ADE. Driving-related questions appear to have stronger associations than demographic characteristics and might be used to develop a brief screening tool to identify older drivers at risk for future ADEs.