Exploratory study of incident vehicle crashes among olderdrivers

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Abstract
BACKGROUND: As the number of older adult drivers increases,distinguishing safe from unsafe older adult drivers will become anincreasing public health concern. We report on the medical and functionalfactors associated with vehicle crashes in a cohort of Alabama drivers, 55years old and older. METHODS: This prospective study involved 174 olderadults, on whom demographic, medical, functional, and physical performancedata were collected in 1991. Subjects were then followed through 1996 forincident vehicle crashes. RESULTS: Sixty-one subjects experienced betweenone and four police- reported vehicle crashes during the study period.Following adjustment for age, race, days driven per week, and gender, Coxproportional- hazards models showed the following variables to beassociated with crash involvement: reported difficulty with yardwork orlight housework (relative risk [RR] = 2.1; 95% confidence interval [CI]1.1, 4.0; p = .02), or opening ajar (RR = 3. 1; 95% CI 1.4, 6.7; p = .004);at least one crash before 1991 (RR = 2.1; 95% CI 1.2, 3.7; p = .008); usinghypnotic medication (RR = 2.9; 95% CI 1.3, 6.6; p = .01); self-reportedstroke or transient ischemic attack (RR = 2.7; 95% CI 1.1, 6.6; p = .03);scoring within the depressed range on the Geriatric Depression Scale (RR =2.5; 95% CI 1.1, 6.0; p = .03), and failing the useful field-of-view test(RR = 1.9; 95% CI 1.0, 3.5; p = .05). CONCLUSIONS: Variables related tofunction, medication use, affect, neurological disease, and visuocognitiveskills were associated with vehicle crash involvement in this cohort. Ourfindings suggest that multifactorial assessments are warranted to identifyat-risk older drivers.

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