Risk factors may point to less-safe senior drivers
Tests of physical abilities, such as balance and strength, may reveal how well an elderly driver will perform on the road, according to a new study.
Trouble with balance, weak lower limbs and poor neck flexibility were among the attributes Australian researchers linked to a higher risk of less-safe driving in The Journals of Gerontology: Series A.
“Although there has been a lot of research on the cognitive and visual predictors of driving performance and safety, very little work has so far looked at physical function and its relation to driving,” said Philippe Lacherez, a post-doctoral fellow at Queensland University of Technology who led the study.
Lacherez and his colleagues gave 270 people between the ages of 70 and 88 a battery of physical tests to gauge their strength, flexibility, balance, reaction times and sensory perception. Next, the participants’ driving performance was evaluated for safety.
About 17 percent of the participants made critical errors while driving in a test that was scored by a professional driving instructor and involved a range of traffic densities and complex or simple intersections.
In the physical abilities tests, the unsafe drivers tended to have a decreased ability to move the neck, slower reaction times, poor perception of vibration and lack of strength in the legs and feet. Factors that were not linked with driving safety included the ability to sense where the body or limbs are in space.
The results are preliminary but may open a new avenue to ways of ensuring that older drivers are safe to be on the road, researchers said.
“The study addresses an issue that is a big concern,” said Sharon Brangman, chief of geriatrics at Upstate Medical University in Syracuse, New York. She was not involved in the study.
“We have so many (older) patients who are driving, and we don’t have objective ways to determine who should stay on the road,” Brangman said.
Some U.S. states, such as New Jersey, already have review programs in place that evaluate older adults and determine whether they should continue to drive. However, there is no standardized, nationwide approach used to evaluate driving safety.
“It would be good to have an objective way for physicians or others to quantify whether someone really is safe behind the wheel,” said Brangman, who also noted the need for a change in national policy to better screen and guide older drivers.
As always, older patients and their families should talk to their doctors if they feel they or a loved one may be an unsafe driver. This study can serve as a way to initiate that discussion, Brangman told Reuters Health.
“It’s a good way to start the conversation,” she said. And in the future, results of studies such as this one “may provide some hard evidence that can be given to the patient or family that could justify stopping driving.”
SOURCE: Journals of Gerontology: Series A, online October 29, 2013.
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Sensorimotor and Postural Control Factors Associated With Driving Safety in a Community-Dwelling Older Driver Population
Background. To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults.
Methods. The performance of 270 community-living adults aged 70–88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance.
Results. Forty-seven participants (17.4%) were classified as unsafe based on their driving assessment. Unsafe driving was associated with reduced peripheral sensation, lower limb weakness, reduced neck range of motion, slow reaction time, and poor balance in univariate analyses. Multivariate logistic regression analysis identified poor vibration sensitivity, reduced quadriceps strength, and increased sway on a foam surface with eyes closed as significant and independent risk factors for unsafe driving. These variables classified participants into safe and unsafe drivers with a sensitivity of 74% and specificity of 70%.
Conclusions. A number of sensorimotor and balance measures were associated with driver safety and the multivariate model comprising measures of sensation, strength, and balance was highly predictive of unsafe driving in this sample. These findings highlight important determinants of driver safety and may assist in developing efficacious driver safety strategies for older drivers.
Philippe Lacherez,
Joanne M. Wood,
Kaarin J. Anstey and
Stephen R. Lord