Driving concerns among older adults: Associations with driving skill,behaviors, and experiences

Objectives: The purpose of this investigation was to determine what older adults find most concerning about driving as they age and how these concerns are related to driving skill, behaviors, and experiences.

Methods: In partnership with the Maryland Motor Vehicle Administration, a sample of 751 older adults ages 65 and older completed an online survey between October 2017 and May 2018. A content analysis was used to code open-ended responses about driver concerns, and multivariate logistic regression models were used to analyze the associations between driving concerns and driving skill, behavior, and experiences.

Results: Eighty-four percent of participants reported at least one driving concern, with 44% concerned about others’ driving, 34% concerned about their own driving, and 24% concerned about driving conditions. The most frequently mentioned driving concerns were other drivers in general, driving at night, visual ability and awareness, and other drivers being aggressive or reckless. Being concerned with their own driving was significantly associated with decreased perceived driving skill and increased odds of experiencing negative driving experiences in the past year. Being concerned about others’ driving was associated with increased odds of wearing a seat belt (adjusted odds ratio [AOR]?=?2.67; 95% confidence interval [CI], 1.02, 7.00), having high perceived driving skills in emergency situations (AOR = 1.56; 95% CI, 1.14, 2.12), and getting in a near crash or collision in the past year (AOR = 1.50; 95% CI, 1.04, 2.18).

Conclusions: Older adult drivers are frequently concerned about their own driving as well as the driving of others. Implications for future research and health practice are discussed.     

The effects of a joint range-of-motion physical fitness training program on the automobile driving skills of older adults

Previous attempts to sustain the automobile driving skills of older adults have centered on modifying the driving environment, improving the design of the vehicle, or introducing comprehensive educational programs. This research represents the first experimental investigation of the effects of a physical fitness training program on the automobile driving performance of older adults. Thirty-two older adults were assigned randomly, stratified by gender, to either an experimental group who participated in an 8 week range-of-motion exercise training program or a control group. A 2 (Experimental group/Control group) × 3 (Testing Session) repeated measures experimental design was used to examine the effects of the 8 week range-of-motion exercise training program on subject range of motion and a field-based assessment of automobile driving skill. The results indicated that the program was successful in improving subject shoulder flexibility and trunk rotation, as well as improving scores on the driving skill measure of observing.     

Impact of impulsiveness, venturesomeness, and empathy on driving by older adults

PROBLEM: Although personality characteristics such as impulsiveness have been linked to the driving safety and driving habits of young and middle-aged adults, little research has focused on the role of personality in older driver behavior. METHOD: Using the IVE questionnaire in an exploratory study, three personality dimensions (impulsiveness, venturesomeness, and empathy) were measured in 305 older drivers (ages 57-87 years old). In addition, the Driving Habits Questionnaire was used to estimate driving exposure, and the Driver Behavior Questionnaire (DBQ) was used to estimate driving errors and violations. State-recorded crash data were made available by the state public safety agency. RESULTS: Subjects who reported four or more driving errors had higher impulsivity and empathy scores and lower venturesomeness scores. Subjects reporting driving violations were more likely to have high impulsivity scores. Driving six or more places per week was associated with lower levels of impulsivity. IMPACT: These results suggest that a comprehensive understanding of driving problems among older adults should also include a consideration of personality dimensions. In doing so, the challenges faced in the interpretation of self-report instruments on driving behaviors must be acknowledged, with a move in research toward greater reliance on more objective measures of driving behavior when assessing the impact of personality variables.     

Measures of health,fitness, and functional movement among firefighter recruits

Aim. The purpose of this study was to examine the associations between various health and fitness measures and Functional Movement Screen? (FMS?) scores among 78 firefighter recruits. Methods. Relationships between FMS? scores and age, body mass index (BMI), sit and reach (S&R) distance, estimated maximal aerobic capacity (V˙_O2max), estimated one-repetition maximum squat (1RM-Squat_max), and plank endurance (%Plank_max) were examined. Results. Total FMS? scores were significantly correlated with BMI (r?=??0.231, p?=?0.042), estimated 1RM-Squat_max (r?=?0.302, p?=?0.007), and %Plank_max (r?=?0.320, p?=?0.004). Multiple regression analyses indicated that this combination of predictors significantly predicted (F(3, 74)?=?5.043, p?=?0.003) Total FMS? score outcomes and accounted for 17% of the total variance (R²?=?0.170). In addition, logistic regression analyses indicated that estimated 1RM-Squat_max also significantly predicted (χ²?=?6.662, df?=?1, p?=?0.010) FMS? group membership (≤14 or ≥15). Conclusion. These results suggest that the health and fitness measures of obesity (BMI), bilateral lower extremity strength (estimated 1RM-Squat_max), and core muscular endurance (%Plank_max) are significantly associated with functional movement patterns among firefighter recruits. Consequently, injury prevention programs implemented among firefighter recruits should target these aspects of health and fitness.     

Deconstructing a gender difference: driving cessation and personal driving history of older women

PROBLEM: The purpose of this study is to understand the reasons behind older women's driving cessation by comparing the driving histories of Finnish women who either gave up or renewed their drivers license at the age of 70. METHOD: A mail survey was sent to all Finnish women born in 1927 who gave up their license in 1997 (N=1,476) and to a corresponding random sample of women who renewed their license (N=1,494). The total response rate was 42.1%. RESULTS: The length and level of activity of personal driving history were strongly associated with driving cessation and continuation. Ex-drivers tended to have an inactive driving career behind them, whereas drivers had a more active personal driving history. In addition, those women with an active, "male-like" driving history who had decided to stop driving gave reasons for driving cessation that were similar to what is known about older men's reasons to give up driving. The results suggest that the decision to stop driving is related to driving habits rather than gender.     

Road safe seniors: Screening for age-related driving disorders in inpatient and outpatient settings

Introduction

Older drivers are increasing in number and they often have health conditions that place them at high risk for motor-vehicle crashes (MVC). Screening is underutilized, and is rarely done in hospital settings.

Methods

A convenience sample of 755 older adults completed age related driving disorders screening at University of California, San Diego inpatient and outpatient health centers. Screening included three strength/frailty tests, two vision tests (acuity and fields), and two cognitive tests, based on AMA recommendations. The average age of participants was 72.5; 55.5% were male and 94% English-speaking; 17.8% of older adults failed at least one aspect of screening.

Results

In multivariate analysis, significant associations of failed status were age, male sex, selfrestrictions of driving, and inpatient screening locations. The screening identified one in six adults to be 'high-risk' for age related driving disorders. Screening was effective and feasible in both inpatient and outpatient settings.

Impact on industry

As the driving population ages, industry, government and health car providers need to plan for the management of driving impairments in older adults.     

Association between older driver characteristics, on-road driving test performance, and crash liability

From May 1999, a new system for licensing older drivers was introduced in New Zealand. It included a practical on-road driving test with expanded scope, to be completed every two years from the time the driver turns 80. The relationship between crashes and test performance needed to be studied to inform the debate regarding the testing system. The population studied was all drivers who entered this licensing system during its first three years of operation. They were defined as crash involved if they were involved in an injury crash during the two years following their first licensure under the new system. Logistic regression was used to describe the risk of crash involvement in terms of driving test performance and other driver characteristics. Each driving test failure was associated with a 33% increase in the odds of crash involvement (95% CI 14% to 55%), controlling for age, gender, minor traffic violations, and whether the older driver lived with another licensed driver or not. Minor traffic violations in the two years following the driving test were associated with twice the odds of crash involvement. These results suggest that the new on-road driving test does identify older driver behaviors or limitations that are related to crash liability. It is anticipated that the results presented here will provide essential information for discussing older driver licensing systems, whose impact will grow in importance as the population of drivers ages.     

Development and pilot testing of an assessment battery for older drivers

INTRODUCTION: The purpose of the study reported here was to develop and pilot test a comprehensive battery of assessment instruments for older drivers that would be inexpensive and easy to administer so that it could be used in longitudinal studies. METHOD: The resulting battery was developed by selecting a set of validated assessment instruments and combining them into a package, with a total acquisition cost of less than $900. As part of this battery, three questionnaires were developed utilizing items from established questionnaires with minor modifications. The battery was pilot tested with a convenience sample of 38 drivers aged 65 years or older. RESULTS: Results showed that the entire battery required less than one hour to complete. Data from the assessment outcomes fell within normative ranges. Feedback from subjects indicated that the battery was acceptable, free of problems, presented tasks in a good order, and was not too long. CONCLUSIONS: Based on study findings, the assessment battery appeared to be low-cost, transportable, easy to administer, easy for subjects to complete, provides a comprehensive assessment of a person's physical health, mental health, and driving behaviors, and would serve as a valuable data collection tool for a longitudinal study of older drivers. Such a longitudinal study is needed in order to answer some of the most important questions about older driver safety and mobility.     

Examination of personality traits and social problem-solving skills of individuals whose driving licenses have been confiscated due to drunk driving

Objective: Drunk driving is one of the major behavioral issues connected with problematic alcohol consumption. The objective of this study was to evaluate the relationship between personality traits and social problem-solving skills of individuals who drive while intoxicated.

Method: One hundred forty-four individuals apprehended twice while driving drunk and sent to a driver behavior training program (9 females and 135 males) participated in our study. The Eysenck Personality Questionnaire Revised–Abbreviated (EPQ-RA) composed of 4 subscales (Extroversion, Neuroticism, Psychoticism, and Lying) and the Social Problem Solving Inventory (SPSI) composed of 7 subscales (Cognitive, Emotion, Behavior, Problem Definition and Formulation, Creating Solution Options, Solution Implementation and Verification, and Decision Making) were used to evaluate the participants.

Results: A positive relationship was found between the Extroversion subscale of the EPQ-RA and the Cognition subscale (P <.01), Emotion subscale (P <.01), Behavior subscale (P <.01), Generation of Alternatives subscale (P <.01), Decision Making subscale (P <.05), and Solution Implementation and Verification subscale (P <.01). For individuals who repeated intoxicated driving, all subscales of the EPQ-RA (Extroversion, Lying, Neuroticism, and Psychoticism subscales) explained 12% of the scores of the Cognition subscale and 16.2% (P <.001) of the Emotion subscale of the SPSI. There was no significant relationship between the first and second incident alcohol blood levels (P >.05).

Conclusion: Drinking and driving behaviors appear to be negative or maladaptive behaviors closely related to personality traits and may represent an effort to avoid negative emotions. Evaluation of negative emotions may have an important place in training programs intended to change drunk driving behavior.     

Distracting behaviors among teenagers and young,middle-aged,and older adult drivers when driving without and with warnings from an integrated vehicle safety system

IntroductionNegative reinforcement from crash warnings may reduce the likelihood that drivers engage in distracted driving. Alternatively, drivers may compensate for the perceived safety benefit of crash warnings by engaging in distractions more frequently, especially at higher speeds. The purpose of this study was to examine whether warning feedback from an integrated vehicle-based safety system affected the likelihood that various secondary behaviors were present among drivers ages 16–17, 20–30, 40–50, and 60–70.MethodParticipants drove an instrumented sedan with various collision warning systems for an extended period. Ten 5-second video clips were randomly sampled from driving periods at speeds above 25 mph and below 5 mph each week for each driver and coded for the presence of 11 secondary behaviors.ResultsAt least one secondary behavior was present in 46% of video clips; conversing with a passenger (17%), personal grooming (9%), and cellphone conversation (6%) were the most common. The likelihood that at least one secondary behavior was present was not significantly different during periods when drivers received warnings relative to periods without warnings. At least one secondary behavior was 21% more likely to be present at speeds below 5 mph relative to speeds above 25 mph; however, the effect of vehicle speed was not significantly affected by warning presence. Separate models for each of the five most common secondary behaviors also indicated that warnings had no significant effect on the likelihood that each behavior was present.ConclusionsCollision warnings were not associated with significant increases or decreases in the overall likelihood that teen and adult drivers engaged in secondary behaviors or the likelihood of the behaviors at speeds above 25 mph or below 5 mph.Practical applicationsThere was no evidence that forward collision warning and other technologies like those in this study will increase or decrease distracted driving.     

Measurement of driving patterns of older adults using data logging devices with and without global positioning system capability

BACKGROUND: Methods to study driving patterns and exposure of older drivers have typically relied on surveys or driving diaries. Electronic data logging devices may offer a reliable, alternative method of measuring driving exposure, and global positioning system (GPS) technology may be able to provide further information about driving patterns. OBJECTIVES: The aim of this study was to compare a driving diary with two electronic data logging devices, one of which had GPS capability, in order to identify which method best assesses the driving exposure and habits of older drivers as well as the method most acceptable to study participants. METHOD: In this prospective cohort study we recruited 20 participants aged 70 years or more (mean 78; range 70-85) (15 men and 5 women). The participants' driving patterns were recorded for one week with an electronic data logging device with GPS (FleetPulse), followed by recording for a further week with an electronic data logging device without GPS (CarChip). During both time periods the subjects also completed a standard driving diary. RESULTS: More comprehensive information, including braking and acceleration patterns, duration of driving time, time of day, and maximum speeds, was collected with the electronic devices than with the driving diary. There was excellent correlation between the driving diary data and those obtained with the CarChip (r = 0.9; p < 0.01). The correlation between the driving diary data and the FleetPulse data was moderate (r = 0.56; p = 0.02). The subjects clearly preferred the electronic monitoring devices over the driving diary. GPS data were able to demonstrate driving routes. CONCLUSIONS: Electronic data logging devices are a valid method for recording the driving patterns of older adults. These devices also reduce burden and improve the completeness of data.     

Enhancing older driver safety: A driving survey and evaluation of the CarFit program

Objective

To evaluate CarFit, an educational program designed to promote optimal alignment of driver with vehicle.

Methods

A driving activity survey was sent to 727 randomly selected participants living in retirement communities. Drivers (n = 195) were assigned randomly to CarFit intervention (n = 83, M age = 78.1) or Comparison (n = 112, M age = 79.6) groups. After 6 months, participants completed a post-test of driving activity and CarFit recommendations.

Results

Nonconsenting drivers were older and participated in fewer driving activities. CarFit participation was moderate (71%) with 86% of the participants receiving recommendations. 60% followed the recommendations at the 6-month re-evaluation). The CarFit (67.6%) and Comparison (59.3%) groups reported at least one type of self-regulation of driving activity at baseline. There was no significant change in the driving behaviors at the six-month follow-up.

Conclusion

CarFit was able to detect addressable opportunities that may contribute to the safety of older drivers.

Impact on industry

CarFit recommendations may need stronger reinforcement in order to be enacted by a participant.     

Predictors of health care provider anticipatory guidance provision for older drivers

Objective: The objective of this study was to determine the frequency of health care provider (HCP) driving safety/cessation-related anticipatory guidance provision and predictors of driving safety-related anticipatory guidance provision by HCPs.

Methods: HCPs in several central/upper Midwest states were surveyed about frequency of anticipatory guidance provision (n = 265).

Results: More than half of HCPs stated that they frequently or always provide driving safety/cessation-related anticipatory guidance to patients aged 85 or older, 38.7% provided this guidance to patients aged 75 to 84, and 13.7% to patients aged 65 to 74. Predictors of driving safety/cessation-related anticipatory guidance provision differed by patient age. For patients aged 65–74, HCP personal experience with a motor vehicle crash (either the HCP themselves or a friend/family member) was significant in predicting anticipatory guidance provision. However, for patients aged 75 and older, significant predictors included HCP rural practice, HCP age, and percentage of HCP patients who were older adults.

Conclusion: HCP counseling provision related to driving issues differs by patient age and several HCP characteristics, including HCP rurality, age, and personal experience with motor vehicle crashes. Because aging results in physical and mental changes that affect driving and can be identified by HCPs, HCPs are in a position to counsel patients on the potential impacts of aging on the act of driving. Future research should examine the reasons for the differences in anticipatory guidance provision found in this study.     

A neuro-fuzzy algorithm for assessment of health,safety, environment and ergonomics in a large petrochemical plant

Process plants such as petrochemical units have been continuously trying to improve Health, Safety, Environment and Ergonomics (HSEE) programs. This study proposes an adaptive network-based fuzzy inference system (ANFIS) for assessment of HSEE programs in a petrochemical plant. The proposed neuro-fuzzy approach is applied to a set of operators in the petrochemical unit to show its applicability and superiority. To achieve the objectives of this study, standard questionnaires with respect to HSEE are completed by operators. The average results for each category of HSEE are used as inputs and accomplishment of HSEE programs is used as output for the algorithm. Moreover, this algorithm is used to rank operators performance with respect to HSEE. Finally, the algorithm identifies efficient operators with respect to HSEE. This is the first study that introduces an intelligence algorithm for assessment and improvement of HSEE program in a petrochemical plant.     

Covariability in three dimensions of teenage driving risk behavior: impaired driving,risky and unsafe driving behavior,and secondary task engagement

Objective: This research examined the extent to which teenagers who engaged in one form of risky driving also engaged in other forms and whether risky driving measures were reciprocally associated over time.

Methods: The data were from waves 1, 2, and 3 (W1, W2, and W3) of the NEXT Generation study, with longitudinal assessment of a nationally representative sample starting with 10th graders starting in 2009–2010. Three measures of risky driving were assessed in autoregressive and cross-lagged analyses: driving while alcohol/drug impaired (DWI), Checkpoints Risky Driving Scale (risky and unsafe driving), and secondary task engagement while driving.

Results: In adjusted autoregression models, the risk variables demonstrated high levels of stability, with significant associations observed across the 3 waves. However, associations between variables were inconsistent. DWI at W2 was associated with risky and unsafe driving at W3 (β = 0.21, P < .01); risky and unsafe driving at W1 was associated with DWI at W2 (β = 0.20, P < .01); and risky and unsafe driving at W2 is associated with secondary task engagement at W3 (β = 0.19, P < .01). Over time, associations between DWI and secondary task engagement were not significant.

Conclusions: Our findings provide modest evidence for the covariability of risky driving, with prospective associations between the Risky Driving Scale and the other measures and reciprocal associations between all 3 variables at some time points. Secondary task engagement, however, appears largely to be an independent measure of risky driving. The findings suggest the importance of implementing interventions that addresses each of these driving risks.     

Perceived stress,mental health,organizational factors,and self-reported risky driving behaviors among truck drivers circulating in France

Introduction: The growth of the European market for road-freight transport has recently led to important changes. The growing number of foreign pavilion drivers transiting in France, which plays a bridging role among European countries, has influenced the lives of truck drivers by increasing competition, pressure on day-to-day activities, and constraints related to delivery deadlines. Adding this new pressure to those inherent in the road-freight transport sector has raised concerns, especially ones linked to levels of perceived stress by truck drivers. Method: With safety concerns in mind, we devised a questionnaire aimed at understanding how French truck drivers and non-French truck drivers, passing through four highway rest areas in France perceive stress, organizational factors, mental health, and risky driving behaviors. A sample of 515 truck drivers took part in the survey (260 French nationals), 97.9% of whom were male. Results: The results of a structural equation model indicated that perceived stress can increase self-reported risky driving behaviors among truck drivers. Furthermore, organizational factors and mental health were closely linked to perceived stress. Finally, some differences were found between French and non-French truck drivers with respect to mind-wandering and mental health, and to perceive driving difficulties to overcome and driving skills. Practical Applications: Several recommendations based on the findings are provided to policymakers and organizations.     

Risk assessment of safety and health (RASH) for building construction

In this research Risk Assessment of Safety and Health RASH method for building construction has been developed with risks classified into Safety Risks and Health Risks. 11 factors representing safety risks and 8 factors representing health risks were identified based on field survey in Oman. 40 Safety and Health specialists were involved in carrying out risk assessment using the existing method of risk analysis RA and the proposed RASH method. It was found that RASH method resulted in superior accuracy for assessment of risk zones than the existing RA method. The accuracy by RASH was almost twice the accuracy by RA. The overall percentages of the correct answers for the four scenarios using the RASH method and the RA method were 72.5 percent and 40 percent respectively. The proposed RASH method gave fewer errors than the existing RA method for all scenarios. Two scenarios were found to be the most problematic ones with largest overestimation of risks occur when using the existing RA method. Wilcoxon Ranked Test showed that the two methods are significantly different (z = −3.357, p > 0.01). The new method RASH is statistically acceptable and it resulted in better response in terms of estimating the risk than the RA method.     

A comparison of web-based and telephone surveys for assessing traffic safety concerns, beliefs, and behaviors

Introduction

The purpose of this investigation was to compare the results of a web-based and a telephone interview survey measuring driver concerns about a variety of traffic safety issues, their beliefs, and specific driving behaviors.

Method

State-wide, annual random digit-dial telephone surveys and web-based surveys were conducted in Maryland. A total of 1,700 drivers were surveyed by telephone and 6,806 took a web survey.

Results

Telephone respondents were more likely to be female and older. Web respondents were more likely to be white and not Latino/Hispanic. After controlling for demographic differences, telephone survey respondents were more likely to be concerned about traffic safety. They were more likely to believe that sobriety checkpoints reduce drunk driving (OR = 2.18, 95% CI 1.94, 2.45), they would be ticketed for not wearing a seat belt (OR = 1.26, 95% CI 1.12, 1.43), and they would be stopped by the police if they drove after drinking too much (OR = 1.17, 95% CI 1.03, 1.32). They were less likely to report a variety of risky behaviors including using a cell phone while driving (OR = .54, 95% CI .48, .61) and driving 10+ mph over the speed limit (OR = .81, 95% CI .72, .91), but were more likely to report having been ticketed for a moving violation in the last month (OR = 2.22, 95% CI 1.70, 2.90). Suggestions are offered for overcoming potential sources of sampling bias.

Impact on Industry

Web-based surveys produce substantially different results than random-digit-dial telephone surveys, when used for public assessments of traffic safety concerns and behaviors.     

Sleeping with a broken promise: The moderating role of generativity concerns in the relationship between psychological contract breach and insomnia among older workers

This paper examines the relationship between psychological contract breach and insomnia among older workers (aged 40 years and up). Drawing upon the conservation of resources theory, we conceptualize breach as a stressful event characterized by a perceived threat, failure to gain, or actual loss of valued resources, which increases psychological distress and insomnia. Moreover, we hypothesized that older workers' generativity concerns would act as a personal resource that would buffer the negative impact of breach. We tested our proposed model in 2 studies (Study 1 = 123; Study 2 = 168) of employee–spouse dyads. Results revealed that psychological distress mediated the relationship between psychological contract breach and insomnia. These mediated relationships were significant for those with low, but not for those with high levels of generativity concerns. These effects remained significant even after controlling for perceived organizational support (i.e., a social exchange mechanism). Theoretical and practical implications are discussed.