Aging and Driving: 2019

A special issue of Geriatrics (ISSN 2308-3417). This special issue belongs to the section "Geriatric Neurology".

Deadline for manuscript submissions: closed (1 March 2020) | Viewed by 31994

Special Issue Editors


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Guest Editor
Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA
Interests: Alzheimer's disease; driving; functional outcomes; cognitive reserve; biomarkers
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA
Interests: driving; naturalistic methodologies; AD; diverse populations; health disparities; mood disorders; emotion; stress and aging

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Guest Editor
Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
Interests: driving; AD; driving cessation; diverse populations; emotion; stress and aging

Special Issue Information

Dear Colleagues,

Driving is an important activity of daily living for most seniors, allowing them to maintain autonomy and have ready access to food, medical care, and companionship. The aging population is increasing worldwide, as is the proportion of drivers who are older adults. In the United States, persons aged 65 years or older will represent 1 in every 4 drivers by 2050. Since older adults are healthier and living longer than ever before, they are driving well into older age. However, older adults are more likely than younger adults to have medical conditions that may interfere with safe driving, such as frailty, vision problems, and cognitive impairment. Safety concerns among older drivers must be balanced with undesirable effects associated with driving cessation, such as depression.

Additionally, the driving/transportation landscape has changed rapidly over the last few years. These changes include enhanced safety technology, such as early warning systems in vehicles, the rise of e-hail services, and the possibility of self-driving cars. However, the benefits and costs of these newer technologies have not been fully explored. For example, it is possible that early warning systems, in addition to any safety advantage they provide, may also prove distracting to some older adults and this reduce the amount of attention devoted to the task of driving. E-hail services are unavailable in rural areas. Finally, the feasibility, affordability, and acceptability of self-driving cars among the general population, particularly among older adults, is many years away.

This is the second in a series of Special Issues on Geriatrics that will focus on risk factors of impaired driving in older adults, new methodologies and technologies that identify drivers at risk of driving decline, and driving interventions to improve driving skills and transportation alternatives. The Special Issue provides an open access opportunity to publish research articles, reviews, opinions, letters, and case reports related to this important and increasingly noticed field of research. We hope that you and your colleagues will submit for publication in this Special Issue.

Prof. Dr. Catherine M. Roe, PhD
Dr. Ganesh M. Babulal, OTD, PhD
Sarah H. Stout, MSW
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • Driving
  • Aging
  • Transportation
  • Alzheimer's disease
  • Crashes

Published Papers (7 papers)

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Research

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10 pages, 1209 KiB  
Article
Use of GPS for Older Adults to Decrease Driving Risk: Perceptions from Users and Non-Users
by Anne E. Dickerson
Geriatrics 2020, 5(3), 60; https://doi.org/10.3390/geriatrics5030060 - 22 Sep 2020
Cited by 3 | Viewed by 2036
Abstract
Community mobility is important for social participation and quality of life. Thus, it is important to sustain older adults in their communities by supporting their ability to drive as long as possible. Use of global positioning system (GPS) technology may provide such support. [...] Read more.
Community mobility is important for social participation and quality of life. Thus, it is important to sustain older adults in their communities by supporting their ability to drive as long as possible. Use of global positioning system (GPS) technology may provide such support. This descriptive study examined 89 healthy community older adults’ perspective on using and programming a GPS after using it for wayfinding to unfamiliar destinations. Participants were equally divided between two age groups (60s, 70s) and familiarity with GPS (familiar, unfamiliar). The results showed age differences in problems following GPS directions and those who were familiar found it significantly easier to use. The majority of the unfamiliar group indicated an increased interest in using GPS and were significantly more interested in training to use a GPS. Preference for learning how to use a GPS included in-person delivery and practice with troubleshooting, using the menus and changing routes as topics critical for training. The implications of these results are discussed. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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19 pages, 1043 KiB  
Article
Feasibility and Validity of a Low-Cost Racing Simulator in Driving Assessment after Stroke
by Jonathan Tiu, Annie C. Harmon, James D. Stowe, Amen Zwa, Marc Kinnear, Latch Dimitrov, Tina Nolte and David B. Carr
Geriatrics 2020, 5(2), 35; https://doi.org/10.3390/geriatrics5020035 - 29 May 2020
Cited by 6 | Viewed by 4519
Abstract
There is a myriad of methodologies to assess driving performance after a stroke. These include psychometric tests, driving simulation, questionnaires, and/or road tests. Research-based driving simulators have emerged as a safe, convenient way to assess driving performance after a stroke. Such traditional research [...] Read more.
There is a myriad of methodologies to assess driving performance after a stroke. These include psychometric tests, driving simulation, questionnaires, and/or road tests. Research-based driving simulators have emerged as a safe, convenient way to assess driving performance after a stroke. Such traditional research simulators are useful in recreating street traffic scenarios, but are often expensive, with limited physics models and graphics rendering. In contrast, racing simulators developed for motorsport professionals and enthusiasts offer high levels of realism, run on consumer-grade hardware, and can provide rich telemetric data. However, most offer limited simulation of traffic scenarios. This pilot study compares the feasibility of research simulation and racing simulation in a sample with minor stroke. We determine that the racing simulator is tolerated well in subjects with a minor stroke. There were correlations between research and racing simulator outcomes with psychometric tests associated with driving performance, such as the Trails Making Test Part A, Snellgrove Maze Task, and the Motricity Index. We found correlations between measures of driving speed on a complex research simulator scenario and racing simulator lap time and maximum tires off track. Finally, we present two models, using outcomes from either the research or racing simulator, predicting road test failure as linked to a previously published fitness-to-drive calculator that uses psychometric screening. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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13 pages, 232 KiB  
Article
The Relationship between in-Vehicle Technologies and Self-Regulation among Older Drivers
by Austin M. Svancara, Leon Villavicencio, Tara Kelley-Baker, William J. Horrey, Lisa J. Molnar, David W. Eby, Thelma J. Mielenz, Linda Hill, Carolyn DiGuiseppi, David Strogatz and Guohua Li
Geriatrics 2020, 5(2), 23; https://doi.org/10.3390/geriatrics5020023 - 16 Apr 2020
Cited by 1 | Viewed by 3734
Abstract
The study sought to understand the relationship between in-vehicle technologies (IVTs) and self-regulatory behaviors among older drivers. In a large multi-site study of 2990 older drivers, self-reported data on the presence of IVTs and avoidance of various driving behaviors (talking on a mobile [...] Read more.
The study sought to understand the relationship between in-vehicle technologies (IVTs) and self-regulatory behaviors among older drivers. In a large multi-site study of 2990 older drivers, self-reported data on the presence of IVTs and avoidance of various driving behaviors (talking on a mobile phone while driving, driving at night, driving in bad weather, and making left turns when there is no left turn arrow) were recorded. Self-reports were used to identify whether avoidance was due to self-regulation. Hierarchical logistic regressions were used to determine whether the presence of a particular IVT predicted the likelihood of a given self-regulatory behavior after controlling for other factors. Results suggest that the presence of Integrated Bluetooth/Voice Control systems are related to a reduced likelihood of avoiding talking on a mobile phone while driving due to self-regulation (OR = 0.37, 95% CI = 0.29–0.47). The presence of a Navigation Assistance system was related to a reduced likelihood of avoiding talking on a mobile phone while driving (OR= 0.65, 95% CI = 0.50–0.84) and avoiding driving at night due to self-regulation (OR = 0.80, 95% CI = 0.64–1.00). Present findings suggest in-vehicle technologies may differently influence the self-regulatory behaviors of older drivers. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
10 pages, 366 KiB  
Article
Associations of Frailty Status with Low-Mileage Driving and Driving Cessation in a Cohort of Older Drivers
by Christopher L. Crowe, Sneha Kannoth, Howard Andrews, David Strogatz, Guohua Li, Carolyn DiGuiseppi, Linda Hill, David W. Eby, Lisa J. Molnar and Thelma J. Mielenz
Geriatrics 2020, 5(1), 19; https://doi.org/10.3390/geriatrics5010019 - 19 Mar 2020
Cited by 13 | Viewed by 4151
Abstract
The US older adult population is projected to considerably increase in the future, and continued driving mobility is important for health aspects in populations with fewer transportation alternatives. This study evaluated whether frailty is associated with low-mileage driving (<1865 miles per year) and [...] Read more.
The US older adult population is projected to considerably increase in the future, and continued driving mobility is important for health aspects in populations with fewer transportation alternatives. This study evaluated whether frailty is associated with low-mileage driving (<1865 miles per year) and driving cessation among older adults. Baseline demographics and health data were collected for 2990 older drivers via in-person assessments and questionnaires, with 2964 reporting baseline frailty data. Multivariable log-binomial regression models were used to evaluate the association between baseline frailty status and low-mileage driving. Multivariable Cox proportional hazards regression were used to evaluate the association between baseline frailty status and driving cessation. For every unit increase in frailty, the estimated adjusted risk of driving fewer than 1865 miles/year increased by 138% (adjusted risk ratio: 2.38, 95% CI: 1.63–3.46). Relative to older drivers who were not frail, the adjusted hazard ratios of driving cessation were 4.15 (95% CI: 1.89–9.10) for those classified as prefrail and 6.08 (95% CI: 1.36–27.26) for those classified as frail. Frailty is positively associated with low-mileage driving status and driving cessation in a dose-response fashion. Public health interventions that reduce frailty, such as physical activity, may help older drivers maintain safe and independent mobility. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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Review

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14 pages, 982 KiB  
Review
The Role of Eye Tracking Technology in Assessing Older Driver Safety
by David B. Carr and Prateek Grover
Geriatrics 2020, 5(2), 36; https://doi.org/10.3390/geriatrics5020036 - 7 Jun 2020
Cited by 20 | Viewed by 6078
Abstract
A growing body of literature is focused on the use of eye tracking (ET) technology to understand the association between objective visual parameters and higher order brain processes such as cognition. One of the settings where this principle has found practical utility is [...] Read more.
A growing body of literature is focused on the use of eye tracking (ET) technology to understand the association between objective visual parameters and higher order brain processes such as cognition. One of the settings where this principle has found practical utility is in the area of driving safety. Methods: We reviewed the literature to identify the changes in ET parameters with older adults and neurodegenerative disease. Results: This narrative review provides a brief overview of oculomotor system anatomy and physiology, defines common eye movements and tracking variables that are typically studied, explains the most common methods of eye tracking measurements during driving in simulation and in naturalistic settings, and examines the association of impairment in ET parameters with advanced age and neurodegenerative disease. Conclusion: ET technology is becoming less expensive, more portable, easier to use, and readily applicable in a variety of clinical settings. Older adults and especially those with neurodegenerative disease may have impairments in visual search parameters, placing them at risk for motor vehicle crashes. Advanced driver assessment systems are becoming more ubiquitous in newer cars and may significantly reduce crashes related to impaired visual search, distraction, and/or fatigue. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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10 pages, 578 KiB  
Review
A Systematic Review Examining Associations between Cardiovascular Conditions and Driving Outcomes among Older Drivers
by Ganesh M. Babulal, Ramana Kolady, Sarah H. Stout and Catherine M. Roe
Geriatrics 2020, 5(2), 27; https://doi.org/10.3390/geriatrics5020027 - 28 Apr 2020
Cited by 4 | Viewed by 4587
Abstract
There is a vast literature on stroke as a cardiovascular disease and driving outcomes, however little is known about other cardiovascular conditions and driving. The purpose of this review is to examine the literature for studies assessing the effect of non-stroke, vascular conditions [...] Read more.
There is a vast literature on stroke as a cardiovascular disease and driving outcomes, however little is known about other cardiovascular conditions and driving. The purpose of this review is to examine the literature for studies assessing the effect of non-stroke, vascular conditions on daily driving, reported crash risk and driving decline in older adult drivers as captured by naturalistic methodologies. A systematic review of Embase, Ovid and Scopus Plus examined articles on driving and vascular conditions among older adults. A search yielded 443 articles and, following two screenings, no articles remained that focused on non-stroke, vascular conditions and naturalistic driving. As a result, this review examined non-stroke, vascular conditions in nine driving studies of older adults that used road testing, driving simulators and self-report measures. These studies fell into three categories—heart failure, vascular dementia and white matter hyperintensities/leukoaraiosis. The combined findings of the studies suggest that heart failure, vascular dementia and white matter hyperintensities (WMH) negatively impact driving performance and contribute to driving cessation among older adults. Future research should examine cardiovascular risk factors like hypertension, hypercholesterolemia, myocardial infraction or atherosclerosis using naturalistic driving measurement, as well as traditional measures, in order to more fully characterize how these conditions impact older adult driving. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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Other

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14 pages, 756 KiB  
Commentary
Semi-Autonomous Vehicles as a Cognitive Assistive Device for Older Adults
by Frank Knoefel, Bruce Wallace, Rafik Goubran, Iman Sabra and Shawn Marshall
Geriatrics 2019, 4(4), 63; https://doi.org/10.3390/geriatrics4040063 - 16 Nov 2019
Cited by 20 | Viewed by 6390
Abstract
Losing the capacity to drive due to age-related cognitive decline can have a detrimental impact on the daily life functioning of older adults living alone and in remote areas. Semi-autonomous vehicles (SAVs) could have the potential to preserve driving independence of this population [...] Read more.
Losing the capacity to drive due to age-related cognitive decline can have a detrimental impact on the daily life functioning of older adults living alone and in remote areas. Semi-autonomous vehicles (SAVs) could have the potential to preserve driving independence of this population with high health needs. This paper explores if SAVs could be used as a cognitive assistive device for older aging drivers with cognitive challenges. We illustrate the impact of age-related changes of cognitive functions on driving capacity. Furthermore, following an overview on the current state of SAVs, we propose a model for connecting cognitive health needs of older drivers to SAVs. The model demonstrates the connections between cognitive changes experienced by aging drivers, their impact on actual driving, car sensors’ features, and vehicle automation. Finally, we present challenges that should be considered when using the constantly changing smart vehicle technology, adapting it to aging drivers and vice versa. This paper sheds light on age-related cognitive characteristics that should be considered when developing future SAVs manufacturing policies which may potentially help decrease the impact of cognitive change on older adult drivers. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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