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At least 235 records · Page 13Linked to original sources
PubMed2000

The relationship between cognitive/neuropsychological factors and car driving performance in older adults.

OBJECTIVES: Because demographic changes produce a society with a growing number of older people, seniors constitute the fastest growing segment of car drivers. The objective of this research project was to identify cognitive factors related to driving problems in older adults. A top-down approach has been used, testing theory-driven hypotheses. DESIGN: Correlational study. SETTING: Fitness-to-Drive Assessment Centre of the Belgian Road Safety Institute. PARTICIPANTS: The research sample consisted of 84 car drivers aged over 65 years, who were referred for a general fitness-to-drive evaluation. MEASUREMENTS: The relations between seven specific neuropsychological tests and self-reported accidents were investigated. Furthermore, the relations between these same tests and a road test, independently assessed using a detailed evaluation grid, were analyzed in depth. These analyses were followed by stepwise multiple regression analyses. RESULTS: In a stepwise regression model, four neuropsychological tests could account for 64% of the variance of the score on the road test. Moreover, it could be demonstrated that specific cognitive subskills share common variance with specific real-world situations. However, neuropsychological tests could explain only 19% of the variance of self-reported at fault car accidents. CONCLUSIONS: The initial results of this study indicate the relevance of a cognitive/neuropsychological approach to the driving ability of older people. However, the link with accident risk seems more complex. Consequently, neuropsychological screening procedures are in need of a broader perspective to prevent an overemphasis on unidimensional screening procedures focusing mainly on deficit and less on capacities for safe behavior.

Accidents, Traffic↗
PubMed1992

Driving with Parkinson's disease. A controlled laboratory investigation.

The part played in traffic safety by illness or disability is unknown, as is the identity and degree of the disorders which necessitate the use of driving aids or completely incapacitate a person from driving. By means of a mock car, 28 persons suffering from Parkinson's disease were compared with 109 healthy controls. Only patients in presumed optimal drug regimen and without complicating disorders were included in the study group. The main results were failure to react to stimuli on several occasions, a high frequency of erroneous reactions in particular directional errors, reduced strength and speed of movement and increased reaction times. Typically the latter would entail a prolongation of the reaction distance with more than 1/3, i.e. 6 m when driving a car at a speed of 80 km/h. The Webster score proved to be an unreliable predictor of the results of the mock car test, and the UPDRS is suggested for future studies.

Accidents, Traffic↗
PubMed2005

Glare sensitivity and professional drivers' safety: a case of rod-cone dystrophy with negative electroretinogram.

BACKGROUND: To obtain a driver's licence certain requirements for visual acuity and visual field have to be fulfilled. Mesopic contrast and glare sensitivity are not regularly tested and are not crucial to passing the driving test. CASE REPORT: We report a case of a 39-year-old professional bus driver whose only complaint was increased glare sensitivity. After he had been involved in four traffic accidents, ophthalmological investigations revealed binocular annular scotomata and night blindness, leading to the diagnosis of rod-cone dystrophy. DISCUSSION: Enhanced glare sensitivity is a common complaint in elderly people or people with the beginnings of cataract but may also represent an initial symptom of a retinal disorder. It is therefore advisable for traffic safety if drivers with such complaints undergo a complete ophthalmological investigation including visual field testing.

Accidents, Traffic↗
PubMed1997

Cataract and driving.

Explore the source record for details and available documents.

Automobile Driver Examination↗
PubMed1971

Epilepsy and driving.

The status of the epileptic applicant for a licence to drive a private motor vehicle has changed from total prohibition through a stage of partial approval subject to medical assessment to the present conditional right to a driving licence. We report a study of a series of patients which shows that many and probably most epileptics have obtained driving licences by concealment of their condition, yet the new regulations continue to expect true declarations. It is suggested that, in common with applicants for a public service vehicle or a heavy goods vehicle driving licence, the applicant for a licence to drive a private motor vehicle should provide a medical report of fitness. The epileptic should be included in a general category of medically restricted drivers subject to individual medical assessment.

Automobile Driver Examination↗
PubMed2006

Can novice drivers be trained to scan for information that will reduce their likelihood of a crash?

Sixteen year old drivers are involved in 10.3 fatal crashes per 100 million vehicle miles, a rate almost double that of 18 year olds and almost eight times that of 45-64 year olds, who are the safest group of drivers. Crash rates are particularly higher during the first month of licensure and decline rapidly for about six months and 1000 miles and then much more slowly for at least two years, consistent with a typical learning curve. Research indicates that drivers who have their learner's permit or are just newly licensed have particular difficulties identifying areas of a scenario from which hidden risks could emerge. Standard driver education programs do not appear to address these difficulties adequately. This suggests that some alternative form of driver training could reduce the crashes, either in the classroom or on the road. A PC based program designed to teach drivers to recognize risks early on is shown to improve their awareness of hazards, both on an advanced driving simulator and on the road.

Accidents, Traffic↗
PubMed1999

Graduated licensing comes to the United States.

OBJECTIVE: To describe the young driver problem and the emergence of graduated licensing as a way to address it. METHODS: Literature review and commentary. RESULTS: Twenty-four states in the United States adopted versions of graduated licensing in 1996-98; initial results show positive effects. CONCLUSIONS: A major public health movement is under way that can be expected to produce significant reductions in crashes and injuries involving young drivers.

Accidents, Traffic↗
PubMed1998

Natural deaths while driving: would screening for risk be ethically justified?

OBJECTIVES: To determine the epidemiology and the underlying pathological conditions of natural deaths among motor vehicle drivers. Sudden death while driving may cause damage to properties, other vehicles or road users. Although the Medical Commission on Accident Prevention recommended restrictions to drivers at risk of sudden death due to their medical conditions, these restrictions are useless if they do not result in greater safety to the public. DESIGN: A retrospective study of natural deaths of motor vehicle drivers. SETTING: Natural deaths of motor vehicle drivers reported to the coroner for Birmingham and Solihull. SUBJECTS: 86 consecutive natural deaths of motor vehicle drivers in a five-year period between 1984 and 1988. RESULTS: Of the 86 fatalities reviewed, 80 (93%) sudden deaths were caused by ischaemic heart disease. Fifty vehicles were involved in collision with 32 properties, 20 other vehicles and six pedestrians. Fifty-one out of 80 cardiac deaths had past cardiac history and three had reported chest pain prior to the sudden death. CONCLUSION: An applied normative ethical assessment based on the basic moral principles of autonomy, justice, beneficence and non-maleficence are discussed. We conclude that medical screening of drivers has little benefit for the drivers or other persons.

Adult↗
PubMed1998

Decreased driving ability in people with Parkinson's disease.

BACKGROUND: Driving is a complex form of activity involving especially cognitive and psychomotor functions. These functions may be impaired by Parkinson's disease. The relation between Parkinson's disease and driving ability is still obscure and clinicians have to make decisions concerning the driving ability of their patients based on insufficient information. Until now no studies have compared different methods for evaluating the driving ability of patients with Parkinson's disease. METHODS: The driving ability of 20 patients with idiopathic Parkinson's disease and 20 age and sex matched healthy control subjects was evaluated by a neurologist, psychologist, vocational rehabilitation counsellor, and driving instructor using a standard 10 point scale. The patients and controls also evaluated their own driving ability. Cognitive and psychomotor laboratory tests and a structured on road driving test were used for evaluating the subjects' driving ability. RESULTS: The patients with Parkinson's disease performed worse than the controls both in the laboratory tests and in the driving test. There was a high correlation between the laboratory tests and driving test both in the patient group and in the control group. Disease indices were not associated with the driving test. The neurologist overestimated the ability of patients with Parkinson's disease to drive compared with the driving ability evaluated by the structured on road driving test and with the driving related laboratory tests. Patients themselves were not capable of evaluating their own ability reliably. CONCLUSION: Driving ability is greatly decreased in patients with even mild to moderate Parkinson's disease. The evaluation of patients' driving ability is very difficult to carry out without psychological and psychomotor tests and/or a driving test.

Adult↗
PubMed2003

Are medical reports on fitness to drive trustworthy?

PURPOSE: Previous studies have shown that physicians often have poor knowledge of the medical restriction on fitness to drive, or submit poor quality medical reports. To determine the reliability of physicians' reports on fitness to drive, the medical data provided on the standard medical fitness form was compared with the additional data collected on repeated assessment. METHODS: A random sample of 100 applicants for a driver's licence aged more than 49 years who submitted the standard medical form were asked to provide, from their regular family doctor, confirmation of their health status and/or additional medical data in order to make a re-evaluation. RESULTS: The rate of rejection for a licence for medical reasons was 3% on the basis of the standard evaluation and 17% on the basis of the re-evaluation (p<0.001). CONCLUSION: This study shows that the random evaluation of physician assessments of applicants for a driver's licence increases the detection rate of medical problems that can affect fitness to drive. The alarming difference in the rate of rejection between the two assessments may reflect a lackadaisical attitude of medical professionals toward the licence assessment procedure and/or physician unawareness of the medical restrictions on fitness to drive. Results of this study suggest that this subject must be included in medical education programmes.

Aged↗