Ageing and Driving

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: closed (30 September 2022) | Viewed by 8487

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

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Guest Editor
Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada
Interests: artificial intelligence; smart cities; health monitoring; mobility and driving; healthy aging

Special Issue Information

Dear Colleagues,

These are exciting times in aging and driving research. The rapid development of new digital technologies, including sensors, cameras, and activity trackers has brought unprecedented insight into how, when, and where people drive on a daily basis. Increasingly, sophisticated simulators yield life-like virtual reality environments in which driving can be studied while an individual is exposed to difficult, and sometimes alarming (e.g., near crashes and crashes) driving situations, while maintaining safety. Older methodologies such as self-report surveys and interviews continue to play an important role in driving research methodologies, yielding data that is difficult to obtain in other ways (e.g., being stopped by a police officer for unsafe driving behavior, reasons for traveling to a particular destination). On-road testing delivers performance data in a situation that is similar to the assessment that takes place at driver’s license test testing facilities when determining whether an older adult is fit to drive.

These driving outcomes are being used to answer novel questions about driving in older adulthood. Researchers are examining how driving differs for persons with comorbidities common in this age group, such as mild cognitive impairment, Alzheimer’s disease, Parkinson’s disease, diabetes, and stroke. Other studies are revealing how driving behavior for older adults differs by place (e.g., rural vs. urban) and by driving conditions (e.g., weather). Driver-assist technologies are now common in newer vehicles, and semi-autonomous and fully autonomous vehicles are now a reality. Research is needed to determine how older adults use, perceive, and react to these technologies. Finally, the COVID pandemic has had an immense impact on the mobility and driving behavior of older adults.

This Special Issues of Geriatrics will focus on all areas related to older adult driving and mobility including new methodologies and technologies to characterize older adults’ driving behavior, approaches to identify drivers at risk of driving decline and driving cessation, 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 area of research. We look forward to receiving your submission.

Dr. Catherine M. Roe
Dr. Sayeh Bayat
Guest Editors

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Keywords

  • driving
  • older adults
  • motor vehicle crashes
  • Alzheimer’s disease
  • dementia

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Published Papers (4 papers)

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Research

10 pages, 415 KiB  
Article
Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic
by Frank Knoefel, Shehreen Hossain and Amy T. Hsu
Geriatrics 2023, 8(1), 7; https://doi.org/10.3390/geriatrics8010007 - 5 Jan 2023
Viewed by 2132
Abstract
Background: Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having access to a driving [...] Read more.
Background: Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having access to a driving risk assessment tool could help older adults and their caregivers prepare for discussions around driving retirement. This study compares the clinical profiles of older adult drivers assessed in an academic memory clinic who were referred to the driving authority to older drivers who were not with a focus on instrumental activities of daily living (iADLs). Methods: Data on referred (R) and not-referred (NR) drivers were extracted from medical records. Elements from the medical history, cognitive history, functional abilities, Modified Mini-Mental State (3MS) examination, Trails A/B, and clock drawing were included in the analysis. Four risk factors of interest were examined in separate logistic regression analyses, adjusted for demographic variables. Results: 50 participants were identified in each group. The R group was older on average than the NR. As expected, R were more likely to have Trails B scores over 3 min and have significantly abnormal clock drawing tests. R also showed lower 3MS scores and a higher average number of functional impairments (including managing appointments, medications, bills, or the television). Conclusion: Beyond standard cognitive tests, impairment in iADLs may help general practitioners identify at-risk drivers in the absence of standardized guidelines and tools. This finding can also inform the design of a risk assessment tool for driving and could help with approaches for drivers with otherwise borderline test results. Full article
(This article belongs to the Special Issue Ageing and Driving)
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12 pages, 2159 KiB  
Article
Autonomous Shuttle Operating on Highways and Gravel Roads in Rural America: A Demonstration Study
by Justin Mason, Cher Carney and John Gaspar
Geriatrics 2022, 7(6), 140; https://doi.org/10.3390/geriatrics7060140 - 8 Dec 2022
Cited by 5 | Viewed by 2298
Abstract
The safe integration of Automated Driving Systems (ADS) into the nation’s on-road transportation system, particularly in rural areas, could vastly improve overall quality of life for a rapidly growing segment of the US population. This paper describes findings from the first half (i.e., [...] Read more.
The safe integration of Automated Driving Systems (ADS) into the nation’s on-road transportation system, particularly in rural areas, could vastly improve overall quality of life for a rapidly growing segment of the US population. This paper describes findings from the first half (i.e., three of six phases) of a demonstration project called “ADS for Rural America”. The goal of this project is to conduct a series of demonstrations that utilizes an autonomous shuttle to show how older adults (≥65 years old) could be transported from their rural homes to other locations in rural areas, as well as an urban center. This paper examines older adults’ perceptions of automation before and after riding in an autonomous shuttle and their ratings of anxiety throughout the ride as they experience particular road types and maneuvers. After riding in the shuttle, older adults expressed decreased suspicion, increased trust, and increased reliability of ADS compared to baseline. Older adults reported low levels of anxiety during the 90 min ride in the shuttle. To promote the adoption and acceptance of ADS, older adults should be exposed to this technology. Full article
(This article belongs to the Special Issue Ageing and Driving)
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24 pages, 300 KiB  
Article
Driving Cessation: What Are Family Members’ Experiences and What Do They Think about Driving Simulators?
by Frank Knoefel, Salma Mayamuud and Rania Tfaily
Geriatrics 2022, 7(6), 126; https://doi.org/10.3390/geriatrics7060126 - 11 Nov 2022
Cited by 1 | Viewed by 1708
Abstract
Background: Driving cessation is difficult for persons living with cognitive decline (PLWCD) and their caregivers (CG). Physicians are often required to notify authorities of driving risks, and typically base decisions on paper-based cognitive assessments and on-road tests. This study examines experiences surrounding cessation [...] Read more.
Background: Driving cessation is difficult for persons living with cognitive decline (PLWCD) and their caregivers (CG). Physicians are often required to notify authorities of driving risks, and typically base decisions on paper-based cognitive assessments and on-road tests. This study examines experiences surrounding cessation and CG’s views regarding simulators in the process. Methods: Semi-structured virtual interviews were conducted with CGs of PLWCD from an academic memory clinic. Experiences around cessation were explored first, followed by discussions regarding the simulator. Framework analysis was applied to transcribed interviews. Results: Six females and two males, three children and five spouses participated. PLWCD viewed driving cessation negatively, often had difficulty understanding why, and believed cessation was temporary. CGs experienced relief and/or shock. Cessation negatively impacted the relationships between the PLWCD and both the physician and CG. Isolation, coping challenges and loss of independence were experienced by the PLWCD. The lives of caregivers were adversely affected, especially regarding driving burden and worsening mental health. CGs were generally supportive of simulators. Positives included: measurement of driving skills, method of testing, and providing an understanding regarding the driving suspension. Potential drawbacks included difficulty using the machine, testing anxiety and stress induced by a crash. Caregivers were concerned about: PLWCD’s disappointment of failure, requesting to retest, and reluctance to accept the decision. Conclusion: PLWCD and caregivers had negative experiences related to the driving cessation. Generally, caregivers viewed implementing driving simulators positively, in a context of a practice session and support for PLWCD’s potential reactions to the decision. Full article
(This article belongs to the Special Issue Ageing and Driving)
21 pages, 2507 KiB  
Article
Exploring Psychosocial Dynamics Underpinning Driver Identity in an Older Adult Sample
by Andrew K. Lee and Theresa L. Scott
Geriatrics 2022, 7(6), 122; https://doi.org/10.3390/geriatrics7060122 - 25 Oct 2022
Viewed by 1626
Abstract
Many older adults consider driving a crucial aspect of their daily routine and the prospect of driving cessation to be disruptive to their current lifestyle. Driving cessation is associated with multiple adverse consequences, including poorer health trajectories, and increased depressive symptoms. Research suggests [...] Read more.
Many older adults consider driving a crucial aspect of their daily routine and the prospect of driving cessation to be disruptive to their current lifestyle. Driving cessation is associated with multiple adverse consequences, including poorer health trajectories, and increased depressive symptoms. Research suggests that driving cessation may be disruptive to identity. This study aimed to explore the characteristics that are associated with driver identity and whether identity impacted people’s readiness for mobility changes. Of interest was whether stopping driving was perceived as either a positive or negative event. Participants, (N = 410) older adults recruited via Prolific survey panel between July and November 2021, responded to questions about transport and travel behaviors, driver identity, and perceptions of mobility changes. Driving cessation was generally perceived as a negative change. However, individuals with self-reported low readiness for mobility change also had higher overall scores for Identity, and for the subscales, Centrality and Ingroup Affect. These findings suggest that people with more concerns for mobility transition may think about and have more of an emotional investment regarding driving. The findings provide novel insight into the psychosocial dynamics of driving and the factors that influence driver identity, however further research, co-designed with older drivers and retired drivers is required. Full article
(This article belongs to the Special Issue Ageing and Driving)
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