Hostname: page-component-7c8c6479df-xxrs7 Total loading time: 0 Render date: 2024-03-28T23:27:19.170Z Has data issue: false hasContentIssue false

Transport, driving and ageing

Published online by Cambridge University Press:  16 June 2015

Desmond O’Neill*
Affiliation:
Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Ireland
*
Address for correspondence: Professor Desmond O’Neill, Professor in Medical Gerontology, Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Dublin 2, Ireland. Email: doneill@tcd.ie

Summary

Transport is the invisible glue that holds our lives together, an under-recognized contributor to economic, social and personal well-being. In public health terms, the medical profession had previously allowed itself to focus almost exclusively on the downsides of transport. However, the research basis for transport, driving and ageing is steadily evolving and has important academic and practical considerations for gerontologists and geriatricians. For gerontologists, teasing out the critical role of transport in the health and well-being of older people is an imperative, as well as the key challenges inherent in transitioning from driving to not driving. The safe crash record of a group with significant multi-morbidity allows us to focus on the remarkable strategic and adaptive skills of older people. From a policy perspective, strictures on older drivers are an exemplar of institutionalized ageism. For geriatricians, a key challenge is to develop strategies for including transportation in our clinical assessments, formulating effective strategies for assessment of medical fitness to drive, incorporating enabling techniques, giving due consideration to ethical and legal aspects, and developing and promoting multi-modality and alternative transportation options.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Cicchino, JB, McCartt, AT. Trends in older driver crash involvement rates and survivability in the United States: an update. Accident Analysis and Prevention 2014; 72: 4454.Google Scholar
2 O’Neill, D. The art of the demographic dividend. Lancet 2011; 377: 1828–29.Google Scholar
3 Henretig, FM, Durbin, DR, Kallan, MJ, Winston, FK. Grandparents driving grandchildren: an evaluation of child passenger safety and injuries. Pediatrics 2011; 128: 289–95.Google Scholar
4 O’Neill, D. Safe mobility for older people. Reviews Clin Gerontol 2000; 10: 181–92.Google Scholar
5 Mindell, JS, Cohen, DL, Shelton, NJ, Sutaria, S, Hayward, A, Watkins, SJ. Transport and clinical practice. J Transport Health 2014; 1: 7380.Google Scholar
6 Marmot, M, Marmot, MG, Wilkinson, RG. Social determinants of health. Oxford; New York: Oxford University Press; 1999.Google Scholar
7 Hjorthol, R. Transport resources, mobility and unmet transport needs in old age. Ageing and Society 2013; 33: 1190–211.Google Scholar
8 Bartley, M, O’Neill, D. Transportation and driving in longitudinal studies on ageing. Age Ageing 2010; 39: 631–36.Google Scholar
9 OECD. Ageing and Transport: Mobility Needs and Safety Issues. Paris: OECD, 2001.Google Scholar
10 Oxley, J, Whelan, M. It cannot be all about safety: the benefits of prolonged mobility. Traffic Inj Prev 2008; 9: 367–78.Google Scholar
11 Lynott, J, Figueiredo, C. How the travel patterns of older adults are changing: highlights from the 2009 National Household Travel Survey. Washington DC: AARP Public Policy Institute, 2011.Google Scholar
12 Marottoli, RA, Mendes de Leon, CF, Glass, TA, Williams, CS, Cooney, LM Jr, Berkman, LF et al. Driving cessation and increased depressive symptoms: prospective evidence from the New Haven EPESE. Established Populations for Epidemiologic Studies of the Elderly. J Am Geriatr Soc 1997; 45: 202–6.Google Scholar
13 Freeman, EE, Gange, SJ, Munoz, B, West, SK. Driving status and risk of entry into long-term care in older adults. Am J Public Health 2006; 96: 1254–59.Google Scholar
14 Edwards, JD, Lunsman, M, Perkins, M, Rebok, GW, Roth, DL. Driving cessation and health trajectories in older adults. J Gerontol A Biol Sci Med Sci 2009; 64: 1290–95.Google Scholar
15 Banister, D, Bowling, A. Quality of life for the elderly: the transport dimension. Transport Policy 2004; 11: 105–15.Google Scholar
16 Davey, J. Older people and transport: coping without a car. Ageing and Society 2007; 27: 4965.Google Scholar
17 Curl, AL, Proulx, CM, Stowe, JD, Cooney, TM. Productive and social engagement following driving cessation: a couple-based analysis. Research on Aging 2015; 37: 171–99.Google Scholar
18 Kim, H, Richardson, VE. Driving cessation and consumption expenses in the later years. J Gerontol B Psychol Sci Soc Sci 2006; 61: S34753.Google Scholar
19 May, D, Nayak, US, Isaacs, B. The life-space diary: a measure of mobility in old people at home. Int Rehabil Med 1985; 7: 182–86.Google Scholar
20 Peel, C, Sawyer Baker, P, Roth, DL, Brown, CJ, Brodner, EV, Allman, RM. Assessing mobility in older adults: the UAB Study of Aging Life-Space Assessment. Phys Ther 2005; 85: 1008–19.Google Scholar
21 Rantakokko, M, Portegijs, E, Viljanen, A, Iwarsson, S, Rantanen, T. Life-space mobility and quality of life in community-dwelling older people. J Am Geriatr Soc 2013; 61: 1830–32.Google Scholar
22 Portegijs, E, Rantakokko, M, Mikkola, TM, Viljanen, A, Rantanen, T. Association between physical performance and sense of autonomy in outdoor activities and life-space mobility in community-dwelling older people. J Am Geriatr Soc 2014; 62: 615–21.Google Scholar
23 Webber, SC, Porter, MM, Menec, VH. Mobility in older adults: a comprehensive framework. Gerontologist 2010; 50: 443–50.Google Scholar
24 Yeom, HA, Fleury, J, Keller, C. Risk factors for mobility limitation in community-dwelling older adults: a social ecological perspective. Geriatr Nurs 2008; 29: 133–40.Google Scholar
25 Rantanen, T, Portegijs, E, Viljanen, A, Eronen, J, Saajanaho, M, Tsai, LT et al. Individual and environmental factors underlying life space of older people – study protocol and design of a cohort study on life-space mobility in old age (LISPE). BMC Public Health 2012; 12: 1018.Google Scholar
26 Viljanen, A, Mikkola, TM, Rantakokko, M, Kauppinen, M, Kaprio, J, Rantanen, T. Genetic effects on life-space mobility in older women. J Am Geriatr Soc 2013; 61: 1232–34.Google Scholar
27 Musselwhite, C, Haddad, H. Mobility, accessibility and quality of later life. Quality in Ageing and Older Adults 2010; 11: 2537.Google Scholar
28 O’Neill, D. Medical screening of older drivers is not evidence based. BMJ 2012; 345: e6371.Google Scholar
29 Hakamies-Blomqvist, L, Ukkonen, T, O’Neill, D, Raitanen, T, O’Neill, D. Driver ageing does not cause higher accident rates per km. Transportation Research Part F: Traffic Psychology and Behaviour 2002; 5: 271–74.Google Scholar
30 Langford, J, Methorst, R, Hakamies-Blomqvist, L. Older drivers do not have a high crash risk – a replication of low mileage bias. Accid Anal Prev 2006; 38: 574–78.Google Scholar
31 Staplin, L, Gish, KW, Joyce, J. ‘Low mileage bias’ and related policy implications – a cautionary note. Accid Anal Prev. 2008;40 (3):1249–52. eng.Google Scholar
32 Langford, J, Koppel, S, McCarthy, D, Srinivasan, S. In defence of the ‘low-mileage bias’. Accid Anal Prev 2008; 40: 1996–99.Google Scholar
33 Li, G, Braver, ER, Chen, LH. Fragility versus excessive crash involvement as determinants of high death rates per vehicle-mile of travel among older drivers. Accid Anal Prev 2003; 35: 227–35.Google Scholar
34 Martin, A, Balding, L, O’Neill, B. A bad press: older drivers and the media. Br Med J 2005; 330: 368.Google Scholar
35 White, S, O’Neill, D. Health and relicensing policies for older drivers in the European union. Gerontology 2000; 46: 146–52.Google Scholar
36 Siren, A, Haustein, S. Driving licences and medical screening in old age: review of literature and European licensing policies. J Transport Health 2014.Google Scholar
37 Kalish, RA. The new ageism and the failure models: a polemic. Gerontologist 1979; 19: 398402.Google Scholar
38 Korner-Bitensky, N, Kua, A, von Zweck, C, Van Benthem, K. Older driver retraining: an updated systematic review of evidence of effectiveness. J Safety Res 2009; 40: 105–11.Google Scholar
39 Nasvadi, GE, Vavrik, J. Crash risk of older drivers after attending a mature driver education program. Accid Anal Prev 2007; 39: 1073–79.Google Scholar
40 Zur, BM, Vrkljan, BH. Screening at-risk older drivers: a cross-program analysis of Canadian occupational therapy curricula. Physical Occupational Therapy Geriatrics 2014; 32: 1024.Google Scholar
41 O’Neill, D. More mad and more wise. Accid Anal Prev 2012; 49: 263–65.Google Scholar
42 Martin, AJ, Hand, EB, Trace, F, O’Neill, D. Pedestrian fatalities and injuries involving Irish older people. Gerontology 2010; 56: 266–71.Google Scholar
43 Palacio, A, Tamburro, G, O’Neill, D, Simms, CK. Non-collision injuries in urban buses – strategies for prevention. Accid Anal Prev 2009; 41: 19.Google Scholar
44 Foley, DJ, Heimovitz, HK, Guralnik, JM, Brock, DB. Driving life expectancy of persons aged 70 years and older in the United States. Am J Public Health 2002; 92: 1284–89.Google Scholar
45 Choi, M, Mezuk, B, Rebok, GW. Voluntary and involuntary driving cessation in later life. J Gerontol Soc Work 2012; 55: 367–76.Google Scholar
46 Keay, L, Munoz, B, Turano, KA, Hassan, SE, Munro, CA, Duncan, DD et al. Visual and cognitive deficits predict stopping or restricting driving: the Salisbury Eye Evaluation Driving Study (SEEDS). Invest Ophthalmol Vis Sci 2009; 50: 107–13.Google Scholar
47 Lafont, S, Laumon, B, Helmer, C, Dartigues, JF, Fabrigoule, C. Driving cessation and self-reported car crashes in older drivers: the impact of cognitive impairment and dementia in a population-based study. J Geriatr Psychiatry Neurol 2008; 21: 171–82.Google Scholar
48 MacLeod, KE, Satariano, WA, Ragland, DR. The impact of health problems on driving status among older adults. J Transport Health 2014; 1: 8694.Google Scholar
49 Kullkov, E, Kulikov, E. The social and policy predictors of driving mobility among older adults. J Aging Soc Policy 2010; 23: 118.Google Scholar
50 Connell, CM, Harmon, A, Janevic, MR, Kostyniuk, LP. Older adults’ driving reduction and cessation perspectives of adult children. J Appl Gerontol 2013; 32: 975–96.Google Scholar
51 Liddle, J, Bennett, S, Allen, S, Lie, DC, Standen, B, Pachana, NA. The stages of driving cessation for people with dementia: needs and challenges. International Psychogeriatrics 2013; 25: 2033–46.Google Scholar
52 Musselwhite, CB, Shergold, I. Examining the process of driving cessation in later life. Eur J Ageing 2013; 10: 89100.Google Scholar
53 Choi, M, Adams, KB, Kahana, E. The impact of transportation support on driving cessation among community-dwelling older adults. J Gerontol B Psychol Sci Soc Sci 2012; 67: 392400.Google Scholar
54 Edwards, JD, Bart, E, O’Connor, ML, Cissell, G. Ten years down the road: predictors of driving cessation. Gerontologist 2010; 50: 393–99.Google Scholar
55 Freund, K, Vine, J. Aging, mobility and the Model T: approaches to smart community transportation. Generations 2010; 34: 7681.Google Scholar
56 Marshall, SC. The role of reduced fitness to drive due to medical impairments in explaining crashes involving older drivers. Traffic Inj Prev 2008; 9: 291–98.Google Scholar
57 De Raedt, R, Ponjaert-Kristoffersen, I. Can strategic and tactical compensation reduce crash risk in older drivers? Age Ageing 2000; 29: 517–21.Google Scholar
58 Caragata Nasvadi, G, Wister, A, Nasvadi, GC, Wister, A. Do restricted driver's licenses lower crash risk among older drivers? A survival analysis of insurance data from British Columbia. Gerontologist 2009; 49: 474–84.Google Scholar
59 Redelmeier, DA, Yarnell, CJ, Tibshirani, RJ. Physicians’ warnings for unfit drivers and risk of road crashes. N Engl J Med 2013; 368: 8788.Google Scholar
60 Rapoport, MJ, Weegar, K, Kadulina, Y, Bédard, M, Carr, D, Charlton, J et al. An international study of the quality of national-level guidelines on driving with medical illness. QJM 2015.Google Scholar
61 Carr, DB, Schwartzberg, JG, Manning, L, Sempek, J. Physician's Guide to Assessing and Counseling Older Drivers, 2nd edn. Washington, DC: NHTSA; 2010.Google Scholar
62 McNamara, A, McCluskey, A, White, J, George, S. The need for consistency and equity in driver education and assessment post-stroke. J Transport Health 2014; 1: 9599.Google Scholar
63 MacMahon, M, O’Neill, D, Kenny, RA. Syncope: driving advice is frequently overlooked. Postgrad Med J 1996; 72: 561–63.Google Scholar
64 George, S, Clark, M, Crotty, M. Development of the Adelaide driving self-efficacy scale. Clin Rehabil 2007; 21: 5661.Google Scholar
65 Adler, G, Rottunda, S, Rasmussen, K, Kuskowski, M. Caregivers dependent upon drivers with dementia. J Clin Geropsychol 2000; 6: 8390.Google Scholar
66 Stapleton, T, Connolly, D, O’Neill, D. Exploring the relationship between self-awareness of driving efficacy and that of a proxy when determining fitness to drive after stroke. Aust Occup Ther J 2012; 59: 6370.Google Scholar
67 Winter, SM, Classen, S, Shanahan, M. User evaluation of the fitness-to-drive screening measure. Physical Occupational Therapy Geriatrics 2014.Google Scholar
68 Fuller, R. Towards a general theory of driver behaviour. Accid Anal Prev 2005; 37: 461–72.Google Scholar
69 Ranney, TA. Models of driving behaviour: a review of their evolution. Accid Anal Prev 1994; 26: 733–50.Google Scholar
70 Molnar, FJ, Patel, A, Marshall, SC, Man-Son-Hing, M, Wilson, KG. Clinical utility of office-based cognitive predictors of fitness to drive in persons with dementia: a systematic review. J Am Geriatr Soc 2006; 54: 1809–24.Google Scholar
71 Michon, JA. A critical review of driver behaviour models: what do we know, what should we do? In Evans, L, Schwing, RC (eds), pp. 487525. New York: Plenum; 1985.Google Scholar
72 Galski, T, Ehle, HT, Williams, JB. Off-road driving evaluations for persons with cerebral injury: a factor analytic study of predriver and simulator testing. Am J Occup Ther 1997; 51: 352–59.Google Scholar
73 Akinwuntan, AE, Feys, H, DeWeerdt, W, Pauwels, J, Baten, G, Strypstein, E. Determinants of driving after stroke. Arch Phys Med Rehabil 2002; 83: 334–41.Google Scholar
74 Breen, DA, Breen, DP, Moore, JW, Breen, PA, O’Neill, D. Driving and dementia. BMJ 2007; 334: 1365–69.Google Scholar
75 Akinwuntan, AE, De Weerdt, W, Feys, H, Pauwels, J, Baten, G, Arno, P et al. Effect of simulator training on driving after stroke: a randomized controlled trial. Neurology 2005; 65: 843–50.Google Scholar
76 Brooks, JO, Goodenough, RR, Crisler, MC, Klein, ND, Alley, RL, Koon, BL et al. Simulator sickness during driving simulation studies. Accident Analysis Prevention 2010; 42: 788–96.Google Scholar
77 Kowalski, K, Tuokko, H, Tallman, K. On-road evaluation: its use for the identification of impairment and remediation of older drivers. Physical Occupational Therapy Geriatrics 2010; 28: 7585.Google Scholar
78 Uc, EY, Rizzo, M, Anderson, SW, Shi, Q, Dawson, JD. Driver route-following and safety errors in early Alzheimer disease. Neurology 2004; 63: 832–37.Google Scholar
79 Stav, W. CarFit: an evaluation of behaviour change and impact. Br J Occupational Therapy 2010; 73: 589–97.Google Scholar
80 Duchek, JM, Carr, DB, Hunt, L, Roe, CM, Xiong, C, Shah, K et al. Longitudinal driving performance in early-stage dementia of the Alzheimer type. J Am Geriatr Soc 2003; 51: 1342–47.Google Scholar
81 Bahro, M, Silber, E, Box, P, Sunderland, T et al. Giving up driving in Alzheimer's disease – an integrative therapeutic approach. Int J Geriatric Psychiatry 1995; 10: 871–74.Google Scholar
82 Howe, E. Improving treatments for patients who are elderly and have dementia. J Clin Ethics 2000; 11: 291303.Google Scholar
83 Hartford, F. At the crossroads: a guide to Alzheimer's disease, dementia and driving. Hartford, CT: Hartford Foundation; 2000.Google Scholar
84 Langford, J, Koppel, S. Licence restrictions as an under-used strategy in managing older driver safety. Accid Anal Prev 2011; 43: 487–93.Google Scholar
85 Auger, C, Demers, L, Gélinas, I, Jutai, J, Fuhrer, MJ, DeRuyter, F. Powered mobility for middle-aged and older adults: systematic review of outcomes and appraisal of published evidence. Am J Physical Med Rehabilitation 2008; 87: 666–80.Google Scholar
86 May, E, Garrett, R, Ballantyne, A. Being mobile: electric mobility scooters and their use by older people. Ageing Society 2010; 30: 1219–37.Google Scholar
87 McLachlan, RS, Starreveld, E, Lee, MA. Impact of mandatory physician reporting on accident risk in epilepsy. Epilepsia 2007; 48: 1500–5.Google Scholar
88 Remillard, GM, Zifkin, BG, Andermann, F. Epilepsy and motor vehicle driving – a symposium held in Quebec City, November 1998. Can J Neurol Sci 2002; 29: 315–25.Google Scholar
89 Marottoli, RA, Allore, H, Araujo, KL, Iannone, LP, Acampora, D, Gottschalk, M et al. A randomized trial of a physical conditioning program to enhance the driving performance of older persons. J Gen Intern Med 2007; 22: 590–97.Google Scholar
90 O’Neill, D. Driving and safe mobility in Parkinson's disease. In Playfer, J, Hindle, J (eds), pp. 239–52. Oxford: Radcliffe Publishing; 2008.Google Scholar
91 Rubinsztein, J, Lawton, CA. Depression and driving in the elderly. Int J Geriatric Psychiatry 1995; 10: 1517.Google Scholar
92 Sorajja, D, Nesbitt, GC, Hodge, DO, Low, PA, Hammill, SC, Gersh, BJ et al. Syncope while driving: clinical characteristics, causes, and prognosis. Circulation 2009; 120: 928–34.Google Scholar
93 Alvarez, FJ, Fierro, I, Gomez-Talegon, MT, Vicondoa, A, Ozcoidi, M. Patients treated with obstructive sleep apnea syndrome and fitness to drive assessment in clinical practice in Spain at the medical traffic centers. Traffic Inj Prev 2008; 9: 168–72.Google Scholar
94 Monestam, E, Wachtmeister, L. Impact of cataract surgery on car driving: a population based study in Sweden. Br J Ophthalmol 1997; 81: 1622.Google Scholar
95 Stork, AD, van Haeften, TW, Veneman, TF. The decision not to drive during hypoglycemia in patients with type 1 and type 2 diabetes according to hypoglycemia awareness. Diabetes Care 2007; 30: 2822–26.Google Scholar
96 Jones, JG, McCann, J, Lassere, MN. Driving and arthritis. Br J Rheumatol 1991; 30: 361–64.Google Scholar
97 Ray, WA, Thapa, PB, Shorr, RI. Medications and the older driver. Clin Geriatr Med 1993; 9: 413–38.Google Scholar
98 Ray, WA, Gurwitz, J, Decker, MD, Kennedy, DL. Medications and the safety of the older driver: is there a basis for concern? Hum Factors 1992; 34: 3351.Google Scholar