Cognitive Decline and Older Driver Crash Risk

Details

• Personal Author:
  Chan KCG ; Crane PK ; Ebel BE ; Fraade-Blanar LA ; Larson EB ; Sears JM ; Thompson HJ
• Description:
  Objectives: To examine automobile crash risk associated with cognition in older drivers without dementia. Design: Retrospective secondary analysis of longitudinal cohort study. Setting: Our study used data from the Adult Changes in Thought (ACT) Study merged with Washington State crash reports and licensure records. Data were available from 2002 to 2015. Participants: Group Health enrollees from Washington State aged 65 and older with active driver's licenses (N=2,615). Measurements: Cognitive function was assessed using the Cognitive Abilities Screening Instrument scored using item response theory (CASI-IRT). The study outcome was police-reported motor vehicle crash. We used a negative binomial mixed-effects model with robust standard errors clustered on the individual and considered associations between crash risk, level of cognition, and amount of decline since the previous study visit. Covariates included age, sex, education, alcohol, depression, medical comorbidities, eyesight, hearing, and physical function. Individuals were censored at dementia diagnosis, death, or failure to renew their license. Results: Over an average of 7 years of follow-up, 350 (13%) people had at least one crash. A 1-unit lower CASI-IRT score was associated with a higher adjusted incidence rate ratio of crash of 1.26 (95% confidence interval=1.08-1.51). Beyond level of cognition, amount of cognitive decline between study visits was not associated with crash risk. Conclusion: This study suggests that, in older drivers, poorer performance on the CASI-IRT may be a risk factor for motor vehicle crashes, even in individuals without diagnosed dementia. Further research is needed to understand driving behavior and inform driving decisions for older adults with poor cognitive function. [Description provided by NIOSH]
• Subjects:
  Accidents, Occupational Age Factors Automobiles Nervous System Occupational Health Risk Assessment Risk Factors Safety
• Keywords:
  Accident Statistics Age Factors Author Keywords: Older Drivers Cognition Cognitive Function Cognitive Measurement Dementia Drivers Motor Vehicle Crash Motor Vehicles Risk Factors

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• ISSN:
  0002-8614
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 10 ; OSHA Region 9 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  66
• Issue:
  6
• NIOSHTIC Number:
  nn:20055317
• Citation:
  J Am Geriatr Soc 2018 Jul; 66(6):1075-1081
• Contact Point Address:
  Laura Fraade-Blanar, 1776 Main St, PO Box 2138, Santa Monica, CA, 90407
• Email:
  lblanar@uw.edu
• Federal Fiscal Year:
  2018
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of the American Geriatrics Society
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ca4740fe81e96fedad5e543af49f02e4df42de1ab0a9657ba264e4f39532d7e659621dc94be3743e5ad5c2ee61775722542283745a81b8e1e4910ab5d74cff60
• Download URL:
  https://stacks.cdc.gov/view/cdc/217653/cdc_217653_DS1.pdf
• File Type:
  [PDF - 479.71 KB ]