The objective of this prospective cohort study in an urban community was to identify the factors associated with automobile crashes, moving violations, and being stopped by police in a cohort of elderly drivers. Participants were all 283 persons who drove between 1990 and 1991, selected from a representative cohort of community-living persons aged 72 years and older in New Haven, Connecticut. Data on independent variables in five domains (demographic, health, psychosocial, activity, and physical performance) were collected in structured interviews before events occurred. The outcome measure was the self-report of involvement in automobile crashes, moving violations, or being stopped by police in a 1-year period. Of the 283 drivers, 13% reported a crash, a moving violation, or being stopped by police in 1 year. The baseline factors associated with the occurrence of adverse events in multivariable analysis (with adjustment for driving frequency and housing type) were the following: poor design copying on the Mini-Mental State Examination (relative risk, 2.7; 95% CI, 1.5 to 5.0), fewer blocks walked (relative risk 2.3; CI, 1.3 to 4.0), and more foot abnormalities (relative risk 1.9; CI, 1.1 to 3.3). These risk factors were combined for assessment of their ability to predict the occurrence of adverse driving events. If no factors were present, 6% of drivers had events; if 1 factor was present, 12% had events; of 2 factors were present, 26% had events, and if 3 factors were present, 47% had events. It is concluded that in this urban population, several simple clinical measures correlated with the risk for adverse driving events.
Abstract