Identifying crash involvement among older drivers: agreement between self-report and state records.

Older drivers have a high crash rate per vehicle mile of travel. Coupled with the growth of the number of older drivers on the road, this has generated interest in the identification of factors which place older drivers at increased risk. However, much of the existing research on medical and functional risk factors for crash involvement has generally been inconsistent. Methodological differences between studies have been hypothesized as being partly responsible for such inconsistencies. The source of information used to identify crash-involved drivers has been identified as one such difference. This paper reports on the agreement between self-report and state record for identifying crash involved-older drivers. We also sought to determine whether the prevalence of visual and cognitive impairment differs across crash-involved drivers identified by either or both sources. Finally, we assessed whether risk factors for crash involvement differed when crash-involved drivers were identified by either self-report or state records. Results indicated that there was a moderate level of agreement between self-reported and state-recorded crash involvement (kappa = 0.45). However, we did find significant differences between crash-involved drivers identified via state records and/or self-report with respect to demographic (age, race), driving (annual mileage, days per week driven), and vision impairment (acuity, contrast sensitivity, peripheral visual field sensitivity, useful field of view). We also found that the possibility for biased measures of association is real. Useful field of view impairment was associated with both self-reported and state-recorded crash involvement; however, the magnitude of the associations was disparate. Moreover, glaucoma was identified as a significant risk factor when considering state-recorded crashes but not self-reported crashes. While validation of these findings is required, research designed to identify risk factors for crash involvement among older drivers should carefully consider the issue of case definition, particularly if self-report is used to identify crash-involved older drivers.

[1]  F. Meyer,et al.  Risk of automobile accidents among elderly drivers with impairments or chronic diseases. , 1994, Canadian journal of public health = Revue canadienne de sante publique.

[2]  W. Ray.  Psychotropic Drugs and Injuries Among the Elderly: A Review , 1992, Journal of clinical psychopharmacology.

[3]  F. Ferris,et al.  New visual acuity charts for clinical research. , 1982, American journal of ophthalmology.

[4]  L Staplin,et al.  Retrospective evaluation of alternative vision screening criteria for older and younger drivers. , 1993, Accident; analysis and prevention.

[5]  M. Tinetti,et al.  Predictors of Automobile Crashes and Moving Violations among Elderly Drivers , 1994, Annals of Internal Medicine.

[6]  H. W. Hofstetter.  Visual acuity and highway accidents. , 1976, Journal of the American Optometric Association.

[7]  L. McCloskey,et al.  Motor vehicle collision injuries and sensory impairments of older drivers. , 1994, Age and ageing.

[8]  A F Sanders,et al.  Some aspects of the selective process in the functional visual field. , 1970, Ergonomics.

[9]  C. Phelps,et al.  The normal visual field on the Humphrey field analyzer. , 1986, Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde.

[10]  J Katz,et al.  Blindness and visual impairment in an American urban population. The Baltimore Eye Survey. , 1990, Archives of ophthalmology.

[11]  C. Owsley,et al.  The useful field of view test: a new technique for evaluating age-related declines in visual function. , 1993, Journal of the American Optometric Association.

[12]  Marlos Viana,et al.  SHORT NOTE Relative Effects of Age and Compromised Vision on Driving Performance , 1995, Hum. Factors.

[13]  E. Wagner,et al.  Medical Conditions and Motor Vehicle Collision Injuries in Older Adults , 1994, Journal of the American Geriatrics Society.

[14]  H Jick,et al.  Sedating drugs and automobile accidents leading to hospitalization. , 1981, American journal of public health.

[15]  D. Kahneman,et al.  Relation of a test of attention to road accidents. , 1973 .

[16]  K. Ball,et al.  Visual attention problems as a predictor of vehicle crashes in older drivers. , 1993, Investigative ophthalmology & visual science.

[17]  B. L. Beattie,et al.  Vehicle crash involvement and cognitive deficit in older drivers , 1993 .

[18]  J. Szlyk,et al.  Assessment of driving performance in patients with retinitis pigmentosa. , 1992, Archives of ophthalmology.

[19]  Sydney Katz.  Assessing Self‐maintenance: Activities of Daily Living, Mobility, and Instrumental Activities of Daily Living , 1983, Journal of the American Geriatrics Society.

[20]  B. Hemmelgarn,et al.  Benzodiazepine use and the risk of motor vehicle crash in the elderly. , 1997, JAMA.

[21]  Frederick L. McGuire.  The nature of bias in official accident and violation records. , 1973 .

[22]  C Lundberg,et al.  Can a Physician Recognize an Older Driver with Increased Crash Risk Potential? , 1996, Journal of the American Geriatrics Society.

[23]  Denis G. Pelli,et al.  THE DESIGN OF A NEW LETTER CHART FOR MEASURING CONTRAST SENSITIVITY , 1988 .

[24]  C. Johnson,et al.  Incidence of visual field loss in 20,000 eyes and its relationship to driving performance. , 1983, Archives of ophthalmology.

[25]  D. Roenker,et al.  Developmental changes in attention and visual search throughout adulthood. , 1990 .

[26]  K. Ball,et al.  Visual/cognitive correlates of vehicle accidents in older drivers. , 1991, Psychology and aging.

[27]  J P Szlyk,et al.  Evaluation of driving performance in patients with juvenile macular dystrophies. , 1993, Archives of ophthalmology.

[28]  Suzanne G. Leveille,et al.  Psychoactive Medications and Injurious Motor Vehicle Collisions Involving Older Drivers , 1994, Epidemiology.

[29]  J. Gresset,et al.  Risk of accidents among elderly car drivers with visual acuity equal to 6/12 or 6/15 and lack of binocular vision , 1994, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[30]  M. Tinetti,et al.  Self-report versus state records for identifying crashes among older drivers. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[31]  Cynthia Owsley.  Clinical and Research Issues on Older Drivers: Future Directions , 1997, Alzheimer disease and associated disorders.

[32]  R Doll,et al.  Minor tranquillisers and road accidents. , 1979, British medical journal.

[33]  C. I. Neutel,et al.  Risk of traffic accident injury after a prescription for a benzodiazepine. , 1995, Annals of epidemiology.

[34]  O Kiviluoto,et al.  Role of drugs in traffic accidents. , 1980, British medical journal.

[35]  K Simons,et al.  A comparison of the Frisby, Random-Dot E, TNO, and Randot circles stereotests in screening and office use. , 1981, Archives of ophthalmology.

[36]  W A Ray,et al.  Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. , 1992, American journal of epidemiology.

[37]  D. J. Foley,et al.  Risk Factors For Motor Vehicle Crashes Among Older Drivers in a Rural Community , 1995, Journal of the American Geriatrics Society.