Older Driver Safety Research
Being able to safely drive as people age is key to maintaining independence. CIRP researchers are partnering with other research organizations to study older driver safety factors that influence mobility over the lifespan, including how many older adults maintain their driver's licenses and experience crashes and how prescription medication use in older adults affects their crash risk. They are also studying the effect of in-vehicle safety technology on reducing crash involvement and helping to establish practical fitness to drive assessment protocols for clinicians to follow.
Research Projects
- Vehicle Safety Characteristics in Vulnerable Driver Populations
This study, published in Traffic Injury Prevention, highlights important disparities in vehicle safety features among drivers by age and income. The researchers analyzed data from the NJ Safety and Health Outcomes Data Warehouse, which includes all crash and licensing data for the state of NJ from 2010-17 and used NHTSA’s Product Information Catalog and Vehicle Listing platform to decode the VIN of each crash-involved vehicle to obtain model year, presence of electronic stability control (ESC), vehicle type, engine horsepower, and presence of front, side, and curtain airbags. They found that teens, older adults (age 65+), and those from low-income neighborhoods are more likely to be driving vehicles that are less safe, putting them at greater risk of injury and death in the event of a crash.
Read a blog post about the study.
Read a press release about the study.
Read the study abstract.
Principal Investigators: Kristi Busico Metzger, PhD, MPH; Allison E. Curry, PhD, MPH
Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Driver Licensing, Motor Vehicle Crashes, and Moving Violations Among Older Adults
The majority of studies that look at crash rates do not take into account changes in licensing as older adults age, and updated statistics are needed to describe population-based rates of older drivers’ licensing and per-driver rates of crashes and moving violations. A study published in the Journal of Safety Research begins to fill in this research gap. Results show that over a 5-year period (2010-2014) the majority of New Jersey adults (ages 65+) are licensed (86% of males and 71% of females), but there is substantial variation by age and sex. The crash rate for older drivers (ages 65+) was 27% less than middle-aged drivers (ages 35-54) with appreciable differences by sex; but, older drivers had 40% higher fatal crash rates than middle-aged drivers. Moving violation rates among older drivers were 72% lower than middle-aged drivers. Future research is needed to understand the extent to which older adults drive and to identify other factors that influence risk of crash involvement and survivability.
Read a blog post about the research.
Read the abstract.
Principal Investigators: Aimee J. Palumbo, PhD, MPH; Allison E. Curry, PhD, MPH
Funding: National Institute on Aging; Eunice Kennedy Shriver National Institute for Child Health and Development
- Understanding Clinician Strategies for Discussing Driving Fitness with Patients: An Initiative to Improve Provider-Patient Discussions About Safe Driving
A team of researchers from the University of Pennsylvania and Children's Hospital of Philadelphia published results of a survey in Traffic Injury Prevention that aimed to understand neurosurgery and neurology providers’ knowledge and attitudes about fitness-to-drive assessments. Neurological impairments can adversely affect numerous skills important for safe driving, including attention, hand-eye coordination, processing speed, safety awareness, and judgment. Pennsylvania, where this survey was conducted, is one of six states that requires clinicians to notify the state department of transportation about patients with medical conditions that could impair their ability to safely drive.
The researchers found that only 20% of inpatient providers and 50% of outpatient providers usually or always discussed driving with patients, and only 54% reported ever having filed a report about a patient with PennDot. One-third, however, had referred a patient to a driver rehabilitation program within the last year. When asked what would help them improve their ability to assess fitness to drive, providers mentioned developing a handout about driver reporting guidelines in PA and surrounding states, information about local driver rehabilitation programs, and standardized driver screening tools. The research team plan to utilize this feedback to inform future quality improvement efforts.
Read a blog post about the research.
Principal Investigators: Arianna Unger, MPH; Flaura Winston, MD, PhD
Funding: University of Pennsylvania Master of Public Health Program
- Distance From Home to Motor Vehicle Crash Location: Implications for License Restrictions Among Medically-At-Risk Older Drivers
In 30 states, licensing agencies can restrict the distance from home that "medically-at-risk" drivers are permitted to drive. However, where older drivers crash relative to their home or how distance to crash varies by medical condition is unknown. Using geocoded crash locations and residential addresses linked to Medicare claims, researchers from the Brown University School of Public Health and CIRP describe how the relationship between distance from home to crash varies by driver characteristics, finding that a majority of crashes occur within a few miles from home with little variation across driver demographics or medical conditions. Therefore, distance restrictions may not reduce crash rates among older adults. Future research is needed to understand the extent to which older adults drive and to identify other factors that influence risk of crash involvement and survivability.
Read the abstract.
Principal Investigators: Nina R. Joyce, PhD; Andrew R. Zullo, PharmD, PhD
Funding: National Institute on Aging; Brown University Office of the Vice President Research Seed Award; Albert and Elaine Borchard Foundation; Eunice Kennedy Shriver National Institute for Child Health and Development
- Implications of Using Administrative Healthcare Data to Identify Risk of Motor Vehicle Crash-Related Injury: The Importance of Distinguishing Crash From Crash-Related Injury
Administrative healthcare databases, such as Medicare, are being used more often to identify groups of people at risk of a crash. Because these databases only include information on crash-related injuries, not all crashes, driver characteristics associated with crash and crash-related injury may differ. Merging the two may result in ineffective or imprecise policy updates that may be ineffective or not nuanced enough.
To investigate, Brown University School of Public Health and CIRP researchers linked Medicare claims (2008-2017) to NJ police crash reports to compare demographics, clinical diagnoses, and the dispensing of prescription drugs for crash-involved drivers age 68 and older. They found differences in these characteristics and recommend that researchers augment administrative datasets with information from police crash reports, and vice versa when working to develop interventions to improve traffic safety.
Read the abstract.
Principal Investigator: Nina R. Joyce, PhD; Andrew R. Zullo, PharmD, PhD
Funding: National Institute On Aging; National Institute for Child Health and Development
- Medication Changes Among Older Drivers Involved in Motor Vehicle Crashes
Although older adults may use potentially driver-impairing (PDI) medications that can produce psychomotor impairment, little is known about changes to PDI medication use among older adults from the time before to the time after a motor vehicle crash (MVC).
This cohort study, conducted by researchers at the Brown University School of Public Health and the NJ-SHO Center for Integrated Data, suggests that most older drivers involved in MVCs did not use fewer PDI medications after crashes than before crashes. Qualitative research of perceived risks versus benefits of PDI medications is necessary to understand the reasons why MVCs do not appear to motivate clinicians to deprescribe PDI medications as a strategy to avert potential harms, including additional MVCs.
Read the abstract.
Principal Investigator: Andrew R. Zullo, PharmD, PhD
Funding: National Institute On Aging; National Institute for Child Health and Development
