ENHANCING MOBILITY IN THE ELDERLY

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This application proposes a Center of Research on Applied Gerontology at Western Kentucky University. The theme of the proposed Center is research on prolonging the independence of older adults through maintenance of those critical skills and functions underlying driving competence. Many older adults experience difficulty in driving with advancing age due to the deterioration of sensory and cognitive functions. In particular, recent studies have demonstrated that visual attentional problems are good predictors of increased accident involvement in older adults. These accidents, when they occur, are much more likely to result in injury and long-term disability or death than those involving younger drivers. The significance of this research field is underscored by the fact that continued mobility fosters independence, and the ultimate goal of these centers is to benefit the lives of older people by improving quality of life, enhancing productivity, and minimizing the need for care. Furthermore, decreased mobility leads to both social and economic dependence on family members and society at large. A related and essential goal is the maintenance of mobility without sacrificing safety concerns. The proposed Center of Research on Applied Gerontology at Western Kentucky University will have three research components, all designed to evaluate and/or develop interventions to enhance mobility in the elderly. All research projects are primarily interested in members of the community dwelling population who are ambulatory, and able to drive. The Field Intervention Study of the Center is designed to evaluate a training program targeted at both detecting and improving visual attentional problems that have been associated with increased accident risk, and to determine if this training leads to reduced accident involvement and continued mobility through driving. There are two laboratory projects. One study will identify individuals in the Eye Foundation Hospital at the University of Alabama in Birmingham who are scheduled for imminent cataract removal. This project will evaluate a battery of predictors known to be related to crash history both before and following cataract removal to determine how improvement of visual function relates to future driving performance and other higher order functional predictors such as visual attention. The second laboratory study will evaluate transfer of training not only to reduced accident involvement, but also to driving simulator performance and other laboratory measures of the critical skills essential for safe driving. The Center will also provide a management core, which will provide: l) data management and biostatistical services for all three projects, 2) technical support and equipment as needed for all the projects, and 3) demonstration and information dissemination services for the projects so that new findings about enhancing independence. are communicated to health care professionals, the public, the scientific community, and government policy makers. Finally, the Center will have an Advisory Committee which will oversee the functioning of the core as well as the individual projects.