Older Drivers: An Evidence-Basis for Licensure Standards

老年驾驶员：驾驶执照标准的证据基础

• 批准号: 8056823
• 负责人: CYNTHIA OWSLEY
• 金额: $ 34.57万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8056823
• 关键词: Address; Age; Alabama; Attention; Automobile Driving; Back; Basic Science; Cognitive; Contrast Sensitivity; Country; Data; Elderly; Ensure; Excision; Government Agencies; Health Status; Healthcare; Impairment; Laws; Licensing; Licensure; Link; Mental Depression; Motor Vehicles; Policies; Population; Process; Prospective Studies; Quality of life; Research; Resources; Risk; Risk Factors; Safety; Sampling; Screening procedure; Sensitivity and Specificity; Sensory; Social isolation; Testing; Time; Translations; Travel; Vehicle crash; Vision; Vision Screening; Visual; Visual Acuity; Visual Fields; cohort; design; evidence base; improved; mental state; older driver; prevent; processing speed; programs; public health relevance; skills; spatial relationship; visual information; visual process; visual processing

DESCRIPTION (provided by applicant): Driving of the personal vehicle is the primary and preferred mode of travel for older adults in the US. More than fulfilling the critically important "getting around" or mobility function, driving in older adults profoundly impacts health status and thus has direct public health relevance. Being a driver has been linked to increased quality of life, reduced likelihood of depression and social isolation, and increased accessibility to healthcare. Therefore policies defining the vision standards for licensure as applied to the elderly population must be rational, i.e., evidence-based. This research is designed to take critical steps toward establishing this evidence-basis by making use of unique opportunities and resources available in Alabama. Alabama is a state with no visual acuity re-screening after initial licensure. Such a situation represents an opportunity to conduct a study would overcome methodological problems of earlier studies purporting to examine the association between visual acuity and crash involvement and the safety benefit of visual acuity re-screening of senior drivers. The distribution of visual acuity values in a study carried out on drivers licensed in Alabama will not be limited to those with good visual acuity, since drivers with visual acuity impairment are not detected and removed from the road by a re-screening law as they would be in most other states. Toward this end, a prospective study on older drivers ages = 70 years will be carried out, where certain visual and cognitive functional screening tests will be administered at baseline, followed by tracking of the samples' crash data for the subsequent three years. This research program is translational in that it involves the translation of basic research findings on what factors elevate the risk of older driver crash involvement to the practical issue of how these known risk factors can guide screening for re-licensure in this population. The practical question to be addressed is what screening tests and cutpoints should motor vehicle licensing offices be using when older drivers present for license renewal in order to optimize older driver safety in the subsequent years? Using the data from this prospective study, we will be able to determine the number of at-fault crashes for the cohort that would have been prevented had various screening criteria for license removal been implemented at baseline. This will allow us to characterize the public safety benefit of the various, alternative screening criteria for licensure of older drivers, information that will be useful to state agencies in designing driver re-screening policies to optimize public safety.

描述（由申请人提供）：驾驶私家车是美国老年人主要且首选的出行方式。老年人的驾驶不仅满足至关重要的“出行”或出行功能，还深刻影响健康状况，因此具有直接的公共卫生相关性。成为一名司机与提高生活质量、降低抑郁和社会孤立的可能性以及增加获得医疗保健的机会有关。因此，定义适用于老年人口的视力许可标准的政策必须是合理的，即基于证据的。这项研究旨在利用阿拉巴马州独特的机会和资源，采取关键步骤建立这一证据基础。阿拉巴马州是一个在初次获得许可后不进行视力重新筛查的州。这种情况代表了进行一项研究的机会，该研究将克服早期研究的方法学问题，旨在检查视力与碰撞事故之间的关联以及对高级驾驶员进行视力重新筛查的安全益处。在阿拉巴马州对有执照的驾驶员进行的一项研究中，视力值的分布不会仅限于视力良好的驾驶员，因为与大多数其他州一样，视力受损的驾驶员不会被重新筛查法检测到并从道路上移走。为此，将对年龄 = 70 岁的老年驾驶员进行前瞻性研究，在基线上进行某些视觉和认知功能筛查测试，然后跟踪样本在随后三年的碰撞数据。该研究计划具有转化性，因为它涉及将哪些因素会增加老年驾驶员撞车风险的基础研究成果转化为这些已知风险因素如何指导该人群重新驾驶执照筛查的实际问题。要解决的实际问题是，当老年驾驶员前来换领执照时，机动车辆执照办公室应使用哪些筛选测试和切点，以优化老年驾驶员在接下来的几年中的安全？利用这项前瞻性研究的数据，我们将能够确定如果在基线时实施各种许可证删除筛选标准，本可以避免的同类事故的数量。这将使我们能够描述老年驾驶员执照的各种替代筛选标准对公共安全的好处，这些信息将有助于国家机构设计驾驶员重新筛选政策以优化公共安全。