Taxonomy of Older Driver Behaviors and Crash Risk
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DOT HS 811 468C February 2012 Taxonomy of Older Driver Behaviors and Crash Risk Appendix D DISCLAIMER This publication is distributed by the U.S. Department of Transportation, National Highway Traffic Safety Administration, in the interest of information exchange. The opinions, findings, and conclusions expressed in this publication are those of the authors and not necessarily those of the Department of Transportation or the National Highway Traffic Safety Administration. The United States Government assumes no liability for its contents or use thereof. If trade names, manufacturers’ names, or specific products are mentioned, it is because they are considered essential to the object of the publication and should not be construed as an endorsement. The United States Government does not endorse products or manufacturers. Technical Report Documentation Page 1. Report No. 2. Government Accession No. 3. Recipient's Catalog No. DOT HS 811 468C 4. Title and Subtitle 5. Report Date Taxonomy of Older Driver Behaviors and Crash Risk, February 2012 Appendix D 6. Performing Organization Code 7. Authors 8. Performing Organization Report No. Loren Staplin, Kathy H. Lococo, Carol Martell, and Jane Stutts 9. Performing Organization Name and Address 10. Work Unit No. (TRAIS) TransAnalytics, LLC 336 West Broad Street 11. Contract or Grant No. Quakertown, PA 18951 Contract No. DTNH22-05-D-05043, Highway Safety Research Center, University of North Carolina Task Order No. 08 730 Martin Luther King, Jr. Blvd. Chapel Hill, NC 27599-3430 12. Sponsoring Agency Name and Address 13. Type of Report and Period Covered Office of Behavioral Safety Research Final Report National Highway Traffic Safety Administration U.S. Department of Transportation 14. Sponsoring Agency Code 1200 New Jersey Avenue SE Washington, DC 20590 15. Supplementary Notes Dr. Kathy Sifrit was the NHTSA Task Order Manager on this project. 16. Abstract This project’s objectives were to identify risky behaviors, driving habits, and exposure patterns that have been shown to increase the likelihood of crash involvement among older drivers; and to classify these crash-contributing factors according to a set of underlying functional deficits specific to, or more prevalent among, the older driver population. Such deficits may result from normal aging, age-related medical conditions, or medication use. A further goal was to identify and critically examine behavioral countermeasures with the potential to mitigate functional loss and/or diminish the occurrence of risky behaviors—and thus ameliorate crashes among older drivers. The first task was an analysis of older driver injuries and fatalities using national databases (FARS, GES), to identify driving patterns, driving tasks, and contributing factors associated with crashes by older drivers; more details are available in a separate document, Report No. DOT HS 811 093, “Identifying Behaviors and Situations Associated With Increased Crash Risk for Older Drivers.” Additional project tasks included a review of the literature describing age-related functional changes, and evaluations of existing behavioral countermeasures to reduce older drivers’ crash risk; an expert panel meeting to supplement the information from the database analyses and literature review; and unstructured interviews with older drivers who have had crashes within the previous three years, and an age-matched group who have not had crashes within that period, to determine whether these groups differ in factors such as exposure or use of countermeasures. The outcomes of these project activities were used to develop and refine a taxonomy table that captures critical relationships between topics and subtopics highlighted in the literature review and crash database analyses. This table identifies critical performance errors that underlie crash types where older drivers are most strongly overrepresented; the functional deficits that are implicated in causing such performance errors; and the countermeasure strategies that presently appear to hold the greatest promise to ameliorate or to accommodate those (age-related) deficits. The taxonomy table is a resource that provides at-a-glance, state-of-the-knowledge information to assist researchers, health care practitioners, and others concerned about older driver safety to identify particular risk factors, and what can be done to reduce the risk. A hard copy version and an expanded, electronic version of this resource were developed. 17. Key Words 18. Distribution Statement Safety, older drivers, functional abilities, crash analysis, Document is available to the public from the countermeasure, driver performance, driving errors, National Technical Information Service rehabilitation, remediation, accommodation, compensation. www.ntis.gov 19. Security Classif. (of this report) 20. Security Classif. (of this page) 21. No. of Pages 22. Price Unclassified Unclassified 212 Form DOT F 1700.7 (8-72) Reproduction of completed page authorized i APPENDIX D: LITERATURE REVIEW Effects of Functional Aging, Medical Conditions, and Medications on Driving Performance and Behavioral Countermeasures to Reduce Crash Risk A Task Report for Taxonomy of Older Driver Behaviors and Crash Risk Contract DTNH22-05-D-05043, Task Order 008 Submitted to: Dr. Kathy Sifrit National Highway Traffic Safety Administration 1200 New Jersey Avenue SE. Washington, D. C. 20590 Submitted by: Kathy H. Lococo Loren Staplin, Ph. D. D-1 Appendix D: Literature Review Table of Contents DIMINISHED SENSORY/PERCEPTUAL CAPABILITIES ................................................... D-5 An Overview of Changes in Vision With Aging ............................................................ D-5 Static Visual Acuity ........................................................................................................ D-7 Dynamic Visual Acuity ................................................................................................. D-10 Contrast Sensitivity ....................................................................................................... D-12 Visual Fields ................................................................................................................. D-17 Depth and Motion Perception ....................................................................................... D-20 Glare Sensitivity............................................................................................................ D-24 Color Vision .................................................................................................................. D-26 References for Diminished Sensory/Perceptual Capabilities ....................................... D-27 DIMINISHED COGNITIVE CAPABILITIES ........................................................................ D-36 Working Memory.......................................................................................................... D-36 Speed of Processing ...................................................................................................... D-38 Pre-Attentional and Attentional Processes .................................................................... D-41 Executive Functioning .................................................................................................. D-54 Visuospatial Abilities .................................................................................................... D-59 References for Diminished Cognitive Capabilities ....................................................... D-62 DIMINISHED PHYSICAL/PSYCHOMOTOR RESPONSE CAPABILITIES ...................... D-71 An Overview of Changes in Physical Abilities with Aging and Increased Crash Risk............................................................................................... D-71 Response Time Related to Movement .......................................................................... D-74 Strength......................................................................................................................... D-77 Flexibility and Range of Motion of Extremities ........................................................... D-78 Head and Neck Mobility............................................................................................... D-80 References for Diminished Physical/Psychomotor Response Capabilities .................. D-82 MEDICAL CONDITIONS AND OLDER DRIVER SAFETY ............................................... D-87 An Overview of Diseases and Medical Conditions and Crash Risk .............................. D-87 Conditions that Impair Visual Function ......................................................................... D-88 Conditions that Impair Cognitive Function .................................................................... D-91 Conditions that Impair Psychomotor Function ............................................................... D-93 References for Medical Conditions and Older Driver Safety ......................................... D-94 D-2 TABLE OF CONTENTS (Cont’d) MEDICATION USE IN THE OLDER POPULATION AND EFFECTS ON DRIVING ...... D-99 Medication Use in the Community-Dwelling Older Population ................................ D-100 Central Nervous System Depressants ......................................................................... D-102 Cardiovascular/Renal Medications ............................................................................. D-112 Hematologic Agents ...................................................................................................