The Association between Psychological Resilience and Driving Behavior among Older Drivers in Australia.

This study compared a sample of Australian drivers aged 77 years and older to participants from an older driver longitudinal cohort study (Ozcandrive) and examined the relationship between resilience and self-reported driving measures within these samples. Using a survey with a subset of questions from Ozcandrive, data were collected from 237 older drivers throughout Australia. The two samples were analyzed for differences in demographics, health, resilience, and self-reported driving behavior. A series of multiple regression models were fit for each driving outcome measure for both samples. The two samples had both similarities and differences, with the largest difference observed for resilience. Strong and consistent associations were found between resilience and driving comfort, abilities, and frequency for the Australian sample. Across samples, resilience remained a significant variable in seven of 10 regression models, more than any other independent variable.

Examining the contribution of psychological resilience on self-reported and naturalistic driving behavior of older adults.

INTRODUCTION: This study examined the contribution of psychological resilience on self-reported driving comfort, abilities, and restrictions, and on naturalistic driving (ND) behavior of older adults at two time points, five years apart (N = 111; Male: 65.8%, Mean age = 86.1 years). METHOD: Participants from the Ozcandrive older driver cohort study completed a demographic questionnaire, functional assessments, psychosocial driving questionnaires, and a resilience scale. Participants' vehicles were equipped with a recording device to monitor driving behavior throughout the study. Over 1.7 million kilometers of ND data were analyzed. RESULTS: There was a significant increase in resilience over time, and both self-reported and ND measures revealed reduced driving across five years. Hierarchical regression analyses using age, sex, driving exposure, functional measures, and resilience showed that adding resilience into the models at the final step resulted in statistically significant increases in the amount of variance explained for driving comfort during the day and night, perceived driving abilities, number of trips, trip distance, and proportion of night trips. CONCLUSIONS: This research leveraged the longitudinal nature of the Ozcandrive study to provide the first insights into the role of resilience and ND. The observed patterns of reduced driving, captured by both subjective and objective measures, are suggestive of increased levels of self-regulation. As resilience is associated with adaptive coping skills, older adults with higher resilience may be able to more effectively engage in appropriate coping behaviors with regard to driving behavior, safety, and mobility. PRACTICAL APPLICATIONS: Effective methods of increasing resilience in the context of driving is worthy of future research as it will provide valuable information about how older drivers navigate the process of aging as it relates to driving and may assist stakeholders in developing suitable measures to support older driver safety.

Perceived Community Age-friendliness is Associated With Quality of Life Among Older Adults.

We examined the positive association between perceived community age-friendliness and self-reported quality of life for older adults. A total of 171 participants, aged 77-96 years, completed a mail-in questionnaire package that included measures of health (SF-36 Physical), social participation (Social Participation Scale), community age-friendliness (Age-Friendly Survey [AFS]), and quality of life (WHO Quality of Life). Hierarchical regression models including age, gender, driving status, finances, health, social participation, and AFS scores explained 8 to 21 per cent of the variance in quality of life scores. Community age-friendliness was a statistically significant variable in all models, accounting for three to six and a half per cent of additional variance in quality of life scores. Although the proportion of variance explained by age-friendliness was small, our findings suggest that it is worthwhile to further investigate whether focused, age-friendly policies, interventions, and communities could play a role towards successful and healthy aging.

Canadian Older Adults' Perceptions of Transitioning from Driver to Non-Driver.

Ceasing driving is associated with many negative outcomes. We examined the perceived impact of driving cessation among current older drivers. Transcripts from 92 interviews with participants from several locations across Canada were analyzed using inductive thematic analysis. We identified five themes: planning for mobility change, mobility supports and neighborhoods, financial security, fearing loss of control and independence, and coping and acceptance as a part of aging. Findings highlight diverse attitudes toward driving cessation, ranging from avoidance to acceptance, and emphasize the importance of tailored resources for drivers at various stages of behavior change.

Psychological Resources and Driving Status: A Study of Current and Former Drivers 55 Years of Age and Older.

Psychological resources can help individuals adjust to changes associated with aging. In this study, we examined the effect of demographic, health, and psychological resource variables in explaining driving status among adults 55 years and older. A convenience sample of 222 adults between the ages of 55 and 91 years (mean = 72.20 years) completed questionnaires that included measures of driving status, self-rated health, and psychological resources (e.g., life control, life purpose, and locus of control). Multiple logistic regression models that controlled for confounders were constructed with driver status (i.e., current driver or former driver) as the outcome. Former drivers were older, reported being in poorer health, and reported more depression symptoms. After controlling for age and health, current drivers reported higher levels of life control and life purpose and a more internal locus of control. Results highlight the importance of considering psychological resources when examining driving cessation.

The SIMARD-MD is not an Effective Driver Screening Tool for Determining Fitness-To-Drive.

BACKGROUND: Studies have reported poor sensitivity and specificity of the Screen for the Identification of Cognitively Impaired Medically At-Risk Drivers, a modification of the DemTech (SIMARD-MD) to screen for drivers with cognitive impairment. The purpose of this study was to determine whether the SIMARD-MD can accurately predict pass/fail on a road test in drivers with cognitive impairment (CI) and healthy drivers. METHODS: Data from drivers with CI were collected from two comprehensive driving assessment centres (n=86) and compared with healthy drivers (n=30). All participants completed demographic measures, clinical measures, and a road rest (pass/fail). Analyses consisted of correlations between the SIMARD-MD and the other clinical measures, and a receiver-operating-characteristic (ROC) curve to determine the predictive ability of the SIMARD-MD. RESULTS: All healthy drivers passed the road test compared with 44.2% of the CI sample. On the SIMARD-MD, the CI sample scored significantly worse than healthy drivers (p < .001). The ROC curve showed the SIMARD-MD, regardless of any cut-point, misclassified a large number of CI individuals (AUC=.692; 95% CI = 0.578, 0.806). CONCLUSIONS: Given the high level of misclassification, the SIMARD-MD should not be used with either healthy drivers or those with cognitive impairment for making decisions about driving.

Measuring the impact of driving status: The Centre for Research on Safe Driving-Impact of Driving Status on Quality of Life (CRSD-IDSQoL) tool.

BACKGROUND.: Driving an automobile is often considered an activity of daily living and is crucial to quality of life for many individuals. Following driving cessation, quality of life may become compromised. PURPOSE.: The Centre for Research on Safe Driving-Impact of Driving Status on Quality of Life (CRSD-IDSQoL) was designed to measure various elements of quality of life and how those elements are affected by driving status. METHOD.: The CRSD-IDSQoL was cross-sectionally administered to a convenience sample of 114 individuals (mean age 65.8 years). Exploratory factor analysis was used to examine the factor structure. FINDINGS.: The results supported three factors. Following adjustments for conceptual fit, Cronbach's alphas for the Community Mobility, Emotional, and Resources and Safety domains were .82, .84, and .74, respectively. Community Mobility was positively associated with distance driven per week. IMPLICATIONS.: The CRSD-IDSQoL may be a useful tool to study quality-of-life impacts of driving cessation. Further evaluation of the tool is warranted.

Looking Forward and Looking Back: Older Adults' Views of the Impacts of Stopping Driving.

This project aimed to identify the impact of driving cessation from the perspectives of older drivers and former drivers. Participants included 17 adults aged 65-88 years residing in a city in Northwestern Ontario, Canada. Using a semi-structured interview guide (with questions regarding mobility, personal impact, impact on others, engagement with life, and finances), two focus groups were held with nine current drivers, and one-on-one interviews were held with six former drivers and two current drivers. Two themes emerged concerning stopping driving. The first theme included discussions on experiencing lifestyle changes, relationship impacts, and emotional impacts. The second, the adjustment to stopping driving, included practical adaptations, and emotional responses such as appreciation, resistance, acceptance, and being positive. Although the impacts of stopping driving were substantial, there were few discrepancies between what was anticipated and what was experienced. This information could assist with developing interventions to ease the transition to former-driver status.

The combined effects of alcohol and cannabis on driving: Impact on crash risk.

BACKGROUND/OBJECTIVES: Driving under the influence of alcohol or cannabis alone is associated with increased crash risk. This study explores the combined influence of low levels of alcohol (BAC≤0.08) and cannabis on crash risk. MATERIALS AND METHODS: Drivers aged 20 years or older who had been tested for both drugs and alcohol after involvement in a fatal crash in the United States (1991-2008) were examined using a case-control design. Cases were drivers with at least one potentially unsafe driving action (UDA) recorded in relation to the crash (e.g., weaving); controls had none recorded. We examined the prevalence of driving under the influence of alcohol, cannabis, and both agents, for drivers involved in a fatal crash. Adjusted odds ratios of committing an UDA for alcohol alone, THC alone, and their combined effect were computed via logistic regression and adjusted for a number of potential confounders. RESULTS: Over the past two decades, the prevalence of THC and alcohol in car drivers involved in a fatal crash has increased approximately five-fold from below 2% in 1991 to above 10% in 2008. Each 0.01 BAC unit increased the odds of an UDA by approximately 9-11%. Drivers who were positive for THC alone had 16% increased odds of an UDA. When alcohol and THC were combined the odds of an UDA increased by approximately 8-10% for each 0.01 BAC unit increase over alcohol or THC alone. CONCLUSION: Drivers positive for both agents had greater odds of making an error than drivers positive for either alcohol or cannabis only. Further research is needed to better examine the interaction between cannabis concentration levels, alcohol, and driving. This research would support enforcement agencies and public health educators by highlighting the combined effect of cannabis at low BAC levels.

One- and three-screen driving simulator approaches to evaluate driving capacity: evidence of congruence and participants' endorsement.

OBJECTIVE: We examined the validity of one-screen versus three-screen driving simulators and their acceptability to middle-aged and older drivers. METHOD: Participants aged 40-55 or 65 and older (N = 32) completed simulated drives first with a single monitor and then with a three-monitor setup, followed by pen-and-paper measures and an interview. RESULTS: Mean differences between one- and three-screen drives were not statistically significant for Starting/Stopping and Passing/Speed. Correlations between the two drives indicated moderate positive linear relationships with moderate agreement. More errors occurred on the one-screen simulator for Signal Violation/Right of Way/Inattention, Moving in a Roadway, Turning, and Total Scores. However, for Moving in a Roadway, Turning, and Total Scores, correlations between drives indicated strong positive linear relationships. We found no meaningful correlation between workload, computer comfort, simulator discomfort, and performance on either drive. Participants found driving simulators acceptable. CONCLUSION: Findings support the use of one-screen simulators. Participants were favorable regarding driving simulators for assessment.

The influence of stimulants on truck driver crash responsibility in fatal crashes.

INTRODUCTION: Given the monotony and extended driving periods inherent in transport truck driving, drivers might rely on stimulants to sustain attention and combat fatigue. Research indicates that stimulant use improves some cognitive functions but impairs driving ability and is linked to crashes. The research on crash responsibility among stimulant-positive truck drivers is inconclusive due to small sample sizes and a lack of control over confounding variables. The present study investigated the influence of stimulants on unsafe driving actions (UDAs) in fatal crashes contained in the Fatality Analysis Reporting System (FARS) database. METHODS: Logistic regression was used to calculate the odds ratio of an UDA (cases committed an UDA; controls did not) by stimulant status (present; absent) while accounting for the influence of confounding variables (age, previous driving record, and other drug use). RESULTS: For all truck drivers, we found that 372 truck drivers tested stimulant-positive representing 0.57% of the entire truck driver sample and 3.7% of truck drivers who were actually tested for drug use. Stimulant-positive truck drivers had a greater proportion of driving record infractions and narcotic drug use compared to stimulant-negative truck drivers. The adjusted odds of committing an UDA were 78% greater for truck drivers who were stimulant-positive (OR: 1.78, 95% CI: 1.41-2.26) compared to truck drivers stimulant-negative. CONCLUSION: The results suggest stimulants are associated with crash responsibility and warrant further study into their impact on truck drivers.

Aggressive driving behaviour in young drivers (aged 16 through 25) involved in fatal crashes.

INTRODUCTION: We wished to determine the extent to which number of passengers, driver age, and sex were associated with aggressive driving actions (ADAs) in young drivers involved in a fatal crash. METHODS: We used U.S. fatal-crash data from Fatality Analysis Reporting System (FARS), 1991 -2008. Proxy measures of aggressive driving included ADA presence and speed differential (posted speed limit minus estimated travel speed). We examined the odds of an ADA and speed differential in young drivers (aged 16 to 25) by passenger status. RESULTS: Compared to driving alone young drivers (aged 16) had increased odds of an ADA between 14% (OR: 1.14; 95% CI: 1.07; 1.22) and 95% (OR: 1.95; 95% CI: 1.40; 2.74) when accompanied by one and five passengers, respectively. Further, carrying a higher number of passengers was a stronger predictor of speeding in younger drivers. CONCLUSIONS: This study supports the use of graduated licensing approaches. Specifically, developing interventions to reduce aggressive driving appear imperative. IMPACT ON INDUSTRY: While the results of our study support the use of graduated licensing approaches there is room for improvement. Our study indicates that tackling impaired driving is not sufficient to drastically reduce aggressive driving among the youngest drivers. Further research on young drivers is required to understand the influence of peers and the role of gender on driving behavior. Strategies to reduce aggressive driving behaviors among the youngest drivers may not only prevent crashes during their early driving careers but may also translate into a reduced crash risk over their lifetime.

Physiological responses to simulated and on-road driving.

Driving simulators have become an increasingly popular tool to study and assess drivers. Physiological measurements not only provide an important index of an individual's presence in the virtual environment, but they also permit us to compare simulated and on-road experiences. However, at this point, few studies examining the ecological validity of simulated driving have included physiological variables. In a first study, we embedded three surprising events into a typical simulated road circuit. The first event consisted of a car pulling out suddenly from the shoulder of the road, while the remaining two events consisted of a green traffic light changing to amber as the driver approached the intersection. We noted statistically significant elevations in the mean heart rate (MHR) response to virtual events of about 4beats per minute (bpm) during the 15s immediately following the events. In a second study, we directly compared heart rate, oxygen consumption (VO(2)), and mean ventilation (MV(E)) responses to similar simulated and on-road drives. The change in physiological variables from baseline to driving was similar between simulated and on-road conditions, and a very strong correlation between simulated and on-road driving values for MV(E) (r=0.90) was observed. MHR and maximum heart rate (HR(max)) were nonetheless significantly higher during on-road drives. These studies suggest that the level of immersion of a fixed base simulator is great enough to elicit presence, and achieve both relative and absolute validity for certain physiological parameters. Nonetheless, the absolute responses between virtual and real world experiences remain different. For both research and evaluation purposes, it is critical that we better understand the impact of the driver's perceived level of risk or difficulty during simulation on their driving behaviour and physiological responses.

Driving performance and susceptibility to simulator sickness: are they related?

We examined whether participants who failed to complete a simulated drive because of simulator sickness (dropouts) differed from those who completed the simulation (completers). Thirteen healthy older adult dropouts (mean age = 74.8 yr) and 12 comparable completers were compared on the following variables: on-road driving performance, the Useful Field of View test, the Attention Network Test, and the Trail Making Test Part A. Results showed that completers scored more demerit points during the on-road drive than did dropouts. In addition, only 1 of 13 comparisons based on participants' cognition was statistically significant. These results suggest that in healthy senior drivers, simulator sickness does not prevent examination of those who need it most (i.e., those with the poorest on-road driving performance) and that cognitive differences are not associated with dropping out because of simulator sickness.

Implicit perceptions of risk and anxiety and pilot involvement in hazardous events.

OBJECTIVE: The aim of the studies was to examine the role of implicit processes in aeronautical risk perception and risk taking. BACKGROUND: Aeronautical decision making consists of both explicit processes (e.g., comparing options, seeking information) and implicit, or intuitive, processes (e.g., immediate affective reactions). The present studies utilized a novel methodology, adapted from studies in social cognition, to examine the relationship between general aviation pilots' implicit reactions toward risk and their involvement in hazardous events. METHOD: The Implicit Association Test was used to measure pilots' (Study 1: N= 23; Study 2: N= 32) implicit associations between good and bad weather conditions and perceptions of risk and anxiety. RESULTS: There was a relationship between the pilots' implicit perceptions and previous involvement in hazardous aeronautical events as measured by D. R. Hunter's (1995, 2002) Hazardous Events Scale. The more weather-related hazardous events the pilots had been involved in, the less they associated implicit risk with adverse weather (Study 1) and the less implicitly anxious they were toward adverse weather (Study 2). CONCLUSION: The results show a relationship between implicit associations and risk-taking behavior. APPLICATION: Pilots may be involved in risk-taking behavior because they perceive less risk in, and are implicitly less afraid of, hazardous conditions.