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）：个人车辆的驾驶是美国老年人的主要和首选旅行方式。不仅仅实现了至关重要的“围绕”或流动性功能，驱动老年人会深刻影响健康状况，因此具有直接的公共卫生相关性。成为驾驶员与增加的生活质量，抑郁和社会隔离的可能性降低以及医疗保健的可及性有关。因此，定义适用于老年人口的许可的视力标准的政策必须是理性的，即基于证据。这项研究旨在通过利用阿拉巴马州可用的独特机会和资源来采取关键步骤来建立这种证据。阿拉巴马州是一个最初许可后没有视力重新筛查的州。这种情况代表了进行研究的机会，这将克服早期研究的方法论问题，这些研究声称要检查视力与崩溃的参与与敏锐度重新筛查高级驱动因素的安全益处之间的关联。在对阿拉巴马州许可的驾驶员进行的一项研究中，视力值的分布将不限于视力良好的人，因为重新筛查法律不会像其他大多数州那样通过重新筛查法律从道路上检测到视力障碍的驱动器。为此，将对对年龄较大的驱动因素进行的前瞻性研究进行= 70岁，其中将在基线时进行某些视觉和认知功能筛选测试，然后在随后的三年中跟踪样品的崩溃数据。该研究计划的转化是因为它涉及基础研究发现的翻译，内容涉及哪些因素提高了较旧的驾驶员崩溃参与的风险，即这些已知风险因素如何指导该人群重新许可的筛查如何指导筛查。要解决的实际问题是，当出席许可证更新的老年驾驶员以在随后的几年中优化较老的驾驶员安全时，机动车许可办公室应该使用哪些筛选测试和切割点？使用这项前瞻性研究的数据，我们将能够确定如果在基线实施了各种筛查标准，则可以预防该队列的拨号撞车事故数量。这将使我们能够描述各种替代筛查标准的公共安全利益，以获得老年驾驶员的许可，这些信息对于州机构设计驾驶员重新筛选政策以优化公共安全方面对国家机构有用。