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Jian Q, Chihuri S, Andrews HF, Betz ME, DiGuiseppi C, Eby DW, Hill LL, Jones V, Mielenz TJ, Molnar LJ, Strogatz D, Lang BH, Li G. Association between polypharmacy and hard braking events in older adult drivers. ACCIDENT; ANALYSIS AND PREVENTION 2024; 204:107661. [PMID: 38820927 DOI: 10.1016/j.aap.2024.107661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/08/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Polypharmacy (i.e., simultaneous use of two or more medications) poses a serious safety concern for older drivers. This study assesses the association between polypharmacy and hard braking events in older adult drivers. METHODS Data for this study came from a naturalistic driving study of 2990 older adults. Information about medications was collected through the "brown-bag review" method. Primary vehicles of the study participants were instrumented with data recording devices for up to 44 months. Multivariable negative binomial model was used to estimate the adjusted incidence rate ratios (aIRRs) and 95 % confidence intervals (CIs) of hard-braking events (i.e., maneuvers with linear deceleration rates ≥0.4 g) associated with polypharmacy. RESULTS Of the 2990 participants, 2872 (96.1 %) were eligible for this analysis. At the time of enrollment, 157 (5.5 %) drivers were taking fewer than two medications, 904 (31.5 %) were taking 2-5 medications, 895 (31.2 %) were taking 6-9 medications, 571 (19.9 %) were taking 10-13 medications, and 345 (12.0 %) were taking 14 or more medications. Compared to drivers using fewer than two medications, the risk of hard-braking events increased 8 % (aIRR 1.08, 95 % CI 1.04, 1.13) for users of 2-5 medications, 12 % (aIRR 1.12, 95 % CI 1.08, 1.16) for users of 6-9 medications, 19 % (aIRR 1.19, 95 % CI 1.15, 1.24) for users of 10-13 medications, and 34 % (aIRR 1.34, 95 % CI 1.29, 1.40) for users of 14 or more medications. CONCLUSIONS Polypharmacy in older adult drivers is associated with significantly increased incidence of hard-braking events in a dose-response fashion. Effective interventions to reduce polypharmacy use may help improve driving safety in older adults.
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Affiliation(s)
- Qi Jian
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Stanford Chihuri
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
| | - Howard F Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA; VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO 80045, USA.
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - David W Eby
- University of Michigan Transportation Research Institute, College of Engineering, Ann Arbor, MI 48109, USA.
| | - Linda L Hill
- School of Public Health, University of California San Diego, La Jolla, CA 92093, USA.
| | - Vanya Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Thelma J Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Columbia Center for Injury Science and Prevention, Columbia University Irving Medical Center, New York, NY 10032, USA.
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, College of Engineering, Ann Arbor, MI 48109, USA.
| | - David Strogatz
- Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY 13326, USA
| | - Barbara H Lang
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
| | - Guohua Li
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
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2
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Hill L, Moran R. Older Adults and Unintentional Injury. Med Clin North Am 2023; 107:1001-1010. [PMID: 37806720 DOI: 10.1016/j.mcna.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Clinicians play an important role in the prevention of unintentional injuries. Falls and motor vehicle crashes (MVC) have predictable and overlapping antecedents. Systematic screening for and management of vision impairment, frailty, cognitive impairment, polypharmacy, and inappropriate medications will reduce both falls and MVC risks. Fall-prevention measures, such as strength training, need to be more widely prescribed by physicians and implemented by older adults. Technologically tailored approaches are needed to leverage fall-reduction programs at home, as well as education of older adults regarding home hazards.
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Affiliation(s)
- Linda Hill
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, MS 0811, La Jolla, CA 92093-0811, USA
| | - Ryan Moran
- Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MS 0811, La Jolla, CA 92093-0811, USA.
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Mirabet E, Tortosa-Perez M, Tortosa F, González-Sala F. Evaluation of Psychophysical Fitness in Drivers over 65 Years of Age. Healthcare (Basel) 2023; 11:1927. [PMID: 37444761 DOI: 10.3390/healthcare11131927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The deterioration of cognitive and psychophysical ability associated with aging has an effect on road safety, especially in the driving of vehicles. The current study's main objective is to evaluate the psychophysical aptitudes in drivers over 65 years of age in a sample of drivers in Spain. METHODS The sample was formed of a total of 1663 drivers who attended a Driver Recognition Center. The evaluation of their psychophysical aptitudes was carried out following the Medical-Psychological Exploration Protocol for Driver Recognition Centers, edited by the Ministry of Health and the General Directorate of Traffic. RESULTS The results show increased restrictions in the evaluation of driving ability with age, which are especially significant after 75 years of age. Regarding sex, 70.1% of women have an approved evaluation, compared to men aged between 65-69, although from 69 onwards, the percentage of approved women decreases significantly. The loss of visual capabilities and poor performance in psycho-technical tests are the main causes associated with an evaluation with restrictions, with the number of restrictive conditions increasing with age. CONCLUSIONS There is an increase in the number of cases with age-related restrictions, especially in the case of women and ophthalmologic-related problems, although the majority of drivers over 65 years old continue driving, thus continuing with a practice that has been related to the well-being and quality of life of older adults.
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Affiliation(s)
- Enrique Mirabet
- Instituto de Investigación en Tráfico y Seguridad Vial-INTRAS, Universidad de Valencia, 46010 Valencia, Spain
| | - Macarena Tortosa-Perez
- Departamento de Psicología, Universidad Internacional de Valencia-VIU, 46002 Valencia, Spain
| | - Francisco Tortosa
- Instituto de Investigación en Tráfico y Seguridad Vial-INTRAS, Universidad de Valencia, 46010 Valencia, Spain
| | - Francisco González-Sala
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Valencia, 46010 Valencia, Spain
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Cao J, Vivoda JM. Maintaining mobility: how productive aging affects driving among older drivers. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2151803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jiawei Cao
- Department of Health and Management in Aging, Nanjing University of Chinese Medicine, 138 Xianlin Dadao, Nanjing, Jiangsu, China
| | - Jonathon M. Vivoda
- Department of Sociology and Gerontology, Miami University, 100 Bishop Circle, Oxford, Ohio, USA
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Doi T, Tsutsumimoto K, Ishii H, Nakakubo S, Kurita S, Kiuchi Y, Nishimoto K, Shimada H. Impact of social frailty on the association between driving status and disability in older adults. Arch Gerontol Geriatr 2022; 99:104597. [DOI: 10.1016/j.archger.2021.104597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 11/02/2022]
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Ratnapradipa KL, Pope CN, Nwosu A, Zhu M. Older Driver Crash Involvement and Fatalities, by Age and Sex, 2000-2017. J Appl Gerontol 2021; 40:1314-1319. [PMID: 32909516 PMCID: PMC7943652 DOI: 10.1177/0733464820956507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Federal reporting of crash fatalities has limited age-by-sex stratification, but both age and sex are associated with driving reduction and cessation. We described older driver fatal crash involvement and fatalities using Fatality Analysis Reporting System data to calculate rates (per 100,000 licensed drivers, per 100,000 population) with age-by-sex stratifications. Nationally from 2000 through 2017, 110,422 drivers 65+ were involved in crashes resulting in at least one death within 30 days, and 67,843 of these older drivers died. Involvement and fatality rates per 100,000 licensed drivers in 2017 were lowest for females 65-69 (7.7 and 3.6, respectively) and highest for males age 85+ (34.3 and 25.5, respectively). Females had lower driver fatal crash involvement and fatality rates throughout the lifespan, even when rates generally decreased over time. Elaborating fatal crash trends and rates by age and sex helps to differentiate the public health burden of older driver crashes and fatalities.
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Affiliation(s)
| | - Caitlin N. Pope
- Graduate Center for Gerontology, University of Kentucky, Lexington, KY 40536
| | - Ann Nwosu
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205
| | - Motao Zhu
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205
- Department of Pediatrics, The Ohio State University, Columbus, OH 43205
- Division of Epidemiology, The Ohio State University, Columbus, OH
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Abstract
Older drivers desire independence in mobility, and automated vehicles hold plausible opportunities to realize this goal. Motion sickness (automated shuttle exposure) or simulator sickness (automated driving simulator exposure) may affect acceptance of these technologies. This study investigated the onset of motion and simulator sickness in older drivers (mean age = 74.29, SD = 5.96; female = 54%) after exposure to an automated shuttle and automated driving simulator and assessed age and sex as determinants of motion and/or simulator sickness. Using a repeated measures design, 104 older drivers were randomly allocated to the shuttle and simulator. Baseline, as well as post exposures, were measured using the Motion Sickness Assessment Questionnaire (domains: sweatiness, queasiness, dizziness, nauseousness). Older drivers who were exposed to the simulator show a statistically significant increase in simulator sickness symptoms across the four domains compared to the same group being tested in the shuttle. No age and sex differences were detected within the groups and no participants dropped out of the study due to motion or simulator sickness. The automated shuttle and simulator hold plausible opportunities for continued exposure of older drivers to these technologies, as long as motion or driving simulator sickness protocols are used properly.
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8
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Morton L, Macfarlane GJ, Jones G, Walker-Bone K, Hollick R. Driving difficulties in patients with axial spondyloarthritis: Results from the Scotland Registry for Ankylosing Spondylitis. Arthritis Care Res (Hoboken) 2021; 74:1541-1549. [PMID: 33734612 DOI: 10.1002/acr.24595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/28/2021] [Accepted: 03/11/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To describe the driving difficulties experienced by individuals with axial spondyloarthritis (axSpA), and characterise associated clinical and sociodemographic features, and impact on work. METHOD The Scotland Registry for Ankylosing Spondylitis (SIRAS) is a cohort study of patients with a clinical diagnosis of axSpA. Baseline information was collected on clinical and patient-reported measures, and work participation measures (Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI: SHP)). Patient-rated difficulties with nine driving tasks were used in a factor analysis, and relationships between driving difficulty and work participation investigated. RESULTS 718 patients provided data for analysis, of which 642 (89%) had some difficulty with at least one driving task and 72 (10%) had some difficulty with all nine tasks. Three domains of driving difficulty were identified: dynamic driving scenarios, crossing traffic, and the physical act of driving. Chronic widespread pain, knee and back pain, fatigue, high disease activity and anxiety/depression were significantly associated with reporting driving difficulties across all three domains, particularly the physical act of driving. After adjusting for socio-demographic, disease activity, physical and mental health, driving difficulties in each domain were associated with a 2-3 times increased likelihood of restricted work productivity and with an increased risk of sickness absence in the past seven days. CONCLUSION Driving difficulties are common in individuals with axSpA and impact on work, even after adjusting for clinical status. Improving understanding and awareness of driving disability will help direct advice and resources to enable individuals to remain independent and economically active.
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Affiliation(s)
- LaKrista Morton
- Epidemiology Group, University of Aberdeen, UK, Aberdeen.,Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK, Aberdeen.,Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, Aberdeen, UK
| | - Gary J Macfarlane
- Epidemiology Group, University of Aberdeen, UK, Aberdeen.,Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK, Aberdeen.,Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, Aberdeen, UK
| | - Gareth Jones
- Epidemiology Group, University of Aberdeen, UK, Aberdeen.,Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK, Aberdeen.,Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, Aberdeen, UK
| | - Karen Walker-Bone
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, Southampton, UK
| | - Rosemary Hollick
- Epidemiology Group, University of Aberdeen, UK, Aberdeen.,Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK, Aberdeen.,Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, Aberdeen, UK
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Zhou DJ, Mikuls TR, Schmidt C, England BR, Bergman DA, Rizzo M, Merickel J, Michaud K. Driving Ability and Safety in Rheumatoid Arthritis: A Systematic Review. Arthritis Care Res (Hoboken) 2021; 73:489-497. [PMID: 31909890 DOI: 10.1002/acr.24137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 12/31/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To identify whether rheumatoid arthritis (RA) is associated with driving ability and/or the use of assistive devices or modifications to improve driving ability. METHODS We conducted a systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of RA and driving ability/adaptations by searching multiple databases from inception to April 2018. Eligible studies were original articles in the English language that had quantitative data regarding the study objective and at least 5 RA patients. Similar outcomes were extracted across studies and grouped into categories for review. RESULTS Our search yielded 1,935 potential reports, of which 22 fulfilled eligibility criteria, totaling 6,285 RA patients. The prevalence of driving issues in RA was highly variable among the studies. Some of the shared themes addressed in these publications included RA in association with rates of motor vehicle crashes, self-reported driving difficulty, inability to drive, use of driving adaptations, use of assistance by other people for transport, and difficulty with general transportation. CONCLUSION Despite variability among individual reports, driving difficulties and the use of driving adaptations are relatively common in individuals with RA. Given the central importance of automobile driving for the quality of life of RA patients, further investigations of driving ability and potential driving adaptations that can help overcome barriers to safe driving are needed.
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Affiliation(s)
| | - Ted R Mikuls
- University of Nebraska Medical Center and Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, Nebraska
| | | | - Bryant R England
- University of Nebraska Medical Center and Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, Nebraska
| | | | | | | | - Kaleb Michaud
- University of Nebraska Medical Center, Omaha, and FORWARD, The National Databank for Rheumatic Diseases, Wichita, Kansas
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10
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Xue Y, Chihuri S, Andrews HF, Betz ME, DiGuiseppi C, Eby DW, Hill LL, Jones V, Mielenz TJ, Molnar LJ, Strogatz D, Lang BH, Kelley-Baker T, Li G. Potentially Inappropriate Medication Use and Hard Braking Events in Older Drivers. Geriatrics (Basel) 2021; 6:20. [PMID: 33672575 PMCID: PMC8005989 DOI: 10.3390/geriatrics6010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/05/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022] Open
Abstract
Potentially inappropriate medications (PIMs) identified by the American Geriatrics Society should generally be avoided by older adults because of ineffectiveness or excess risk of adverse effects. Few studies have examined the effects of PIMs on driving safety measured by prospectively and objectively collected driving data. Data for this study came from the Longitudinal Research on Aging Drivers study, a multisite naturalistic driving study of older adults. Multivariable negative binominal modeling was used to estimate incidence rate ratios and 95% confidence intervals of hard braking events (proxies for unsafe driving behavior defined as events with a deceleration rate ≥0.4 g) associated with PIM use among older drivers. The study sample consisted of 2932 drivers aged 65-79 years at baseline, including 542 (18.5%) who used at least one PIM. These drivers were followed through an in-vehicle recording device for up to 44 months. The overall incidence of hard braking events was 1.16 per 1000 miles. Use of PIMs was associated with a 10% increased risk of hard braking events. Compared to drivers who were not using PIMs, the risk of hard braking events increased 6% for those using one PIM, and 24% for those using two or more PIMs. Use of PIMs by older adult drivers is associated in a dose-response fashion with elevated risks of hard braking events. Reducing PIM use in older adults might help improve driving safety as well as health outcomes.
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Affiliation(s)
- Yuqing Xue
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; (Y.X.); (T.J.M.)
| | - Stanford Chihuri
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA; (S.C.); (B.H.L.)
| | - Howard F. Andrews
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA;
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Marian E. Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA;
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO 80045, USA
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - David W. Eby
- University of Michigan Transportation Research Institute, Ann Arbor, MI 48109, USA; (D.W.E.); (L.J.M.)
- Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, MI 48109, USA
| | - Linda L. Hill
- School of Public Health, University of California San Diego, La Jolla, CA 92093, USA;
| | - Vanya Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Thelma J. Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; (Y.X.); (T.J.M.)
- Center for Injury Science and Prevention, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Lisa J. Molnar
- University of Michigan Transportation Research Institute, Ann Arbor, MI 48109, USA; (D.W.E.); (L.J.M.)
- Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, MI 48109, USA
| | | | - Barbara H. Lang
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA; (S.C.); (B.H.L.)
| | | | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; (Y.X.); (T.J.M.)
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA; (S.C.); (B.H.L.)
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Book S, Ulbrecht G, Tomandl J, Kuehlein T, Gotthardt S, Freiberger E, Graessel E. Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study. BMJ Open 2020; 10:e038434. [PMID: 33234626 PMCID: PMC7684806 DOI: 10.1136/bmjopen-2020-038434] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Having more information about the biopsychosocial functioning of their geriatric patients might help physicians better balance medical interventions according to patients' needs. For this reason, we aimed to develop an easy-to-handle International Classification of Functioning, Disability and Health (ICF) Core Set for community-dwelling geriatric patients aged 75 and older in primary care. In this empirical study, we describe the functioning and health of community-dwelling patients aged 75 and older in primary care in Germany and identify the most common problems encountered by these individuals when using the ICF. DESIGN In this exploratory, cross-sectional study, a health professional conducted semi-structured interviews. SETTING Community-dwelling older adults aged 75 and older in Germany. PARTICIPANTS 65 participants (mean age=80.2, SD=3.6). OUTCOME MEASURES Extended ICF Checklist V.2.1a, patients prioritised chapters of the 'activities and participation' component. RESULTS The three most common impairments for 'body functions' were visual system functions (ICF-code b210; 89%), blood pressure functions (b420; 80%) and sensations associated with hearing and vestibular functions (b240; 59%). For 'body structures', they were eyes, ears and related structures (s2; 81%), structure of mouth (s320; 74%) and structures related to the digestive, metabolic and endocrine systems (s5; 49%). For the 'activities and participation' component, adequate aids compensated for activity limitations to a certain degree. Still, after having adequate aids, the category in which the participants had the most difficulty was walking (d450; 35%). Participants rated the 'mobility' chapter as the most important of all chapters. 'Environmental factors' were facilitators of participants' functioning. CONCLUSIONS This empirical study provides a list of ICF categories relevant to older adults from the clinical perspective. Along with lists from the other three preparatory studies, it will form the basis for the development of an ICF Core Set for community-dwelling older adults in primary care. TRIAL REGISTRATION DETAILS The trial is registered in ClinicalTrials.gov (NCT03384732).
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Affiliation(s)
- Stephanie Book
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Gudrun Ulbrecht
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Johanna Tomandl
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Thomas Kuehlein
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Susann Gotthardt
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Germany
| | - Elmar Graessel
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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12
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Ang BH, Oxley JA, Chen WS, Yap MKK, Song KP, Lee SWH. The influence of spouses and their driving roles in self-regulation: A qualitative exploration of driving reduction and cessation practices amongst married older adults. PLoS One 2020; 15:e0232795. [PMID: 32413053 PMCID: PMC7228106 DOI: 10.1371/journal.pone.0232795] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/21/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction There is growing evidence to suggest the importance of self-regulatory practices amongst older adults to sustain mobility. However, the decision to self-regulate driving is a complex interplay between an individual’s preference and the influence of their social networks including spouse. To our best knowledge, the influence of an older adult’s spouse on their decisions during driving transition has not been explored. Materials and methods This qualitative descriptive study was conducted amongst married older adults aged 60 years and above. All interview responses were transcribed verbatim and examined using thematic approach and interpretative description method. Results A total of 11 married couples were interviewed. Three major themes emerged: [1] Our roles in driving; [2] Challenges to continue driving; and, [3] Our driving strategies to ensure continued driving. Older couples adopted driving strategies and regulated their driving patterns to ensure they continued to drive safely. Male partners often took the active driving role as the principal drivers, while the females adopted a more passive role, including being the passenger to accompany the principal drivers or becoming the co-driver to help in navigation. Other coping strategies include sharing the driving duties as well as using public transportation or mixed mode transportation. Discussion Our findings suggest spouse play a significant role in their partners’ decision to self-regulate driving. This underscores a need to recognise the importance of interdependency amongst couples and its impact on their driving decisions and outcomes.
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Affiliation(s)
- Boon Hong Ang
- School of Science, Monash University Malaysia, Subang Jaya, Malaysia
| | | | - Won Sun Chen
- School of Health Science, Swinburne University of Technology, Melbourne, Australia
- * E-mail: (WSC); (SWHL)
| | | | - Keang Peng Song
- School of Science, Monash University Malaysia, Subang Jaya, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
- Gerontology Laboratory, Global Asia in the 21 Century (GA21) Platform, Monash University Malaysia, Subang Jaya, Malaysia
- School of Pharmacy, Taylor’s University, Subang Jaya, Malaysia
- * E-mail: (WSC); (SWHL)
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13
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Hauser E, Barbosa AR, Pfützenreuter AH. Prevalence of older drivers in Brazil: results from Vigitel 2018. GERIATRICS, GERONTOLOGY AND AGING 2020. [DOI: 10.5327/z2447-2123202000089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To estimate the prevalence of Brazilian older adults who drive a car/ride a motorcycle, according to sociodemographic characteristics. METHODS: This cross-sectional study uses data from the 2018 Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel). The prevalence of drivers was determined by an affirmative answer to the following question: “Do you drive a car, motorcycle and/or other vehicle?”. RESULTS: Among the 15,333 individuals aged 65 and over living in Brazilian capitals and the Federal District, the overall prevalence of drivers was 28.73% (95%CI 27.22 – 30.29) and was higher among men (53.37%; 95%CI 50.45 – 56.28), those with higher education (65.44%; 95%CI 61.98 – 68.75), and individuals aged 65 to 69 years (35.7%; 95%CI 33.06 – 38.61). Among the regions of Brazil, prevalence varied from 35% (Midwest and South) to approximately 22% (North and Northeast). Florianopolis (42.2%; 95%CI 38.05 – 46.47) and Palmas (40.32%; 95%CI 32.74 – 48.38) were the cities with the highest prevalence of older drivers. CONCLUSIONS: Characteristics such as sex, age group, region, and state capital of residence affect the prevalence of older drivers. Our results contribute to knowledge about how older adults choose to move around in large Brazilian cities, enabling proposal of strategies to improve the quality of this population’s displacement.
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