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• Older drivers preferred cheap, fuel-efficient vehicles with AVTs. • Height of the drivers' seat off the ground was not an important attribute. • Better pricing and packaging of AVTs is needed to promote uptake in older drivers. • Better communication of value of AVTs to older drivers is needed. Introduction: Advanced vehicle technologies (AVTs) can reduce the risk of crashing and serious injuries however their uptake remains low amongst older drivers. A discrete choice experiment (DCE) was used to investigate what vehicle features, including AVTs, are preferred in vehicle purchasing decision in older drivers. Methods: Older drivers (≥65 years) completed a DCE containing 12 choice sets, with 2 vehicles to choose from, described by 4 attributes: Access, Fuel Efficiency, Cost, and AVTs. Conditional logistic models adjusting for age and sex, and then expanded to include a priori interactive terms for socio economic status, self-rated mobility limitations and anxiety/depression, and sex were run in R v4.2.2 with odds ratio (ORs) and 95% confidence intervals (Cls) reported. Marginal willingness to pay for more AVTs was estimated. Results: 133 participants (mean age: 73.6 years; 66% males) completed the survey. Participants significantly preferred vehicles with better "Fuel efficiency" (OR 1.57, 95%Cl 1.44–1.71) and AVT inclusions (OR 1.29, 95%Cl 1.20–1.40), and were less likely to choose more expensive vehicles (per $5000 increase; OR 0.91, 95%Cl 0.86–0.99). "Access" did not influence choice between the two vehicle options. Those on a pension were price sensitive: twice as likely to choose a vehicle with better "fuel efficiency" and approximately 40 % less likely to choose a more expensive vehicle. Participants were willing to pay at most $1,604.17 (95%Cl $337.60-$3,174.50) extra for a car with AVTs that otherwise would cost $30,000. Conclusion: Despite showing interest in AVTs, older adults place more importance on price and fuel efficiency, and therefore would only pay a modest amount to get a car with more technological features. Practical applications: These results can help road safety professionals, industry and policy makers better communicate the value of AVTs to older drivers and help promote the uptake of AVTs and safety amongst older drivers. [ABSTRACT FROM AUTHOR]

Understanding older adults' driving behavior based on their personal assessment, along with challenges they encounter when driving will support community leaders and policymakers to develop effective supportive strategies for their safety on the road. This study uses a mixed methodology approach, including a survey and an interview to examine older drivers' perceptions and concerns regarding their driving habits. Collecting data from cities in Texas and Nevada, to achieve diverse perspectives on older adults who live in environments with different land use patterns and road geometry. Using the survey to understand the older adults' self-evaluated driving skills, where most consider themselves very good drivers even though they have some challenges, based on the roads, their reflexes changing over the years, and the impact of their physical and cognitive health. Supplementing the survey results with the interview allows the study to identify older drivers' major challenges including adverse weather, construction sites, and in-vehicle distractions. Supporting that visual and cognitive challenges are limiting older adults' driving patterns (e.g., not driving at night). To avoid any conflicts with aggressive drivers, the older adults are passively driving, and if accessible, utilizing in-vehicle technologies to increase their safety. However, older drivers suggested that all drivers, particularly younger drivers, should have access to more educational materials. They recommended that older adults' licensing requirements should be evaluated based on their health condition rather than age. Participants' concern regarding roadway infrastructure elements and driver behavior can be resolved through improvements in road design and driver education. [ABSTRACT FROM AUTHOR]

Background Visual fields are important for postural stability and ability to manoeuvre around objects. Objective Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50 +. Methods Older adults aged 50+ with and without visual field loss were identified using a fields database obtained from a cross-section of ophthalmologists' practices in Western Australia (WA). Data were linked to the Hospital Morbidity Data Collection and WA Hospital Mortality System to identify participants who experienced falls-related hospitalisations between 1990 and 2019. A generalised linear negative binomial regression model examined the association between falls requiring hospitalisation for those with and without field loss, based on the better eye mean deviation (mild: −2 to –6 dB, moderate: −6.01 dB to –12 dB, severe < −12.01 dB) in the most contemporaneous visual field test (3 years prior or if not available, 2 years after the fall), after adjusting for potential confounders. Results A total of 31 021 unique individuals of whom 6054 (19.5%) experienced 11 818 falls requiring hospitalisation during a median observation time of 14.1 years. Only mean deviation index of <−12.01 dB (severe) was significantly associated with an increased rate of falls requiring hospitalisations by 14% (adjusted IRR 1.14, 95% CI 1.0–1.25) compared with no field loss, after adjusting for potential confounders. Other factors included age, with those aged 80+ having an increased rate (IRR 29.16, 95% CI 21.39–39.84), other comorbid conditions (IRR 1.49, 95% CI 1.38–1.60) and diabetes (IRR 1.25, 95% CI 1.14–1.37). Previous cataract surgery was associated with a decreased rate of falls that required hospitalisations by 13% (IRR 0.87, 95% CI 0.81–0.95) compared with those who did not have cataract surgery. Conclusion The findings highlight the importance of continuous clinical monitoring of visual field loss and injury prevention strategies for older adults with visual field loss. [ABSTRACT FROM AUTHOR]

• A novel algorithm was developed to analyze driving route uniqueness and driver familiarity using GPS data from a smartphone app, encompassing young novice and older drivers. • The algorithm compares trips of identified users, creating same route trip arrays with statistically determined thresholds for GPS proximity and trip overlap. Optimal thresholds were found using a General Linear Model. • The algorithm outputs driving diversity (number of unique routes) and route-based familiarity using the Rescorla-Wagner model. • Gaussian mixture model clustering revealed two groups in young drivers: high and low frequency drivers with opposite patterns of route diversity and familiarity. • In older drivers, a significant negative correlation was found between the number of unique routes and Geriatric Depression Score, and a positive correlation with walking gait speed, suggesting route diversity and familiarity may complement existing measures of driving safety and behavior-related outcomes. Introduction: This study addresses the lack of methods to quantify driver familiarity with roadways, which poses a higher risk of crashes. Method: We present a new approach to assessing driving route diversity and familiarity using data from the DrivingApp , a smartphone-based research tool that collects trip-level information, including driving exposure and global positioning system (GPS) data, from young novice drivers (15–19 years old) to older drivers (67–78 years old). Using these data, we developed a GPS data-based algorithm to analyze the uniqueness of driving routes. The algorithm creates same route trip (SRT) arrays by comparing each trip of an identified user, employing statistically determined thresholds for GPS coordinate proximity and trip overlap. The optimal thresholds were established using a General Linear Model (GLM) to examine distance, and repeated observations. The Adjusted Breadth-First Search method is applied to the SRT arrays to prevent double counting or trip omission. The resulting list is classified as geographically distinct routes, or unique routes (URs). Results: Manual comparison of algorithm output with geographical maps yielded an overall precision of 0.93 and accuracy of 0.91. The algorithm produces two main outputs: a measure of driving diversity (number of URs) and a measure of route-based familiarity derived from the Rescorla–Wagner model. To evaluate the utility of these measures, a Gaussian mixture model clustering algorithm was used on the young novice driver dataset, revealing two distinct groups: the low-frequency driving group with lower route familiarity when having higher route diversity, whereas the high-frequency driving group with the opposite pattern. In the older driver group, there was a significant correlation found between the number of URs and Geriatric Depression Score, or walking gait speed. Practical Applications: These findings suggest that route diversity and familiarity could complement existing measures to understand driving safety and how driving behavior is related to physical and psychological outcomes. [ABSTRACT FROM AUTHOR]

• Openness to experience predicts better on-road performance in older drivers. • Openness to experience is positively related to different driving situations. • Openness to experience and extraversion are associated with greater driving practice. Particularly in older age, personality has been an underrepresented predictor of driving safety. However, when changes in driving-related abilities are inevitable, on-road performance declines and personality traits may play an important role because the need for self-assessment and self-management is rising. In a prospective on-road study with data from N = 81 older drivers, we therefore examined whether and to what extent the Big Five dimensions predict on-road driving performance. Statistical analyses included a multiple regression of on-road driving performance onto the Big Five dimensions. Moreover, we explored the relation of the Big Five dimensions with specific driving dimensions and different driving-relevant variables. Among all Big Five dimensions, only openness to experience significantly predicted on-road performance in older drivers. Moreover, it showed positive correlations with most driving dimensions and several driving-relevant variables. Both openness to experience and extraversion were associated with greater driving practice. Among different personality factors, our results highlight the relevance of openness to experience for on-road driving behavior in older adults. Although personality alone does not appear to adequately predict on-road performance, the examination of specific personality traits may help to identify at-risk drivers and aid in prevention and intervention. [ABSTRACT FROM AUTHOR]

• Young drivers frequently exposed to online content on illegal driving behaviours. • Online content on illegal driving behaviours commonly seen on Snapchat. • Middle-aged and older drivers rarely exposed to online content on illegal driving. • Young drivers most likely to 'call out' online content they do not agree with. • Online content on illegal driving may have the potential to encourage behaviour. A substantial amount of online content on illegal driving behaviours is shared on social media platforms. Yet, the influence of online content on behaviours remains unclear. Accordingly, this qualitative study explored perspectives across different age groups on a) the nature and extent of social media content that encourages illegal driving behaviours and b) whether such content influences engagement in these behaviours. Sixty-six licenced drivers within Queensland, Australia, participated in a focus group. The sessions were conducted with three different age groups: younger drivers (17–25 years), middle-aged drivers (26–49 years), and older drivers (50 + years). Data was analysed using reflexive thematic analysis, resulting in three recognised themes: 1) exposure to online illegal driving behaviours on social media, 2) the influence of online illegal driving content on behaviour, and 3) drivers' engagement with online content that encourages illegal driving behaviours. A key finding was that young drivers are frequently exposed to online content encouraging illegal driving behaviours, whereas middle-aged and older drivers are rarely exposed to this content. Opinions surrounding the influence of online content on illegal driving behaviours was varied, yet across ages it was believed that young drivers may be most susceptible to this content. The findings from this study provide support for the potential link between social media exposure and illegal driving behaviours. Implications for future research are discussed, with an emphasis on longitudinal research to examine the impact of social media content on changes in behaviour, specifically for younger drivers. [ABSTRACT FROM AUTHOR]

• Investigated the changes in the risky driving behavior of older drivers with age using naturalistic driving data. • There was heterogeneity in individual trajectories of risky driving behaviors. • The heterogeneity can be explained by the presence of three subgroups of drivers. • Initial levels of risky driving behaviors were much more important than time slopes in identifying subgroups of drivers. • Female, sensation-seeking, and low-mileage drivers were associated with higher driving risk. This study aimed to investigate changes in the risky driving behavior of older drivers with age using naturalistic driving data. The driving behaviors of 44 drivers aged 60 years or older at baseline were tracked for two to five years. Harsh events characterized by elevated g-forces were used as driving outcomes. A multilevel modeling approach was used to examine (1) the heterogeneity in individual trajectories of risky driving behaviors and (2) the factors associated with the average risky driving behavior over the study period and changes in risky driving behavior over time. The results indicated that there was heterogeneity in individual trajectories of risky driving behaviors. Older female drivers and a higher level of sensation seeking (i.e., the tendency to pursue new and different sensations, feelings, and experiences) were associated with higher rates of harsh events over the study period. A reduction in driving exposure was associated with an increase in harsh event rates, and driving exposure can partly explain the sex difference in risky driving behaviors. The cluster analysis indicated that the heterogeneity in individual trajectories of risky driving behaviors can be explained by the presence of three subgroups of drivers, with each group exhibiting specific trajectories. Initial levels of risky driving behaviors were much more important than time slopes in identifying subgroups of drivers, indicating that differences between drivers existed early and remained relatively consistent over the study period. A multinomial logistic regression was used to examine the predictors of class membership identified by the clustering algorithm, and the findings were similar to those from the multilevel regression analysis. The findings of this study enhance our understanding of how older drivers' risky driving behaviors change with age and indicate the distinctive individual processes of change in driving behaviors with age. [ABSTRACT FROM AUTHOR]

• Analyzed the relationship between driving styles and crash risk among older drivers. • Developed a novel driving style recognition method for the analysis. • Although crash involvement rate of cautious older drivers is lower, the difference is not statistically significant. • A cautious driving style alone may not be sufficient to compensate for specific declining functions. Older drivers who are aware of their declining functions tend to adopt a cautious driving style to compensate for their declining driving abilities. However, whether cautious older drivers are associated with a reduced crash risk has not been well studied. In this study, we examined the association between older drivers' cautious driving style and crash risk using a novel driving style recognition method. We proposed a driving style recognition method that does not require predefined thresholds and applied it to the driving data of 71 drivers comprising 59 drivers aged 65 years or older (mean age 72.4; 67.8 % male) and 12 drivers aged 51–64 years (mean age 58.3; 66.7 % male). Drivers were classified into cautious and relatively aggressive groups based on the classification results of their speed, acceleration, and braking styles. The results showed that cautious drivers were characterized by older age, poorer Trail Making Test Part B performance, less frequent night driving, and lower driving exposure, indicating that older drivers may adopt multiple compensatory strategies. Although the crash involvement rate of cautious older drivers was approximately half that of relatively aggressive drivers, the difference was not statistically significant. Furthermore, this difference was expected to decrease when driving exposure was considered. Older drivers who adopted a cautious driving style but were involved in traffic crashes had poorer visual acuity and contrast sensitivity. The results of this study indicate that a cautious driving style alone may not be sufficient to compensate for older drivers' declining functions, particularly the loss of two visual functions observed in the present study. [ABSTRACT FROM AUTHOR]

Despite the growth in the number of older drivers and accidents, there is still a lack of clarity about the risk of elderly-related accidents in China. Cognitive function is an important factor affecting driving behavior. This study links cognitive function and driving behavior, aiming to explore the micro cognitive driving behavior characteristics of older drivers. An emergency event of sudden lane-changing of the leading vehicle is set in a driving simulator. 18 younger and 20 older drivers participate in the testing and their driving behavior data are used to build trajectory graphs. It can be observed that older drivers have more risk of behavioral changes. Further, the subjects' collision avoidance responses are divided into perception, judgment, and operation stages to reveal the mechanism of cognitive action on driving response. In contrast to the younger, older drivers have longer braking reaction time, smaller braking speed, larger minimum braking acceleration, and smaller maximum steering wheel speed. Based on these characteristics of older drivers, some age-appropriate vehicle designs and interventions have been proposed to improve their driving safety. This study contributes to better understanding the essence of risky driving behavior of older adults, and provides a basis for the formulation of management measures. [ABSTRACT FROM AUTHOR]

• We examined on-road performances of older drivers in different driving dimensions. • Among all driving dimensions, older drivers showed the poorest performances at speed adaptation. • The largest differences in performance between fit and unfit older drivers were observed at traffic signs and signals. • Performance in different driving situations was associated with different cognitive and non-cognitive factors. Aging goes along with cognitive and non-cognitive changes leading to impaired driving skills in a relevant proportion of older people. However, it is unclear which driving dimensions are affected in unfit older drivers and how performance in these dimensions is related to driving-relevant cognitive and non-cognitive factors. In a prospective cross-sectional study, 110 healthy older drivers completed a standardized 50-minute on-road driving assessment being accompanied by a driving instructor and a driving expert. The driving expert evaluated practical driving skills with the TRIP protocol (TRIP total score) and determined fitness to drive (fit versus unfit). We used repeated-measures analysis of variance to compare fit (n = 89) and unfit (n = 21) older drivers with respect to their practical driving performance in the 12 dimensions of the TRIP. Moreover, we explored how driving performance in the different TRIP dimensions is related to driving-relevant cognitive and non-cognitive factors. Results revealed performance differences between the different TRIP dimensions across all drivers (main effect of TRIP dimension) with the poorest overall performances in speed adaptation. Unfit older drivers showed poorer practical driving performances than fit older drivers across all TRIP dimensions (main effect of group). The most pronounced group differences were observed at traffic signs and signals, complex intersections and left turns (TRIP dimension × group interaction). Driving performance in these dimensions was associated with different driving-relevant cognitive and non-cognitive factors. The results of the current on-road study show that impaired driving skills of unfit older drivers can be observed in multiple driving dimensions, but particularly involve traffic signs and signals, complex intersections and left turns. The findings provide both high diagnostic and therapeutic relevance. This paper matters, because the current study identified those dimensions of practical driving behavior that best distinguish between fit and unfit older drivers. In a standardized on-road driving assessment, we identified traffic signs and signals, complex intersections and left turns as being those driving dimensions that involve the greatest difficulties for unfit compared to fit older drivers. In a diagnostic context, the results show which driving dimensions deserve a closer look when evaluating fitness to drive. In a therapeutical context, they show which driving dimensions need more intense training. Finally, in a practical context, the results imply that traffic signs and signals need to be optimized to facilitate and accelerate their perception. [ABSTRACT FROM AUTHOR]

• Readiness for change in mobility may be an important element in promoting smooth transitions to non-driving for older people. • Participants who reported positive attitudes towards driving relative to themselves and others were less ready for mobility transition. • Participants who reported lower agreeableness were less ready for mobility transition. For many older adults, driving is an important means of community mobility. With changes in health, aging increases the likelihood of ceasing to drive. Driving cessation is associated with a host of negative physical and mental health outcomes. Increased readiness to transition to non-driving status may mitigate some of the adverse consequences of driving cessation, making the transition to non-driving a pivotal period for intervention. We examined the relationship between attitudes towards driving (positive and negative) and readiness for mobility transition. Participants (n = 253, mean age = 79.13) completed measures of health, cognition, personality, attitudes towards driving, and readiness for mobility change. The results from the multiple hierarchical regression analysis showed that individuals who reported more positive attitudes towards driving relative to themselves (i.e., pro-self scale) and others (i.e., pro-other scale), as well as scored lower on the personality trait agreeableness, were less ready for mobility transition. The results emphasize the importance of taking into account driver attitudes, in addition to health considerations, when supporting the transition to non-driving. [ABSTRACT FROM AUTHOR]

Background: It has been determined that both confidence and cognition impact driving performance and self-regulation. While it is known that cognitive decline impacts driving safety and that decreases in driving confidence can lead to self-driving regulation, further research is needed to determine whether cognition, demographics, and driving routines are associated with driving confidence. Method: A non-experimental, cross-sectional design study using a convenience sample of 100 older adults was conducted to determine if individual factors are related to daytime and nighttime driving confidence. Results: Multiple regression indicated that four variables predicted daytime driving confidence, including cognition, driving at night, highway driving, and driving importance, F(4, 95) = 6.82, p F(4, 95) = 8.58, p < .001, adjusted R2 =.23. Conclusion: The results indicate both daytime and nighttime driving confidence in older adults is associated with greater cognition and driving in challenging situations, including at night, on the highway (daytime only), and in the winter versus summer (nighttime only). Daytime driving confidence was also associated with increased driving importance while nighttime driving confidence was associated with being male. [ABSTRACT FROM AUTHOR]

Background: Previous research has shown that drivers from different age groups demonstrated different Situation Awareness (SA) levels in the takeover process of conditional automated driving, where drivers need to collect surrounding information, perceive hazardous events, and make correct actions. Objective: To further explore the reason for this age-related difference, we investigated the SA from two different measures, Hazard Perception Time and scores from delayed SAGAT questions. The Hazard Perception time reflects both cognitive processes and ocular movements. The delayed SAGAT test was completed after each scenario, revealing how drivers perceived and comprehended information. Method: This study recruited drivers from three age groups, young, middle-aged, and older drivers. Especially, this study recruited old-old drivers (75+ years old), who have more severe cognitive impairments compared to young-old drivers (65 - 75 years old). Each driver went through 12 driving scenarios with different road types (highway straight, highway curved, city straight, and city curved) and driver types (manual only, autopilot only, and autopilot with non-driving-related Tasks). Results: The result showed that older drivers had significantly higher Hazard Perception Time and statistically equivalent SAGAT scores compared to the other two age groups. Also, curved roads led to significantly higher Hazard Perception Time for older drivers. Conclusion: Older drivers’ decreased SA mainly came from the delayed ocular movement, which was moving their gaze toward hazardous events in the current experiment. Researchers should be more mindful regarding the slowed ocular movement of older drivers when designing takeover systems.

Background/Objectives: Life expectancies have increased in most countries, leading to a higher accident rate among older drivers than their younger counterparts. While numerous studies have analyzed the decline in cognitive abilities and physical limitations as contributing factors, there are other considerations. For instance, younger male drivers tend to take more risks than younger female drivers. However, there is a lack of research and evidence regarding the role of gender in risk-taking among individuals over 65. Given this gap, our current study aims to investigate the relationship between gender and risk propensity in this particular age group. The primary goal was to determine if driving experience affects the gender gap in risk attitude; Methods: We studied risk behavior in both car drivers and pedestrians. Our sample included 200 individuals (101 women), all over 65, with the same weekly driving times. After a brief demographic and anamnestic interview, they completed the Driver Road Risk Perception Scale (DRPS) and the Pedestrian Behavior Appropriateness Perception Scale (PBAS) questionnaires. They also provided information about traffic violations and road crashes; Results: Our research revealed that older male drivers continue to tend to risky behavior, highlighting the need for targeted interventions to improve risk awareness, especially among older men; Conclusions: Our findings suggest that road safety messages should specifically target male drivers as they are less likely to view responsible driving actions, such as observing speed limits, as desirable.

• Advanced Driver Assistance Systems (ADAS)-equipped vehicles have potential to increase mobility and safety of older drivers; • Focus groups explored perceptions of ADAS in older drivers with and without age-related declines; • Findings highlighted the need for warning system alerts to be flexible, and complexity of vehicle interfaces reduced to meet older drivers' needs; • Customising vehicles to better suit older drivers needs will improve their safety and increase mobility and independence. Perceptions of Advanced Driver Assistance Systems (ADAS) were explored in two semi-structured face-to-face focus group studies of 42 older drivers (aged 65 years and older) with and without age-related declines. Study 1 explored perceptions regarding ADAS, focusing on visual, auditory, physical, and cognitive factors. Study 2 extended this by additionally exploring perceptions following exposure to videos and stationary vehicle demonstrations of an ADAS. Participants had a range of visual, hearing, memory, and health characteristics which impacted on their daily life. In both studies, some participants had insights regarding various ADAS technologies prior to the study, but many were unfamiliar with these systems. Nevertheless, overall, participants reported that ADAS would assist them to drive as they age and increase their mobility and independence. There were comments regarding the benefits of warning alerts, although the potential for them to be distracting was also highlighted. Participants with vision impairment preferred audio alerts and participants with hearing impairment preferred visual display alerts. Findings highlighted the potential for ADAS to assist those with age-related declines and the need to increase the flexibility of warning system alerts to suit the varying requirements of older drivers, as well as to reduce the complexity of vehicle interfaces. Collectively, these strategies would maximize the benefits of these vehicles to increase the mobility, independence, and quality of life of older drivers with and without age-related declines. [ABSTRACT FROM AUTHOR]

Abstract Background Our aim was to evaluate Spanish family doctors’ knowledge about medications that increase the risk of traffic accidents involving older drivers, and to obtain data about the involvement of family doctors in accident prevention activities and the associations between these factors and their demographic and workplace characteristics. Methods A cross-sectional study of 1888 family doctors throughout Spain was carried out from 2016 to 2018. Participants completed a previously validated self-administered questionnaire that explored whether family doctors distinguished between medications associated with a high or low risk of involvement in a traffic accident, investigated the appropriateness of advice given to older patients, and physicians’ involvement in preventive activities. Multiple regression models were used to estimate the adjusted association of these variables with each other and with characteristics of family doctors in the sample. Results On a scale of 1 (never or hardly ever) to 4 (always), the indexes constructed to evaluate how often family doctors believed they should oversee the use of high-risk and low-risk medications yielded values of 3.38 for the former and 2.61 for the latter (p

This research addresses the issue of an individual's ability to drive and especially of those individuals that are questionably demented (dementia is suspected) or are in a state of very mild dementia and are therefore the most difficult to identify. A methodology has been developed for categorization of drivers by considering three driving performance indices/parameters simultaneously. This novel approach precluded the previous technique whereby only a single driving performance index (an omnibus approach without the ability to discriminate between normal driving behavior and risky driving habits primarily due to cognitive decline) is considered. Driving performance of 28 young and 28 old drivers was gauged by 24 driving performance parameters through two designed drives on driving simulator. Normal Mixture Model Cluster Analysis was used in the performance-based categorization of drivers. It was found that out of a total of 56 drivers, 8 turned out to be "poor drivers". Results from neuropsychological/cognitive tests showed on average lower cognitive performance for the "poor drivers" group. This methodology will preclude the need for measurement of driving skills through driving instructors.

Introduction: The objective of the present study was to test two Advanced Driving Assistance Systems (ADAS) designed to help older drivers to intercept a moving inter-vehicular space. Method: Older and younger drivers were asked to intercept a moving inter-vehicular space within a train of vehicles in a driving simulator. Three ADAS conditions (No- ADAS, Head Down, Head Up) as well as five distinct speed regulation conditions were tested. Vehicle trajectory, gaze behavior and acceptance were analyzed. Results: Our results reveal that the ADAS tested make it possible to perform the interception task but also to reduce the variability of the behavior produced. They also indicate that the location of the augmented information provided by the ADAS directly impacts the information-gathering strategy implemented. Finally, whereas younger divers reported mixed levels of ADAS acceptance, older drivers reported a good level of acceptance. Discussion: All these results could be particularly useful with a view of designing ADAS for older drivers. [ABSTRACT FROM AUTHOR]

Introduction: The objective of the present study was to test two Advanced Driving Assistance Systems (ADAS) designed to help older drivers to intercept a moving inter-vehicular space. Method: Older and younger drivers were asked to intercept a moving inter-vehicular space within a train of vehicles in a driving simulator. Three ADAS conditions (NoADAS, Head Down, Head Up) as well as five distinct speed regulation conditions were tested. Vehicle trajectory, gaze behavior and acceptance were analyzed. Results: Our results reveal that the ADAS tested make it possible to perform the interception task but also to reduce the variability of the behavior produced. They also indicate that the location of the augmented information provided by the ADAS directly impacts the information-gathering strategy implemented. Finally, whereas younger divers reported mixed levels of ADAS acceptance, older drivers reported a good level of acceptance. Discussion: All these results could be particularly useful with a view of designing ADAS for older drivers. [ABSTRACT FROM AUTHOR]

Background: Our aim was to evaluate Spanish family doctors' knowledge about medications that increase the risk of traffic accidents involving older drivers, and to obtain data about the involvement of family doctors in accident prevention activities and the associations between these factors and their demographic and workplace characteristics. Methods: A cross-sectional study of 1888 family doctors throughout Spain was carried out from 2016 to 2018. Participants completed a previously validated self-administered questionnaire that explored whether family doctors distinguished between medications associated with a high or low risk of involvement in a traffic accident, investigated the appropriateness of advice given to older patients, and physicians' involvement in preventive activities. Multiple regression models were used to estimate the adjusted association of these variables with each other and with characteristics of family doctors in the sample. Results: On a scale of 1 (never or hardly ever) to 4 (always), the indexes constructed to evaluate how often family doctors believed they should oversee the use of high-risk and low-risk medications yielded values of 3.38 for the former and 2.61 for the latter (p < 0.001). Only 24% responded correctly to all three items that inquired about the appropriateness of the advice they gave to older patients. On a scale of 1 to 4, the frequency at which family doctors gave older patients advice about preventive measures was 2.85, and only 43% reported allocating time during appointments to provide this advice. These latter two variables were directly associated with appropriate values for the index used to evaluate physicians' oversight of medications associated with a high risk. The perception of risk associated with medications and involvement in preventive activities were both greater among female participants. Conclusions: Family doctors correctly identified medications according to their risk of playing a role in traffic accidents, although the recommendations they gave to their patients were not always appropriate. These findings, along with physicians' infrequent involvement in preventive activities, suggest a need to improve family doctors' competencies and increase the resources available to them so that they can provide their older patients with advice on ways to prevent involvement in traffic accidents. [ABSTRACT FROM AUTHOR]

The number of older drivers on our roads have been increasing given the upward shift of older people in the population. It is well-known that older drivers are more susceptible to injury given a crash. They are also likely to be at-fault in certain types of crashes due to health conditions associated with old age. This paper identifies factors that influence the severity of crashes involving at-fault older drivers at a disaggregated level for single and multivehicle crashes. Two random parameters multinomial logit with heterogeneity in means and variances models of injury severity were developed to assess the impact of various crash factors on crash outcomes based on the crash type. The study used five years of crash data from Alabama. The model estimations show that rainy weather and dark roadways were associated with an increased likelihood of serious injuries for single-vehicle crashes. Older male drivers were also found to have a higher probability of being at-fault in fatal single-vehicle crashes. For multivehicle older driver crashes, the model estimation results revealed that fatal injury was more likely to occur when the airbags were deployed. In addition, drivers between 65 and 75 years are less likely to be involved in fatal injury crashes for both single and multivehicle crashes. It was further found that older driver at-fault crashes that occurred in the open country were more likely to be fatal regardless of the manner of collision. The findings of this study are expected to help policymakers and transportation stakeholders to implement countermeasures that will make the road safer for older drivers and all other road users.

IntroductionThe objective of the present study was to test two Advanced Driving Assistance Systems (ADAS) designed to help older drivers to intercept a moving inter-vehicular space.MethodOlder and younger drivers were asked to intercept a moving inter-vehicular space within a train of vehicles in a driving simulator. Three ADAS conditions (No-ADAS, Head Down, Head Up) as well as five distinct speed regulation conditions were tested. Vehicle trajectory, gaze behavior and acceptance were analyzed.ResultsOur results reveal that the ADAS tested make it possible to perform the interception task but also to reduce the variability of the behavior produced. They also indicate that the location of the augmented information provided by the ADAS directly impacts the information-gathering strategy implemented. Finally, whereas younger divers reported mixed levels of ADAS acceptance, older drivers reported a good level of acceptance.DiscussionAll these results could be particularly useful with a view of designing ADAS for older drivers.

Introduction: Vision standards for driving are typically based on visual acuity, despite evidence that it is a poor predictor of driving safety and performance. However, visual motion perception is potentially relevant for driving, as the vehicle and surroundings are in motion. This study explored whether tests of central and mid‐peripheral motion perception better predict performance on a hazard perception test (HPT), which is related to driving performance and crash risk, than visual acuity. Additionally, we explored whether age influences these associations, as healthy ageing impairs performance on some motion sensitivity tests. Methods: Sixty‐five visually healthy drivers (35 younger, mean age: 25.5; SD 4.3 years; 30 older adults, mean age: 71.0; SD 5.4 years) underwent a computer‐based HPT, plus four different motion sensitivity tests both centrally and at 15° eccentricity. Motion tests included minimum displacement to identify motion direction (Dmin), contrast detection threshold for a drifting Gabor (motion contrast), coherence threshold for a translational global motion stimulus and direction discrimination for a biological motion stimulus in the presence of noise. Results: Overall, HPT reaction times were not significantly different between age groups (p = 0.40) nor were maximum HPT reaction times (p = 0.34). HPT response time was associated with motion contrast and Dmin centrally (r = 0.30, p = 0.02 and r = 0.28, p = 0.02, respectively) and with Dmin peripherally (r = 0.34, p = 0.005); these associations were not affected by age group. There was no significant association between binocular visual acuity and HPT response times (r = 0.02, p = 0.29). Conclusions: Some measures of motion sensitivity in central and mid‐peripheral vision were associated with HPT response times, whereas binocular visual acuity was not. Peripheral testing did not show an advantage over central testing for visually healthy older drivers. Our findings add to the growing body of evidence that the ability to detect small motion changes may have potential to identify unsafe road users. [ABSTRACT FROM AUTHOR]

• The impact of age, lighting, and cognitive load on DRT and driving performance was studied. • Young drivers drove faster and performed better in the n-back tasks and DRT, compared to older drivers. • Cognitive load increased response time to the DRT, especially for older drivers. • Cognitive load only reduced standard deviation of lane position (SDLP) in the absence of DRT. Over the past 25 years, distracted driving and driver inattention have been one of the main risk factors for road traffic safety. Previous research has shown that increased cognitive load from non-visual activities take our mind off the driving task, by engaging our working memory resources. Studies have shown that engagement in these tasks results in a more concentrated gaze towards the road centre, reducing lateral deviation (e.g., reduced standard deviation of lane position (SDLP) and less high frequency steering reversals). The Detection-Response Task (DRT) is an International Organization for Standardization (ISO) standard used to study the impact of cognitive load, due to secondary task, on performance. This driving simulator study examined the effect of varying levels of cognitive load (using the n-back task) on driving and DRT performance. The effect of age and lighting conditions was examined by comparing the performance of a younger group of drivers (Age Mdn = 22) with that of an older cohort (Age Mdn = 66) during day- and night-time driving conditions. Results showed that young drivers' DRT performance was better at night-time compared to day-time, when compared to that of older drivers. Young drivers also performed better at the n-back task. Overall, an increase in cognitive load increased response time to the DRT task. In line with previous studies, an increase in cognitive load also reduced SDLP, but only in the absence of the DRT. These results provide new knowledge on drivers' detection of peripheral stimuli during different lighting conditions, and how these are affected by a cognitively loading, non-visual, working memory task. The implications of these findings on real-world road safety are discussed. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: Traffic crashes are a significant cause of health expenditure, mainly considering disability and death. Driving skills are key when it comes to traffic crashes, and older drivers may be unfit to drive. The statistics of traffic crashes involving older drivers can contribute to planning actions that reduce accidents. This study aimed to present statistical data on traffic crashes among older adults in a Brazilian state. Methods: This is an epidemiological study performed with data from the Traffic Accident Information System of the Federal District Traffic Department, Brazil, ranging from 2008 to 2017 and comparing the incidence of injury crashes between older drivers and adult drivers. Results: Although the system recorded 60 705 drivers involved in injury crashes, a 24% reduction was seen in the overall crash incidence during the studied period (2008 - 2017); within the older drivers group, this reduction was two times smaller (12%). Despite the smaller drop in incidence, older car drivers presented around three times less risk of crashes when compared to adult drivers, along with a lower risk of accidents on urban, low-speed streets, and were mostly involved in collisions during the day. Conclusion: We found that the risk of older drivers being involved in injury crashes was three times smaller than that of adult drivers. The behavior of older drivers can influence the occurrence of accidents.

• Crash outcomes related to six vehicle technologies were calculated for drivers 35–54 and 70 +. • Older drivers may benefit most from intersection assistance features. • Technologies can reduce crashes, injuries, and fatalities for drivers of all ages. Introduction : Age-related changes and frailty are among the reasons that older drivers are overrepresented in certain crash types. Vehicle safety features that address these crash types may therefore deliver greater safety benefits for older drivers than for other age groups even though they are designed for the general population. Methods: U.S. crash data from 2016–2019 were used to estimate the proportion of crash involvements and fatal and nonfatal driver injuries for older (70 years old and above) and middle-aged (35–54 years old) drivers from crash scenarios to which current crash avoidance features, improved headlights, and forthcoming vehicle-to-vehicle (V2V)-connected intersection-assistance features could be relevant. Risk ratios were then calculated to determine the relative benefits of each technology for older drivers compared with middle-aged drivers. Results: Combined, these technologies were potentially relevant to 65 % of older driver and 72 % of middle-aged driver fatalities during the study period. Intersection assistance features showed the most promise for older drivers. Such features were potentially relevant to 32 % of older driver crash involvements, 38 % of older driver injuries, and 31 % of older driver fatalities. Intersection assistance features were significantly more likely to be relevant to older driver deaths than middle-aged driver fatalities (RR, 3.52; 95 % CI, 3.33–3.71). Conclusions: Vehicle technologies have the potential to substantially reduce or mitigate crashes and the injuries that they cause for everyone, but the potential safety impact of each technology varies by driver age because different age groups are over- or underrepresented in specific crash scenarios. Practical applications: With the older driver population growing, these findings underscore the need to bring intersection assistance technologies to the consumer market. At the same time, everyone stands to benefit from currently available crash avoidance features and improved headlights, so their use should be promoted among all drivers. [ABSTRACT FROM AUTHOR]

Introduction : With an aging population there are more older drivers than ever before. To reduce unnecessary road accidents and assist older drivers to successfully transition to non-driving, a better understanding of the factors that influence planning for driving retirement is required. This review explores documented factors that may influence older adults in planning for driving retirement, thus providing new understandings that can inform future preventative road safety measures, interventions, and policies. Method : A systematic search was performed using four databases to locate qualitative studies on the factors that influenced older drivers to plan for driving retirement. To identify factors influencing planning for driving retirement, a thematic synthesis approach was utilized. Identified themes were categorized in relation to elements of the Social Ecological Model theoretical framework. Results : The systematic search resulted in 12 included studies from 4 countries. Four major themes and 11 subthemes were identified regarding planning driver retirement. Each subtheme denotes a factor that may facilitate and/or impede older drivers planning for driving retirement. Conclusion : These results indicate that it is vitally important to encourage older drivers to plan for driving retirement as early as possible. Stakeholders involved in the safety of older drivers (including family, clinicians, road authorities, and policy makers) should work together on interventions and policies that empower older drivers to successfully plan for driving retirement in order to improve road safety and quality of life. Practical Applications : Introducing conversations about driving retirement via medical appointments, family, media, and peer-support groups could facilitate planning for driving retirement. Community-based ride-sharing systems and subsidized private transport options are needed to ensure continued mobility of older adults, especially in rural and regional areas that lack alternate transport services. When devising urban and rural planning, transport, license renewal, and medical testing rules, policy makers should consider older drivers' safety, mobility, and quality of life after driving retirement. [ABSTRACT FROM AUTHOR]

Acute cannabis use is associated with a higher risk of motor vehicle crashes (MVC). This study aimed to determine if self-reported past-year cannabis use is associated with MVC or traffic stops among older drivers. This cross-sectional analysis used data from a multi-center study enrolling active drivers aged 65-79 years. Data regarding cannabis use, MVC, and traffic stops (i.e., being pulled over by police, whether ticketed or not) within the previous 12 months were collected through participant interviews. Log-binomial regression models examined associations of past-year cannabis use with MVC and traffic stops, adjusting for site and sociodemographic and mental health characteristics. Of 2,095 participating older drivers, 186 (8.88%) used cannabis in the past year but only 10 (<0.5%) within an hour before driving in the last 30 days; 11.41% reported an MVC and 9.45% reported a traffic stop. Past-year cannabis users had a higher prevalence of MVC (adjusted prevalence ratio [aPR] = 1.38; 95%CI: 0.96, 2.00; p = 0.086) and traffic stops (aPR = 1.58; 1.06, 2.35; p = 0.024). Past-year cannabis use was associated with increased traffic stops, which are correlated modestly with increased MVC in past studies and may indicate impaired driving performance. We did not find a statistically significant association of past-year cannabis use with MVC, which may indicate limited sustained effects on driving performance from periodic use among older adults, who report rarely driving immediately after use. [ABSTRACT FROM AUTHOR]

This research addresses the issue of an individual’s ability to drive and especially of those individuals that are questionably demented (dementia is suspected) or are in a state of very mild dementia and are therefore the most difficult to identify. A methodology has been developed for categorization of drivers by considering three driving performance indices/parameters simultaneously. This novel approach precluded the previous technique whereby only a single driving performance index (an omnibus approach without the ability to discriminate between normal driving behavior and risky driving habits primarily due to cognitive decline) is considered. Driving performance of 28 young and 28 old drivers was gauged by 24 driving performance parameters through two designed drives on driving simulator. Normal Mixture Model Cluster Analysis was used in the performance-based categorization of drivers. It was found that out of a total of 56 drivers, 8 turned out to be “poor drivers”. Results from neuropsychological/cognitive tests showed on average lower cognitive performance for the “poor drivers” group. This methodology will preclude the need for measurement of driving skills through driving instructors. [ABSTRACT FROM AUTHOR]

Background: We examined whether the policy amendment from March 2017 for a cognitive screening test for older drivers at driver's license renewal was associated with the decreased risk of motor vehicle collisions for drivers and the increased risk of injuries for pedestrians and cyclists among older people. Methods: This was a controlled interrupted time‐series study. We used police‐reported data on the number of collisions as drivers and injuries as pedestrians and cyclists among people aged 70 years or older in Japan from July 2012 to December 2019. As the outcome measures, we used the ratio of the monthly number of collisions per population among drivers of three groups aged 75 years or older (75–79, 80–84, and ≥85 years), who were targeted or exposed by the policy, to that among drivers aged 70 to 74 years, who were unaffected or unexposed by the policy and would serve as controls. The ratio of pedestrian and cyclist injuries was also calculated, as previous studies have shown a concomitant increase in these injuries after the introduction of cognitive screening for driver's licenses. Results: During the study period, there were 602,885 collisions as drivers and 196,889 injuries as pedestrians and cyclists among people aged 70 years or older. After the policy amendment in March 2017, collisions decreased among male drivers, and injuries increased among some age subgroups in both sexes. Cumulative estimated changes in the numbers of collisions and injuries from March 2017 to December 2019 were −3670 (95% confidence interval: −5125, −2104) and 959 (95% confidence interval: 24, 1834), respectively. Conclusions: Following the policy amendment, there was a decrease in motor vehicle collisions as drivers and an increase in road injuries as pedestrians and cyclists among older people. [ABSTRACT FROM AUTHOR]

Older drivers are a rapidly growing demographic group worldwide; many have visual processing impairments. Little is known about their preferences about vehicle instrument cluster design. We evaluated the psychometric properties of a questionnaire on "dashboard" design for a population-based sample of 1000 older drivers. Topics included gauges, knobs/switches, and interior lighting; items were statements about their visual design. Response options used a Likert-scale ("Definitely True" to "Definitely False"). Factor and Rasch analyses identified underlying subscales. Driver responses revealed four thematic subscales fitting the Rasch model: cognitive processing, lighting, pattern recognition, and obstructions. Internal consistency of subscales was acceptable (0.70–0.87); all possessed a sufficiently unidimensional structure. Opportunities for improvement were identified (item scope, category ordering, discrimination of respondents' perception levels). Assessment of motor vehicle dashboard preferences indicated cognitive processing, lighting, pattern recognition, and obstructions are areas relevant to older drivers. Future work will examine the relationship between older drivers' visual function (e.g., contrast sensitivity, visual processing speed) and their design preferences as revealed by the Dashboard Questionnaire, with the aim to optimize instrument cluster displays for older drivers. [ABSTRACT FROM AUTHOR]

• Drivers ages 35–54 and 70+ were surveyed on vehicle preferences. • Older drivers keep vehicles longer than middle-aged drivers. • Older drivers who drive less often have older vehicles. • Middle-aged drivers consider safety ratings and features at purchase more than older drivers. Introduction: Older adults drive older vehicles despite the safety benefits of newer, more crashworthy vehicles. We aimed to build upon previous research and assess vehicle preferences, buying and ownership patterns, and perceptions of safety among older drivers compared with middle-aged drivers. Methods: Mixed-mode telephone and online panel surveys were conducted with a nationally representative sample of drivers ages 35–54 and 70 and older. Participants were interviewed about their primary vehicle and the characteristics they deemed important at purchase, along with general attitudes surrounding vehicle safety. Results: Fifty-eight percent of drivers ages 70–79 and 63% of drivers 80 and older reported keeping a vehicle on average for 7 years or more before replacing it, compared with 32% of drivers 35–54. At purchase, older drivers were less likely than middle-aged drivers to have insisted upon safety technologies and were less likely to consider safety ratings; 10% of drivers 80 and older and 9% of those 70–79 indicated ratings were not at all important, compared with 4% of those ages 35–54. Among drivers 70 and older, driving patterns and income were strongly associated with vehicle age and type of vehicle driven. Conclusions: Older drivers place lower importance on vehicle safety and are less likely to seek safety features at purchase than middle-aged drivers. Compounding this, drivers 70 and older who do not drive frequently or who associate low mileage with vehicle safety are less likely to replace their older, low-mileage vehicles. Practical Application: Increasing older drivers' understanding of the importance of advancements in vehicle safety may result in greater ownership of safer vehicles and fewer road injuries. [ABSTRACT FROM AUTHOR]

• The aim was to investigate the effect of aging on the detection, under time constraints, of vulnerable road users. • The detection of vulnerable road users decreased with aging, even in the younger-old group. • Older-old adults compensated for their visual-field decline by doing more visual exploration than the other two groups did. • Further studies should investigate the detection of vulnerable road users, including those on personal mobility devices. The detection of vulnerable road users (VRUs), especially under time constraints, may be impaired in elderly drivers, due to their visual and cognitive decline. This represents a major concern for road safety. The objective of the present study was to investigate the effect of aging on the detection of VRUs. A further aim was to investigate the impact of external factors on VRU detection. Twenty-two young adults, 20 younger-old adults, and 32 older-old adults were included in the study. A series of photographs were displayed for 500 ms. Participants were asked to detect the VRU, which could be a motorcyclist, a cyclist, or a pedestrian. The VRU was located at one of two distances (near/far), one of two locations (off-centered/centered), and in two car-DRL (daytime running lights) environments (on/off). The ability to correctly detect a VRU was measured. An eye-tracker was used to record eye movements. The main findings showed that VRU-detection performance decreased with aging, even in the younger-old group (ages 55–68). The ability to correctly detect a VRU by older-old adults was poorer particularly when the VRU was a motorcyclist or a cyclist. As a whole, the older-old adults made more fixations to correctly detect the VRU than the other two age groups did. Moreover, the visual angle between the gaze of the participant's last fixation and the target in the older-old group was lower than in the other two groups, particularly when the VRU was off-centered. This finding suggests that older-old adults compensated for their visual-field decline by doing more visual exploration than the other two groups did to correctly detect the VRU. The results are discussed with regards to age-related cognitive and visual deficits. Word count: 279. [ABSTRACT FROM AUTHOR]

Background: Elderly drivers often face safety challenges due to age-related declines in cognitive, sensory, and motor functions. Advanced Driver Assistance Systems (ADAS) offer a potential solution by enhancing safety and mobility., Objectives and Method: This systematic review investigates the factors influencing the perception and usage of ADAS among elderly drivers, focusing on perceived safety, usefulness, trust, and ease of use., Results: Older adults show a preference for Level 1 ADAS, which they perceive as safer. Although they acknowledge the usefulness of ADAS in supporting their autonomy, skepticism remains regarding higher-level systems, primarily due to concerns about reliability and invasiveness. Trust and ease of use are essential factors influencing their acceptance. The review identifies common themes and barriers to the adoption of these technologies and emphasizes the need for senior-friendly interfaces and targeted training. The findings indicate that addressing these issues can significantly improve the safety and mobility of elderly drivers. The successful adoption of ADAS among older adults depends on balancing safety, control, and ease of use, with gradual and supportive integration fostering greater acceptance and trust., Conclusions: This study outlines practical implications for stakeholders, emphasizing the need for user-friendly ADAS design, public awareness campaigns, government incentives, insurance discounts, and community training to enhance adoption among older drivers.

Background/Objectives : Life expectancies have increased in most countries, leading to a higher accident rate among older drivers than their younger counterparts. While numerous studies have analyzed the decline in cognitive abilities and physical limitations as contributing factors, there are other considerations. For instance, younger male drivers tend to take more risks than younger female drivers. However, there is a lack of research and evidence regarding the role of gender in risk-taking among individuals over 65. Given this gap, our current study aims to investigate the relationship between gender and risk propensity in this particular age group. The primary goal was to determine if driving experience affects the gender gap in risk attitude; Methods : We studied risk behavior in both car drivers and pedestrians. Our sample included 200 individuals (101 women), all over 65, with the same weekly driving times. After a brief demographic and anamnestic interview, they completed the Driver Road Risk Perception Scale (DRPS) and the Pedestrian Behavior Appropriateness Perception Scale (PBAS) questionnaires. They also provided information about traffic violations and road crashes; Results : Our research revealed that older male drivers continue to tend to risky behavior, highlighting the need for targeted interventions to improve risk awareness, especially among older men; Conclusions : Our findings suggest that road safety messages should specifically target male drivers as they are less likely to view responsible driving actions, such as observing speed limits, as desirable.

Abstract Background People over 64 years have a high fatality rate when they are involved in traffic accidents. Besides, older victims of road crashes are expected to rise in the future due to population aging. The purpose of the study was to document their perception on the role of the family doctor, the main facilitating factors, and the perceived barriers to the temporary or permanent restriction of their driving. Methods This qualitative study used focus group methodology. A sample of 16 people over 65 years old was obtained through a series of segmentation criteria at an active participation centre for older adults in a small town in Jaén province (Spain). All were invited to participate in a discussion during which they were asked to express their opinions and subjective experiences concerning the role of their family doctor. The group conversation was taped, fully transcribed and analysed, and codes were generated with both deductive and inductive methods. Results After merging the codes to generate themes, we identified 9 relevant categories: perception of age-related risk, road safety, role of public authorities, driver assessment centre, role of the family doctor, role of the family, proposals for addressing traffic accidents in older adults, consequences of the driving prohibition, and public transport. All categories help to explain the subjective driving and traffic safety experiences of older road users. Conclusions Although family doctors do not usually ask their older patients about road driving, they are highly valued by these patients. Thus, family doctors have a great potential to act, along with the family members, for the benefit of older patients’ traffic safety, in ways that can prevent their involvement in road crashes and reduce the negative consequences of having to stop driving if necessary.

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. [ABSTRACT FROM AUTHOR]

Objectives: Some older drivers choose to avoid certain situations where they do not feel confident driving. Little is known about the process by which older drivers may use avoidance in transitioning to non-driving. Methods: We analyzed 2015 ConsumerStyles data for 1198 drivers aged 60+. Driving patterns were examined by sociodemographic and driving characteristics. Avoidance classes were characterized by latent class analysis. Results: Among drivers 60+, 79% reported driving 3+ days/week and 84% reported good to excellent health. We identified four driving avoidance classes (low, mild, moderate, and high). High- (versus low-) avoidance drivers were more likely female, 75+, not White/non-Hispanic, and to have income <$25,000/year. Discussion: Avoidance of selected driving behaviors may be one component of a multi-step process supporting the transition to non-driving. Drivers displaying avoidance behaviors may be receptive to resources to prepare for this transition and minimize negative health and quality of life outcomes that accompany driving cessation. [ABSTRACT FROM AUTHOR]

Life events in the context of the different life courses of individuals can influence behavior in the acceptance of technology. In this context, driver assistance systems have the potential to create the basis for future mobility solutions. However, the systems should be accepted by the older generation, which can provide them with mobility into old age. Therefore, a literature review was conducted and life events were identified that may moderate the effect relationships in the acceptance of driver assistance systems. Based on the technology acceptance model, a research model was developed and validated by a study (n = 181). The results show that there are differences in the acceptance of driver assistance systems depending on different life events. The results show that the four life events “major illness,” “retirement,” birth of a grandchild, and “major accident” have a moderating influence on the acceptance of driver assistance systems. The study finds that regardless of the life event experienced, trust in technology is a major factor in acceptance, along with perceived usefulness. For example, retired individuals and those with major illnesses focus on the ease of use of the systems, while individuals with grandchildren value the opinion of their close environment.

• Hazard warning modalities and timing thresholds were evaluated for older drivers with impaired vision. • Early warnings improved hazard responses and reduced collisions for older drivers with impaired vision. • Late warnings did not improve hazard responses or collision rates for older drivers with impaired vision. • Non-directional-tactile warnings were the most effective in reducing collisions for older drivers with impaired vision. • Tailored development of hazard warnings can provide benefits for older drivers with impaired vision. We examined collision warning systems with different modalities and timing thresholds, assessing their impact on responses to pedestrian hazards by drivers with impaired contrast sensitivity (ICS). Seventeen ICS (70–84 y, median CS 1.35 log units) and 17 normal vision (NV: 68–73 y, median CS 1.95) participants completed 6 city drives in a simulator with 3 bimodal warnings: visual-auditory, visual-directional-tactile, and visual-non-directional-tactile. Each modality had one drive with early and one with late warnings, triggered at 3.5 s and 2 s time-to-collision, respectively. ICS participants triggered more early (43 vs 37 %) and late warnings (12 vs 6 %) than NV participants and had more collisions (3 vs 0 %). Early warnings reduced time to fixate hazards (late 1.9 vs early 1.2 s, p < 0.001), brake response times (2.8 vs 1.8 s, p < 0.001) and collision rates (1.2 vs 0.02 %). With late warnings, ICS participants took 0.7 s longer to brake than NV (p < 0.001) and had an 11 % collision rate (vs 0.7 % with early warnings). Non-directional-tactile warnings yielded the lowest collision rates for ICS participants (4 vs auditory 12 vs directional-tactile 15.2 %) in late warning scenarios. All ICS participants preferred early warnings. While early warnings improved hazard responses and reduced collisions for ICS participants, late warnings did not, resulting in high collision rates. In contrast, both early and late warnings were helpful for NV drivers. Non-directional-tactile warnings were the most effective in reducing collisions. The findings provide insights relevant to the development of hazard warnings tailored for drivers with impaired vision. [ABSTRACT FROM AUTHOR]

• The effect of a voluntary refresher course for elderly drivers on motor vehicle collisions (MVC) was estimated. • Drivers who attended the course before 75 years of age had lower odds of being at-fault in multi MVCs. • Indications of higher odds of single MVC and at-fault multi MVC was found for course participants at the age of 75 years or more. • A possible explanation is that a certain level of functioning is needed to implement the strategies learned in the course. • The design of the study makes it difficult to determine the causal relationship between course attendance and MVC's. The "Driver 65+" course is a voluntary refresher course offered to all drivers aged 65 years or older in Norway. The current study estimated differences in at-fault motor vehicle collisions (MVCs) between older drivers who had attended in the course and older drivers who had not attended the course. Two samples of drivers were selected from the database of an insurance company and were sent a questionnaire in the mail. The first sample consisted of 2039 car owners aged 70 years or older who had reported a collision to the insurance company during the last 24 months. The second sample consisted of 1569 drivers aged 70 or older who had not reported any collisions during the last 24 months. The results indicated an age-dependent effect; drivers attending the course before 75 years of age had a significantly lower risk of being the at-fault driver in a multi-MVC than older drivers who did not attend the course. The results indicate that the refresher course had a beneficial effect on collision risk for drivers who attended the course before reaching 75 years of age. One possible explanation of this age-dependent effect is that a certain level of visual, cognitive, and motor functioning is needed to implement the strategies learned in the course. However, the design of the study makes it difficult to draw definite conclusions about the causal relationship between course attendance and later collision involvement. [ABSTRACT FROM AUTHOR]