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To test the effects of cognitive training on subsequent motor vehicle collision (MVC) involvement of older drivers. Randomized, controlled, multisite, single-blind clinical trial. Community-dwelling seniors at four U.S. sites: Birmingham, Alabama; Baltimore, Maryland; Indianapolis, Indiana; and State College, Pennsylvania. Nine hundred eight older drivers (mean age 73.1; 18.6% African American) who were randomized to one of three cognitive interventions or a control condition. Up to 10 sessions of cognitive training for memory, reasoning, or speed of processing. State-recorded MVC involvement up to 6 years after study enrollment. Speed-of-processing and reasoning training resulted in lower rates of at-fault collision involvement over the subsequent approximately 6-year period than controls. After adjusting for age, sex, race, education, mental status, health, vision, depressive symptoms, and testing site, participants randomized to the speed-of-processing and reasoning interventions had an approximately 50% lower rate (per person-mile) of at-fault MVCs than the control group (rate ratio (RR)=0.57, 95% confidence interval (CI)=0.34-0.96 for speed of processing), and (RR=0.50, 95% CI=0.27-0.92 for reasoning). There was no significant difference observed for the memory group. Cognitive speed-of-processing and reasoning training resulted in a lower at-fault MVC rate in older drivers than in controls. Considering the importance of driving mobility, the costs of crashes, and the benefits of cognitive training, these interventions have great potential to sustain independence and quality of life of older adults. More research is needed to understand the effects of different types and quantities of training. [ABSTRACT FROM AUTHOR]

This article reviews the research literature on driving and age-related macular degeneration, which is motivated by the link between driving and the quality of life of older adults and their increased collision rate. It addresses the risk of crashes, driving performance, driving difficulty, self-regulation, and interventions to enhance, safety, and considers directions for future research. [ABSTRACT FROM AUTHOR]

Focuses on the retrospective case-control study of a number of decedents whose cause of death remained undetermined following autopsy matched one to one to a control group of passengers killed in motor vehicle collisions. Prevalence of drug abuse in individuals who died of undetermined causes.

Objective To evaluate the association between specific occupant, collision, and vehicle characteristics and the risk of motor vehicle collision (MVC)–related eye injury. Methods The 1988-2001 National Automotive Sampling System Crashworthiness Data System files were used. The Crashworthiness Data System is a national probability sample of passenger vehicles involved in police-reported tow-away MVCs. The risk of eye injury was calculated according to specific occupant (eg, age, seat belt use) and collision (eg, ΔV [estimated change in velocity], vehicular intrusion) characteristics. The association between eye injury and these characteristics was calculated using risk ratios and associated 95% confidence intervals. Results The incidence of eye injuries in MVCs has progressively increased since 1998. Frontal air bag deployment was associated with a statistically significant, 2-fold (risk ratio, 2.13 [95% confidence interval, 1.56-2.91]) increased risk of eye injury, whereas seat belt use was associated with a 2-fold (risk ratio, 2.17 [95% confidence interval, 1.89-2.44]) reduced eye injury risk. In late-model vehicles, frontal air bags are the most common cause of MVC-related eye injury. Older age, female sex, seat position, vehicle weight, and collision severity were also associated with eye injury risk. Conclusions Seat belt use is the most effective means of occupant protection against MVC-related eye injury. For front-seated occupants in frontal collisions, the adverse effect of frontal air bags on the risk of eye injury should be considered against their protective effect for fatal injury. [ABSTRACT FROM AUTHOR]

Objective: To evaluate potential associations of impairments in physical function with motor vehicle crash involvement in older drivers. Methods: Case participantss were randomly selected residents of Mobile County, Alabama, &gte;65 years old who had sustained an at-fault motor vehicle crash in 1996. Similarly selected crash-free controls were frequency matched to cases on gender and age. Self-report data on demographic variables, medical conditions, medications, driving exposure, and function were collected by telephone interviewers. Results: Relative to crash-free subjects, crash-involved drivers were significantly more likely to report difficulty walking 1/4 mile and moving outdoors. Marginally significant associations were observed for trouble carrying a heavy object 100 yards and for the occurrence of falls in the prior year. Increasing numbers of functional limitations were directly related to the odds of crash involvement. Discussion: In comparison to crash-free controls, crash-involved older drivers are more likely to report other mobility-related impairments, possibly including falls. [ABSTRACT FROM AUTHOR]

Provides information on a study that estimated the association between diabetes and its complications and at-fault automobile accidents among older drivers. Demographic and driving characteristics of the subject; Medical and visual function characteristics of the subjects; Conclusion.

Abstract The objective of this case-control study was to identify visual risk factors for vehicle crashes by elderly drivers which result in injury. The sample consisted of licensed current drivers between 55 and 87 years o:f age who resided in Jefferson County, Alabama. Subjects were identified through Alabama Department of Public Safety (ADPS) files. Two groups of cases were identified. One group (N=78) was defined as those drivers who had incurred at least one vehicle crash between 1985 and 1990 resulting in an injury to anyone in the involved vehicles according to the accident report. The other case group (N=101) consisted of drivers involved in non-injurious crashes during the same time period. Controls (N=115), also selected from ADPS files, were older drivers not involved in crashes during the same five-year period. Subjects underwent a battery of visual processing tests and a comprehensive eye examination. The main results were that restricted useful field of view and glaucoma were the only significant independent predictors of injurious crash involvement. Odds ratios (ORs) for reductions in the useful field of view of 23-40%, 41-60% and greater than 60% were 4.2 (95% confidence interval [CI], 1.5-11.8), 13.6 (95% CI, 5.8-39.7), and 17.2 (95% CI, 5.3-55.6), respectively, compared to reductions of less than 23% (p for trend <0.001. The OR for glaucoma was 3.6 (95% CI, 1.0-12.6). Useful field of view impairment was the only variable independently associated with non-injurious crash involvement. This study implies that impaired visual processing and glaucoma may play a role in the etiology of older driver crashes which result in injury. [ABSTRACT FROM AUTHOR]