Older Road Users: Myths and Realities, A Guide for Medical and Legal Professionals

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Author: Morris Odell
ISBN 10: 1933264705
ISBN 13: 978-1933264707
Copyright Date Ed: July 1, 2009
Pages: 320 pages
Binding Information: Hardcover
Size: 6 ✕ 9 Inches (US)

This book, one of the first of its kind, brings you state-of-the-art scientific information on the role of aging in driving behavior and motor vehicle accidents.

As our population ages, there will be an increase in the number of older drivers on the road. Those born during the post World War II baby boom are now reaching age 65 and are the first generation where driving has been a constant part of their lives. In countries such as Australia, the United States, and Canada - where driving is often a necessity - evaluation of driving ability and implications of potential accidents have become a concern.

This book teaches you about older drivers, their driving behaviors and actual risks versus perceived risks. While this study was conducted in Australia with predominantly Australian data, the findings are highly applicable to the United States and Canada.

This book gives you the most up-to-date information possible. It also explores the most common medical conditions that affect driving behavior in older people including neurological, cardiovascular, and other physical conditions; metabolic conditions such as diabetes and hypoglycemia; dementia; psychological issues; visual impairment; and the influence of multiple prescription drugs and alcohol. Extensive chapters are devoted to diabetes, dementia, visual impairment, and prescription drug and alcohol use, as these appear to be the most common causes of impairment of older drivers. A model management program for older drivers with diabetes is presented, with suggestions on how it might be used with other medical conditions.

You will also learn about the epidemiology of accidents involving older drivers including fatalities. This book also covers accidents involving older pedestrians and motor vehicles. It gives you an overview of common types of accidents involving older road users of all types and makes recommendations for managing and decreasing these accidents.

Of important concern is the evaluation of fitness of older drivers. This book teaches you about the different ways that older drivers are evaluated including the pros and cons associated with each. It also discusses mandatory age related driver testing. It also presents suggestions on implementation of driver evaluation programs as well as training for older drivers from an occupational therapy perspective.

This book also teaches you ways to help people manage the transition from driving to no longer being allowed to drive. It covers issues such as alternative modes of transportation, community and family support, and therapy for psychological issues associated with this transition.

This book is a must for your library if you work with older drivers in any capacity.

This book is also available as an eBook. Click here to purchase and download:

Topics Include:

Accidents involving older drivers
Accident risks of older drivers
Licensing procedures
Evaluation of fitness to drive
Medical review of older drivers
Vision and the older driver
Dementia and cognitive problems
Respiratory and sleep disorders
Neurological conditions
Effects of prescription drugs and alcohol
Diabetes and metabolic disorders
Older pedestrians
Occupational therapy assessment and training of older drivers
Transition from driving to no longer driving

Chapter 1. Older Driver Crashes
Jim Langford
1.1 Introduction
1.2 Current Older Driver Crash Levels
A. Contribution to the Road Toll
B. Contribution to Hospital Admissions
C. Contribution to All Deaths
D. Conclusions
1.3 Do Older Drivers Have a Characteristic Crash Pattern?
A. Some Overseas Studies
B. Some Australian Studies
C. Conclusions
1.4 Are Older Drivers Likely to be Overly Responsible for Their Crashes?
A. The Difficulties in Attributing Crash Responsibility
B. Findings from the Research
C. Conclusions
1.5 Do Older Drivers Have a Heightened Crash Involvement?
A. Older Drivers’ High Crash Rates per Distance Driven
B. Frailty Bias
C. Limitations in the Exposure Measurements—Low Mileage Bias
D. Conclusions
1.6 Are Older Drivers a Heightened Crash Risk to Other Road Users?
A. Findings from the Research
B. Conclusions
1.7 Summary and Conclusions

Chapter 2. Managing Older Driver Crash Risk
Judith Charlton, Ph.D., Sjaanie Koppel, Ph.D., Jim Langford, and Justine Irving
2.1 Introduction
2.2 What Are the Current Older Driver Licensing Practices?
A. Australian Licensing Procedures
B. International Licensing Procedures
C. Summary
2.3 Is There Evidence for Universal Licence Testing, Based on Age, as an Effective Strategy for Managing Older Driver Risk?
A. Summary
2.4 Alternative Approaches to Licensing
A. Outline of the Proposed Australasian Model
B. Assessment of Functional Ability
C. Levels of Assessment of the Model Procedure
D. Use of Valid and Reliable Testing Instruments
E. Community Referral
F. Range of Outcome Options for Older Drivers
G. Establishment of a Case Officer Position
H. Assessment Undertaken by Government and Non-government Agencies
2.5 Use of Conditional Licences
2.6 Balancing Safety and Mobility
2.7 Self-regulation as a Means of Reducing Risk
A. Findings from Research on Self-regulatory Practices
2.8 Summary and Conclusions

Chapter 3. Vision and the Ageing Driver
Joanne M. Wood, Ph.D.
3.1 Introduction
3.2 Normal Age-Related Vision Changes
3.3 Visual Function, Ageing and Driving
A. Visual Acuity
B. Visual Fields
C. Contrast Sensitivity
D. Dynamic Visual Acuity
E. Monocular Vision
F. Useful Field of View
3.4 Ocular Diseases in Older Populations
A. Cataracts
B. Glaucoma
C. Age-Related Maculopathy
D. Diabetic Retinopathy
E. Stroke
3.5 Implications for Licensing
3.6 Conclusions

Chapter 4. Older Road Users—Effects of Dementia and Cognitive Changes
Peteris Darzins, BMBS, Ph.D. and Michel Bédard, Ph.D.
4.1 Introduction
4.2 Dementia and Other "Brain Failure Syndromes"
4.3 Pathology of the Dementing Processes
A. Alzheimer Dementia—Pathology
B. Vascular Dementia—Pathology
4.4 Dementia with Lewy Bodies—Pathology
4.5 Fronto-Temporal Dementia—Pathology
4.6 Clinical Features of the Dementing Illnesses
A. Alzheimer Dementia—Clinical Features
4.7 Vascular Dementia—Clinical Features
4.8 Mixed Dementia—Clinical Features
4.9 Dementia with Lewy Bodies—Clinical Features
4.10 Fronto-Temporal Dementia—Clinical Features
4.11 Other Dementing Illnesses
4.12 The Driving Task
4.13 Driving and Cognition
A. Stages of Alzheimer Dementia
B. Driving and Stage of Dementia Syndromes Other than Alzheimer Dementia
4.14 Incidence of Crashes in People with Dementia
4.15 Crash Patterns of Older Drivers
4.16 Driving Patterns of People with Cognitive Impairment
4.17 Differentiating "Safe" from "Unsafe" Drivers with Dementia
4.18 Management of Driving by People with Dementia
4.19 Conclusion

Chapter 5. Respiratory and Sleep Disorders in the Older Driver
Matthew T. Naughton, F.R.A.C.P.
5.1 Introduction
5.2 Respiratory Illnesses
A. Cigarette Smoking
B. Chronic Obstructive Pulmonary Disease
C. Pulmonary Fibrosis
D. Cough Syncope
E. Lung Cancer
F. Deep Venous Thrombosis and Pulmonary Emboli
G. Pneumothorax
H. Post Thoracotomy
I. Asthma
5.3 Sleep Disorders
A. Sleep Deprivation
B. Sleep Apnoea
5.4 Summary

Chapter 6. Driving and the Elderly: Neurological Conditions
Mark Cook, M.D.
6.1 Introduction
6.2 Stroke
6.3 Dementia
6.4 Parkinson’s Disease (PD)
6.5 Head Injury
6.6 Drugs
6.7 Epilepsy
6.8 Conclusions

Chapter 7. Road Safety Effects of Prescription Drugs in the Older Driver
Olaf H. Drummer, Ph.D.
7.1 Introduction
7.2 Terminology Used in Epidemiological Studies
7.3 Baseline Culpability
7.4 Alcohol
7.5 Drugs Other than Alcohol
A. Benzodiazepines
B. Anti-Depressants and Other Mood Altering Drugs
C. Anti-Diabetic Drugs
D. Anti-Coagulants
E. Opiates
F. Other Drugs
7.6 Conclusions

Chapter 8. Diabetes and the Older Road User
Trisha Dunning, Ph.D.
8.1 Diabetes
8.2 Incidence of Traffic Crashes in Older People with Diabetes
8.3 Effects on Driving Ability Related to Diabetes
8.4 Functional Impairment and Disability
A. Physical
B. Depression and Cognitive Functioning
C. Hyperglycaemia <brD. Hypoglycaemia
8.5 Self-Care Knowledge and Behaviours
8.6 Improving Driving Safety in Older People with Diabetes
8.7 Summary

Chapter 9. Walking for Older Road Users: A Safe Alternative to the Car?
Jennie Oxley, Ph.D.
9.1 Introduction
9.2 Walking: Benefits and Drawbacks
9.3 Crash Types
9.4 Why the Over-Involvement of Older Adults in Pedestrian Crashes?
A. Vulnerability
B. Pedestrian Behaviour
C. Vehicle Design
D. The Road and Traffic Environment
9.5 Achieving Safe Pedestrian Environments
9.6 Safer Road Users
9.7 Safer Vehicles
9.8 Safer Roads
A. Moderating Vehicle Speeds
B. Separation of Vehicles and Pedestrians
C. Simplification
9.9 Summary and Conclusions

Chapter 10. Medical Review of Older Road Users
Morris Odell, M.B., B.S.
10.1 Introduction
10.2 Licensing Guidelines
10.3 The Role of Health Professionals
10.4 Medical Assessment of Fitness to Drive
10.5 Principles of Medical Driver Assessment
A. History
B. Examination
C. Investigations
D. Specialist Assessment
10.6 Driving Restrictions and Licence Conditions
10.7 Conclusion

Chapter 11. Assessing Older Drivers with Health-Related Problems: An Occupational Therapy Approach
Carolyn Unsworth, Ph.D.
11.1 Introduction
11.2 Who Are OT Driver Assessors and What Do They Do?
11.3 Occupational Therapy Driver Assessment Processes and Reporting: Systems in Australia (Victoria), the U.S., U.K. and Sweden 241
11.4 Profile of Older Drivers Evaluated by Occupational Therapists
11.5 The Skills Needed to Be a Safe Driver, and the Impact of Age on These Skills
11.6 Off-Road Driver Assessment for Older Adults
A. Driving Simulators
11.7 On-Road Driver Assessment for Older Adults
11.8 Rehabilitation and Strategies to Maintain Driving Independence
11.9 Future Directions in Driver Assessment and Rehabilitation Research
11.10 Summary and Conclusion

Chapter 12. Older Drivers Killed on the Road—Analysis of Data from Coroner’s Files
Morris Odell, M.B., B.S., and Olaf H. Drummer, Ph.D.
12.1 Background
12.2 Method
12.3 Results
A. Alcohol and Drugs
B. Medical Diseases
C. Culpability Analysis
12.4 Discussion

Chapter 13. The End of Driving
Nadia Mullen, Ph.D. and Michel Bédard, Ph.D.
13.1 The End of Driving
13.2 Depressive Symptoms
13.3 Impact on Daily Activities
13.4 Impact on Others
13.5 Positive Effects
13.6 Moderating Factors
13.7 Managing Transport Needs
13.8 Preparation
13.9 Conclusion

The Journal of the Southeast Accident Reconstruction Society

Older Road Users Myths and Realities, A Guide for Medical and Legal Professionals. A review by Joseph E. Badger; When I first saw the title, Older Road Users, a quick thought ran through my head. Is this a book about people who use older roads? Actually, no, the books subject is about the chronologically gifted motorist, that is, elderly drivers old people who use public streets and highways. Morris Odell, Senior Forensic Physician at the Victorian Institute of Forensic Medicine in Melbourne, Australia, edited the book for Lawyers & Judges Publishing Co. of Tucson, AZ; however 13 learned authors also contributed to the text. One of those providers is Carolyn Unsworth, who holds Professorships at various schools including Jnkping University in Sweden. She notes in her chapter Assessing Older Drivers with Health-Related Problems that Medical advances have enabled people to live longer [yet] the accident rate for older drivers per kilometer driven is higher than for all other age groups except young novice drivers. I should explain that the authors are from Australia or Canada so the book uses British style and spellings (e.g., organisation, labour, ageing, licence) throughout. If you think teenagers have a lot of accidents, consider what Jim Langford, Senior Research Fellow at the Monash University Accident Research Centre, points out in his chapter Older Driver Crashes: In 2010 the first of the baby boomers will reach 65 years of age And worse yet, By 2050, one-quarter of the combined population of all OECD countries will be 65 years and over, almost double the rate for 2000” Langford did not explain the acronym OECD. Perhaps everyone in Australia already knows. But for the rest of us OECD refers to Organisation for Economic Cooperation and Development (www.oecd.org/). The OECD consists of 30 countries, from Australia to Canada to most European nations to Japan, Korea, Mexico, and the United States. The 300-page Older Road Users is more of a human factors treatise than a discourse for crash reconstructionists, but after all, of the three elements necessary to have a traffic accident in the first place Environment, Roadway, Driver the latter is surely the most important. Whether you are a human factors expert or merely someone interested in traffic collisions involving our aging population, this book may be an eye-opener into areas you had not considered. It discusses older motorists driving behaviors and risks actual and perceived and delves into neurological, cardiovascular, physical and metabolic conditions. Then there are such issues as dementia, visual impairment, and the influence of alcohol and other drugs, including prescription medicine. Older Road Users also covers the difficult task of helping people cope when losing the right to drive when a family member takes away their keys. VicRoads the trading name for Roads Corporation Victoria (www.vicroads.vic.gov.au) commissioned this book in response to inquiries by the Victorian Parliamentary Road Safety Committee in 2003. Editor Odell anticipates the book will give the reader an understanding of the entire spectrum of the problems surrounding fitness to drive of the aged.; Professor Joanne Wood, School of Optometry, Queensland University of Technology, discusses issues regarding; the visual deterioration of the ageing driver in Chapter 3. In her Visual Acuity segment she talks about normal vision being 6/6 visual acuity. In the U.S., we use 20/20. The reason for the difference is that in the U.S. the length of our eye examination rooms (from patient to eye chart) is generally around 20 feet. In Australia and Great Britain, eye exam rooms are about six meters from patient to chart. Six meters is almost 20 feet (19.685 feet). Close enough. Perhaps I should clarify just how old of a driver Older Road Users refers to. When I was nine years of age, anyone over 30 was old. In Table 1.2, Driver Fatalities and the Contribution of Physical Frailty, there are four age categories for males and females: 65-69, 70-74, 75-79, and 80+. Toxicologist Olaf Drummer, president of The International Association of Forensic Toxicologists, in his chapter Road Safety Effects of Prescription Drugs in the Older Driver, talks about an analysis in the 1960s called the Borkenstein Grand Rapids study. (The references to this chapter lists a paper by Borkenstein, FR. That should be Borkenstein, RF. He invented the Breathalyzer in 1954. He was a captainwith the Indiana State Police before becoming a professor at Indiana University.); Another of the Older Road Users authors, Trisha Dunning, Professor of Nursing at Victorias Deakin University, warns, Increasing age is one of the most important reasons for the increasing diabetes prevalence is most societies. Among other topics, she discusses Hyperglycaemia and Hypoglycaemia abnormally high level of glucose (sugar) in the blood and abnormally low blood sugar usually resulting from excessive insulin, respecti...