Contact: Joy Carter(205) 934-1676[email protected]
Older drivers with heart disease or who have suffered a stroke are more likely to be involved in a car crash than those with other or no chronic illness, according to a recent study by researchers at the University of Alabama at Birmingham (UAB). Details of the study are published in the Sept. 1 issue of the "American Journal of Epidemiology."
"Older drivers are involved in a high number of crashes and are more likely to be injured or die in a crash than someone younger," says Gerald McGwin, Ph.D., assistant professor with the departments of epidemiology and surgery at UAB. "For clinicians, knowing what medical conditions and medications are associated with crashes may provide the groundwork for discussing issues of driving safety with potentially at-risk patients."
The study, funded by the Center for Aging and the Center for Research in Applied Gerontology at UAB, examined the driving records of 901 drivers aged 65 and older living in Mobile County, Ala., in 1996. Of these, 244 were involved in a crash where they were found to be at-fault, 182 in a not-at-fault crash and 475 were not involved in a crash.
The study found that older drivers reporting a stroke were nearly twice as likely to be involved in a crash where they were found to be at fault. "Drivers who have had a stroke may be especially prone to unsafe driving because of the combined effects of age-related deficits and neurological deficits resulting from the stroke," McGwin says.
The study also found that arthritis, particularly among older women, also is associated with an increased risk of crash. "The at-fault crash rate was 20 percent greater in women with arthritis," McGwin says. "This may relate to joint and musculature problems reducing range of motion and increasing reaction times, or it may be that discomfort and diminished muscle mass and strength may lead to excessive fatigue and distraction while driving."
Certain medications, including NSAIDs, such as aspirin, also were found to be associated with an increased risk of crash. "The at-fault crash rate was 70 percent greater in drivers who reported using NSAIDs than in drivers not on the therapy," McGwin says. "It's possible that these drivers have undiagnosed arthritis or musculoskeletal impairments."
On the other hand, researchers found drugs such as calcium channel blockers were associated with a reduced risk of crash involvement. "Drivers taking these medications were 60 percent less likely to be involved in a crash," McGwin says. "Although the reason is unclear, it may be that the drugs' effects on lowering blood pressure, relieving angina or stabilizing certain abnormal heart rhythms have a positive effect on driving safety."
Overall, McGwin says findings indicate that medical diagnoses may serve as markers for functional impairments, the true risk factors for crash involvement; however, further study is needed, particularly on heart disease and stroke as risk factors for a crash. "This information would greatly improve our ability to identify drivers who represent a threat to public safety while maintaining the mobility of older adults."
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