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Searching... | 30000010207099 | HE5620.A24 E39 2009 | Open Access Book | Book | Searching... |
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Summary
Summary
By 2030, 20 percent of the world's drivers, 60 million in all, will be over the age of 65. Consequently, safe and efficient mobility for older adults is a complex and pressing issue. Maintaining Safe Mobility in an Aging Society addresses the complexities surrounding the booming number of aging drivers and practical solutions for sustaining safe transportation for this growing group.
This plainspoken resource informs safe mobility discussions on a variety of areas, including:
Necessary skills for safe driving and how age affects them Current evidence on how medical conditions and medication hinder driving skills Comprehensive screening description and assessment practices, issues, and tools Sensitive ways to help older drivers transition into driving cessation Impact of advanced vehicle technology on aging drivers Approaches to strengthening safety-conscious licensing policiesDraws the Significant Link Between Mobility and Well Being
In addition to discussing how age impacts both the risk and severity of accidents and the link between mobility and well-being, this authoritative work discusses means to achieve safer mobility, including roadway design and community transportation options. Authored by driver safety and awareness experts, it covers psychological and physical changes associated with age (both normal and pathological), including an important but rarely explored aspect of dementia known as wandering behavior. It also addresses the role of emerging technology.
Maintaining Safe Mobility in an Aging Society is a concise reference that encompasses an impressive breadth of ready-to-access information. Thorough and systematically organized, it is a groundbreaking and indispensable resource for those prov
Author Notes
Eby, David W.; Molnar, Lisa J.; Kartje, Paula S.
Table of Contents
Series Foreword | p. xiii |
Preface | p. xv |
Acknowledgments | p. xvii |
Authors | p. xix |
Chapter 1 Introduction | p. 1 |
Population Trends | p. 1 |
Driving Trends | p. 2 |
Dependence on the Personal Automobile | p. 2 |
Driver's License Holding | p. 2 |
Changes in Annual Driving Distances | p. 3 |
Behavioral Adaptations | p. 3 |
Traffic Safety | p. 5 |
Crash Risk | p. 5 |
Crash Types | p. 7 |
Mobility Needs | p. 8 |
Chapter 2 Age-Related Declines in Abilities | p. 11 |
Introduction | p. 11 |
Psychomotor Abilities | p. 11 |
Reaction Time | p. 12 |
Flexibility | p. 12 |
Coordination | p. 13 |
Strength | p. 13 |
Visual Abilities | p. 14 |
Anatomic Changes | p. 14 |
Eye Movements | p. 15 |
Visual Acuity | p. 16 |
Contrast Sensitivity | p. 17 |
Sensitivity to Light | p. 17 |
Dark Adaptation | p. 17 |
Visual Field | p. 18 |
Space Perception | p. 18 |
Motion Perception | p. 19 |
Three-Dimensional Structure from Motion | p. 20 |
Cognitive Abilities | p. 20 |
Attention | p. 20 |
Memory | p. 21 |
Problem Solving | p. 23 |
Spatial Cognition | p. 23 |
Conclusions | p. 24 |
Chapter 3 Critical Driving Skills | p. 25 |
Introduction | p. 25 |
Driving Task Analysis | p. 25 |
A Hierarchical Model of Driver Skills and Control | p. 26 |
Strategic Level | p. 27 |
Tactical Level | p. 27 |
Operational Level | p. 27 |
Critical Driving Skills Most Salient for Older Drivers | p. 28 |
Adding Driver Motives into Michon's Model | p. 29 |
Conclusions | p. 33 |
Chapter 4 Medical Conditions and Driving | p. 35 |
Introduction | p. 35 |
Visual Perception | p. 36 |
Cataracts | p. 36 |
Color Vision Deficits | p. 36 |
Diabetic Retinopathy | p. 37 |
Glaucoma | p. 37 |
Monocular Vision | p. 38 |
Age-Related Macular Degeneration (ARMD) | p. 39 |
Auditory Perception | p. 40 |
Cardiovascular | p. 40 |
Coronary Heart Disease | p. 40 |
Arrhythmia | p. 41 |
Congestive Heart Failure | p. 41 |
Abnormal Blood Pressure | p. 41 |
Cerebrovascular | p. 42 |
Transient Ischemic Attack | p. 42 |
Stroke | p. 42 |
Neurological | p. 43 |
Syncope | p. 43 |
Epilepsy/Seizures | p. 43 |
Sleep Apnea | p. 44 |
Multiple Sclerosis | p. 44 |
Parkinson's Disease | p. 45 |
Dementia | p. 46 |
Metabolic | p. 47 |
Diabetes Mellitus | p. 48 |
Thyroid (Hypothyroidism) | p. 49 |
Respiratory | p. 49 |
Asthma | p. 49 |
Chronic Obstructive Pulmonary Disease | p. 49 |
Musculoskeletal | p. 50 |
Arthritis | p. 50 |
Psychiatric | p. 51 |
Depression | p. 51 |
Conclusions | p. 51 |
Chapter 5 Medications and Driving | p. 53 |
Introduction | p. 53 |
Prevalence of Drug Use Among Older Adults | p. 55 |
Prescription Medications | p. 55 |
Inappropriate Prescription Medication Use | p. 55 |
Nonprescription Medications | p. 57 |
Medications and Driving Safety | p. 58 |
Benzodiazepines | p. 58 |
Antihistamines | p. 60 |
Opioid Analgesics | p. 61 |
Antidiabetic Medications | p. 62 |
Conclusions | p. 62 |
Chapter 6 Screening | p. 65 |
Introduction | p. 65 |
Self-Screening | p. 67 |
Family Screening | p. 68 |
Screening by Physicians | p. 68 |
The Physician's Guide to Assessing and Counseling Older Drivers | p. 69 |
Determining Medical Fitness to Operate Motor Vehicles: CMA Driver's Guide | p. 70 |
Driving and Dementia Toolkit/Safe Drive | p. 70 |
CanDrive | p. 71 |
Screening by Other Health Professionals | p. 72 |
Screening at Licensing Agencies | p. 72 |
Model Driver Screening and Evaluation Program | p. 72 |
California Three-Tiered System | p. 73 |
Conclusions | p. 74 |
Chapter 7 Assessment | p. 75 |
Introduction | p. 75 |
Clinical Assessment | p. 75 |
The Interview | p. 76 |
Assessing Functional Abilities | p. 77 |
On-Road Assessment | p. 78 |
Route Selection | p. 78 |
Assessment of Critical Driving Skills | p. 79 |
Postevaluation Recommendations | p. 80 |
Driver Assessment Team | p. 81 |
Conclusions | p. 81 |
Chapter 8 Licensing, Legal, and Policy Issues | p. 83 |
Introduction | p. 83 |
Driver's License Renewal | p. 84 |
Physician Reporting of At-Risk Drivers | p. 89 |
Approaches to Strengthening Licensing Policy | p. 90 |
Licensing Agencies as Part of a Systems Approach to Safe Mobility | p. 92 |
Conclusions | p. 92 |
Chapter 9 Education and Rehabilitation | p. 95 |
Introduction | p. 95 |
Education | p. 95 |
For the Driver | p. 96 |
Driver Self-Awareness Tools | p. 99 |
For the Family and Friends | p. 101 |
For the Health Professional | p. 102 |
Rehabilitation | p. 103 |
Fitness | p. 103 |
Cognitive | p. 103 |
Conclusions | p. 104 |
Chapter 10 Vehicles and Advanced Technology | p. 107 |
Introduction | p. 107 |
Automobile Design | p. 107 |
Currently Available Features | p. 110 |
Vehicle Adaptations | p. 110 |
Advanced Technology | p. 111 |
Route Guidance | p. 113 |
Night Vision Enhancement | p. 114 |
Crash Warning Systems | p. 115 |
Forward Collision Warning | p. 115 |
Adaptive Cruise Control | p. 115 |
Lane Departure Warning | p. 116 |
Automatic Crash Notification | p. 117 |
Conclusions | p. 117 |
Chapter 11 Roadway Design | p. 119 |
Introduction | p. 119 |
Traffic Control Devices | p. 120 |
Signage | p. 121 |
Pavement Markings | p. 123 |
Signals | p. 125 |
Intersections | p. 125 |
Roundabouts | p. 127 |
Pedestrians | p. 129 |
Roadway Work Zones | p. 130 |
Promising Approaches | p. 131 |
Conclusions | p. 133 |
Chapter 12 Driving Retirement | p. 135 |
Introduction | p. 135 |
Reasons for Driving Cessation | p. 136 |
The Process of Driving Cessation | p. 138 |
Self-Regulation by Older Drivers | p. 139 |
Smoothing the Process of Driving Retirement | p. 141 |
Conclusions | p. 143 |
Chapter 13 Other Community Mobility Options | p. 145 |
Introduction | p. 145 |
Existing Community Mobility Options | p. 146 |
Traditional Public Transit | p. 146 |
Paratransit | p. 147 |
Private Transit | p. 148 |
Supplemental Transportation Programs | p. 149 |
Walking and Bicycling and Other Forms of Transportation | p. 150 |
Creating More Senior-Friendly Community Mobility Options | p. 150 |
Transportation Coordination | p. 151 |
Conclusions | p. 153 |
Appendix Driver Evaluation Tools | p. 155 |
Introduction | p. 155 |
Perceptual Evaluation Tools | p. 155 |
Dynamic Visual Acuity | p. 155 |
Structure from Motion | p. 155 |
Moving "E" Test | p. 156 |
Static Visual Acuity | p. 156 |
Contrast Sensitivity | p. 156 |
Visual Field | p. 156 |
Color Vision/Discrimination | p. 157 |
Stereoacuity | p. 157 |
Visual Attention | p. 157 |
Useful Field of View | p. 157 |
Number Cancellation Task | p. 158 |
Hearing | p. 158 |
Cognitive Evaluation Tools | p. 158 |
Visuospatial Abilities | p. 158 |
Hooper Visual Organization Test | p. 158 |
Embedded Figures Test | p. 159 |
Rey-Osterreith Complex Figures Test | p. 159 |
Block Design Test | p. 159 |
Letter Cancellation Test | p. 160 |
Benton Judgment of Line Orientation | p. 160 |
Wisconsin Card Sorting Test | p. 160 |
Maze Navigation Test | p. 160 |
Visual Form Discrimination Test | p. 161 |
Motor Free Visual Perception Test | p. 161 |
Executive Function | p. 161 |
Clock Drawing Test | p. 161 |
Controlled Oral Word Association Test | p. 162 |
Trail Making Test (Parts A and B) | p. 162 |
Benton Visual Retention Test | p. 162 |
The Stroop Neuropsychological Screening Test | p. 163 |
Divided Attention | p. 163 |
Simultaneous Capacity Test | p. 163 |
Selective Attention | p. 163 |
Zimmermann/Fimm's Incompatibility Test | p. 163 |
Dot Counting Task | p. 164 |
Sustained Attention | p. 164 |
Adaptation of Mackworth Clock Test | p. 164 |
Working Memory | p. 164 |
Wechsler Memory Scale-Visual Reproduction | p. 164 |
Wechsler Adult Intelligence Scale-Digit Symbol | p. 165 |
Wechsler Adult Intelligence Scale-Digit Span | p. 165 |
Short Blessed Test | p. 165 |
Word Recall Memory Test | p. 165 |
Mini-Mental Status Examination | p. 166 |
Clinical Dementia Rating | p. 166 |
Mattis Organic Mental Syndrome Screening Examination | p. 166 |
Traffic Sign Recognition Test | p. 167 |
Psychomotor Evaluation Tools | p. 167 |
Movement Speed | p. 167 |
Grooved Pegboard Test | p. 167 |
Symbol Digit Modalities Test | p. 167 |
Range of Motion | p. 168 |
Foot Tap Test | p. 168 |
Neck Flexibility | p. 168 |
Rapid Pace Walk | p. 168 |
Arm Reach Test | p. 168 |
Reaction Time | p. 169 |
Simple Reaction Time Test | p. 169 |
Doron Cue Recognition | p. 169 |
Upper/Lower Body Muscle Strength | p. 169 |
Manual Muscle Test | p. 169 |
Dynamometer Grip Strength | p. 169 |
References | p. 171 |
Index | p. 217 |