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Cover image for Maintaining safe mobility in an aging society
Title:
Maintaining safe mobility in an aging society
Personal Author:
Series:
Human factors in transportation
Publication Information:
Boca Raton, FL : CRC Press, 2009
Physical Description:
xx, 350 p. : ill. ; 24 cm.
ISBN:
9781420064537

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30000010207099 HE5620.A24 E39 2009 Open Access Book Book
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30000010257900 HE5620.A24 E39 2009 Open Access Book Book
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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 policies

Draws 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 Forewordp. xiii
Prefacep. xv
Acknowledgmentsp. xvii
Authorsp. xix
Chapter 1 Introductionp. 1
Population Trendsp. 1
Driving Trendsp. 2
Dependence on the Personal Automobilep. 2
Driver's License Holdingp. 2
Changes in Annual Driving Distancesp. 3
Behavioral Adaptationsp. 3
Traffic Safetyp. 5
Crash Riskp. 5
Crash Typesp. 7
Mobility Needsp. 8
Chapter 2 Age-Related Declines in Abilitiesp. 11
Introductionp. 11
Psychomotor Abilitiesp. 11
Reaction Timep. 12
Flexibilityp. 12
Coordinationp. 13
Strengthp. 13
Visual Abilitiesp. 14
Anatomic Changesp. 14
Eye Movementsp. 15
Visual Acuityp. 16
Contrast Sensitivityp. 17
Sensitivity to Lightp. 17
Dark Adaptationp. 17
Visual Fieldp. 18
Space Perceptionp. 18
Motion Perceptionp. 19
Three-Dimensional Structure from Motionp. 20
Cognitive Abilitiesp. 20
Attentionp. 20
Memoryp. 21
Problem Solvingp. 23
Spatial Cognitionp. 23
Conclusionsp. 24
Chapter 3 Critical Driving Skillsp. 25
Introductionp. 25
Driving Task Analysisp. 25
A Hierarchical Model of Driver Skills and Controlp. 26
Strategic Levelp. 27
Tactical Levelp. 27
Operational Levelp. 27
Critical Driving Skills Most Salient for Older Driversp. 28
Adding Driver Motives into Michon's Modelp. 29
Conclusionsp. 33
Chapter 4 Medical Conditions and Drivingp. 35
Introductionp. 35
Visual Perceptionp. 36
Cataractsp. 36
Color Vision Deficitsp. 36
Diabetic Retinopathyp. 37
Glaucomap. 37
Monocular Visionp. 38
Age-Related Macular Degeneration (ARMD)p. 39
Auditory Perceptionp. 40
Cardiovascularp. 40
Coronary Heart Diseasep. 40
Arrhythmiap. 41
Congestive Heart Failurep. 41
Abnormal Blood Pressurep. 41
Cerebrovascularp. 42
Transient Ischemic Attackp. 42
Strokep. 42
Neurologicalp. 43
Syncopep. 43
Epilepsy/Seizuresp. 43
Sleep Apneap. 44
Multiple Sclerosisp. 44
Parkinson's Diseasep. 45
Dementiap. 46
Metabolicp. 47
Diabetes Mellitusp. 48
Thyroid (Hypothyroidism)p. 49
Respiratoryp. 49
Asthmap. 49
Chronic Obstructive Pulmonary Diseasep. 49
Musculoskeletalp. 50
Arthritisp. 50
Psychiatricp. 51
Depressionp. 51
Conclusionsp. 51
Chapter 5 Medications and Drivingp. 53
Introductionp. 53
Prevalence of Drug Use Among Older Adultsp. 55
Prescription Medicationsp. 55
Inappropriate Prescription Medication Usep. 55
Nonprescription Medicationsp. 57
Medications and Driving Safetyp. 58
Benzodiazepinesp. 58
Antihistaminesp. 60
Opioid Analgesicsp. 61
Antidiabetic Medicationsp. 62
Conclusionsp. 62
Chapter 6 Screeningp. 65
Introductionp. 65
Self-Screeningp. 67
Family Screeningp. 68
Screening by Physiciansp. 68
The Physician's Guide to Assessing and Counseling Older Driversp. 69
Determining Medical Fitness to Operate Motor Vehicles: CMA Driver's Guidep. 70
Driving and Dementia Toolkit/Safe Drivep. 70
CanDrivep. 71
Screening by Other Health Professionalsp. 72
Screening at Licensing Agenciesp. 72
Model Driver Screening and Evaluation Programp. 72
California Three-Tiered Systemp. 73
Conclusionsp. 74
Chapter 7 Assessmentp. 75
Introductionp. 75
Clinical Assessmentp. 75
The Interviewp. 76
Assessing Functional Abilitiesp. 77
On-Road Assessmentp. 78
Route Selectionp. 78
Assessment of Critical Driving Skillsp. 79
Postevaluation Recommendationsp. 80
Driver Assessment Teamp. 81
Conclusionsp. 81
Chapter 8 Licensing, Legal, and Policy Issuesp. 83
Introductionp. 83
Driver's License Renewalp. 84
Physician Reporting of At-Risk Driversp. 89
Approaches to Strengthening Licensing Policyp. 90
Licensing Agencies as Part of a Systems Approach to Safe Mobilityp. 92
Conclusionsp. 92
Chapter 9 Education and Rehabilitationp. 95
Introductionp. 95
Educationp. 95
For the Driverp. 96
Driver Self-Awareness Toolsp. 99
For the Family and Friendsp. 101
For the Health Professionalp. 102
Rehabilitationp. 103
Fitnessp. 103
Cognitivep. 103
Conclusionsp. 104
Chapter 10 Vehicles and Advanced Technologyp. 107
Introductionp. 107
Automobile Designp. 107
Currently Available Featuresp. 110
Vehicle Adaptationsp. 110
Advanced Technologyp. 111
Route Guidancep. 113
Night Vision Enhancementp. 114
Crash Warning Systemsp. 115
Forward Collision Warningp. 115
Adaptive Cruise Controlp. 115
Lane Departure Warningp. 116
Automatic Crash Notificationp. 117
Conclusionsp. 117
Chapter 11 Roadway Designp. 119
Introductionp. 119
Traffic Control Devicesp. 120
Signagep. 121
Pavement Markingsp. 123
Signalsp. 125
Intersectionsp. 125
Roundaboutsp. 127
Pedestriansp. 129
Roadway Work Zonesp. 130
Promising Approachesp. 131
Conclusionsp. 133
Chapter 12 Driving Retirementp. 135
Introductionp. 135
Reasons for Driving Cessationp. 136
The Process of Driving Cessationp. 138
Self-Regulation by Older Driversp. 139
Smoothing the Process of Driving Retirementp. 141
Conclusionsp. 143
Chapter 13 Other Community Mobility Optionsp. 145
Introductionp. 145
Existing Community Mobility Optionsp. 146
Traditional Public Transitp. 146
Paratransitp. 147
Private Transitp. 148
Supplemental Transportation Programsp. 149
Walking and Bicycling and Other Forms of Transportationp. 150
Creating More Senior-Friendly Community Mobility Optionsp. 150
Transportation Coordinationp. 151
Conclusionsp. 153
Appendix Driver Evaluation Toolsp. 155
Introductionp. 155
Perceptual Evaluation Toolsp. 155
Dynamic Visual Acuityp. 155
Structure from Motionp. 155
Moving "E" Testp. 156
Static Visual Acuityp. 156
Contrast Sensitivityp. 156
Visual Fieldp. 156
Color Vision/Discriminationp. 157
Stereoacuityp. 157
Visual Attentionp. 157
Useful Field of Viewp. 157
Number Cancellation Taskp. 158
Hearingp. 158
Cognitive Evaluation Toolsp. 158
Visuospatial Abilitiesp. 158
Hooper Visual Organization Testp. 158
Embedded Figures Testp. 159
Rey-Osterreith Complex Figures Testp. 159
Block Design Testp. 159
Letter Cancellation Testp. 160
Benton Judgment of Line Orientationp. 160
Wisconsin Card Sorting Testp. 160
Maze Navigation Testp. 160
Visual Form Discrimination Testp. 161
Motor Free Visual Perception Testp. 161
Executive Functionp. 161
Clock Drawing Testp. 161
Controlled Oral Word Association Testp. 162
Trail Making Test (Parts A and B)p. 162
Benton Visual Retention Testp. 162
The Stroop Neuropsychological Screening Testp. 163
Divided Attentionp. 163
Simultaneous Capacity Testp. 163
Selective Attentionp. 163
Zimmermann/Fimm's Incompatibility Testp. 163
Dot Counting Taskp. 164
Sustained Attentionp. 164
Adaptation of Mackworth Clock Testp. 164
Working Memoryp. 164
Wechsler Memory Scale-Visual Reproductionp. 164
Wechsler Adult Intelligence Scale-Digit Symbolp. 165
Wechsler Adult Intelligence Scale-Digit Spanp. 165
Short Blessed Testp. 165
Word Recall Memory Testp. 165
Mini-Mental Status Examinationp. 166
Clinical Dementia Ratingp. 166
Mattis Organic Mental Syndrome Screening Examinationp. 166
Traffic Sign Recognition Testp. 167
Psychomotor Evaluation Toolsp. 167
Movement Speedp. 167
Grooved Pegboard Testp. 167
Symbol Digit Modalities Testp. 167
Range of Motionp. 168
Foot Tap Testp. 168
Neck Flexibilityp. 168
Rapid Pace Walkp. 168
Arm Reach Testp. 168
Reaction Timep. 169
Simple Reaction Time Testp. 169
Doron Cue Recognitionp. 169
Upper/Lower Body Muscle Strengthp. 169
Manual Muscle Testp. 169
Dynamometer Grip Strengthp. 169
Referencesp. 171
Indexp. 217
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