Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T11:02:37.977Z Has data issue: false hasContentIssue false

Cognitive Performance, Driving Behavior, and Attitudes over Time in Older Adults

Published online by Cambridge University Press:  29 March 2016

Mark J. Rapoport*
Affiliation:
Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto
Paweena Sukhawathanakul
Affiliation:
Centre on Aging, University of Victoria
Gary Naglie
Affiliation:
Research Department, Toronto Rehabilitation Institute, University Health Network Department of Medicine and Rotman Research Institute, University of Toronto Baycrest Geriatric Health Care Centre; and Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto
Holly Tuokko
Affiliation:
Centre on Aging, University of Victoria
Anita Myers
Affiliation:
School of Public Health & Health Systems, University of Waterloo
Alexander Crizzle
Affiliation:
School of Public Health & Health Systems, University of Waterloo
Nicol Korner-Bitensky
Affiliation:
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR)
Brenda Vrkljan
Affiliation:
School of Rehabilitation Science, McMaster University
Michel Bédard
Affiliation:
Centre for Research on Safe Driving, Lakehead University
Michelle M. Porter
Affiliation:
Faculty of Kinesiology and Recreation Management, University of Manitoba
Barbara Mazer
Affiliation:
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR)
Isabelle Gélinas
Affiliation:
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR)
Malcolm Man-Son-Hing
Affiliation:
Ottawa Hospital Research Institute, University of Ottawa
Shawn Marshall
Affiliation:
Ottawa Hospital Research Institute, University of Ottawa
*
La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Mark J. Rapoport, MD, FRCPC Department of Psychiatry Sunnybrook Health Sciences Centre University of Toronto FG37-2075 Bayview Ave. Toronto, ON M4C 5N6 ([email protected])

Abstract

We hypothesized that changes over time in cognitive performance are associated with changes in driver perceptions, attitudes, and self-regulatory behaviors among older adults. Healthy older adults (n = 928) underwent cognitive assessments at baseline with two subsequent annual follow-ups, and completed scales regarding their perceptions, attitudes, and driving behaviours. Multivariate analysis showed small but statistically significant relationships between the cognitive tests and self-report measures, with the largest magnitudes between scores on the Trails B cognitive task (seconds), perceptions of driving abilities (β = –0.32), and situational driving avoidance (β = 0.55) (p < 0.05). Cognitive slowing and executive dysfunction appear to be associated with modestly lower perceived driving abilities and more avoidance of driving situations over time in this exploratory analysis.

Résumé

Nous avons théorisé que les changements au fil du temps dans les performances cognitives sont associés à des changements dans les perceptions, les attitudes et les comportements d’auto-régulation des personnes âgées qui conduisent. Les adultes âgés en bonne santé (n = 928) ont subi les évaluations cognitives au début avec deux suivis annuels subséquents, et ils ont rempli des formulaires avec des échelles qui mesurent leurs perceptions, les attitudes et les comportements de conduite. L’analyse multivariée montre des petites relations, mais statistiquement significatives, entre les tests cognitifs et les mesures qui ont été auto-déclarée, les plus grandes amplitudes entre les scores étant sur les sentiers B tâche cognitive (secondes), la perception de la capacité de conduire (β = 0,32), et l’évasion des situations de conduite (β = 0,55) (p <0,05). Selon cette analyse exploratoire, le ralentissement cognitif et le dysfonctionnement exécutif semblent être associés aux capacités à conduire perçues d'être modestement inférieurs et à l’évitement accru des situations de conduite au fil du temps.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ball, K. K., Roenker, D. L., Wadley, V. G., Edwards, J. D., Roth, D. L., McGwin, G. Jr., et al. (2006). Can high-risk older drivers be identified through performance-based measures in a Department of Motor Vehicles setting? Journal of the American Geriatrics Society, 54(1), 7784.Google Scholar
Bédard, M., Weaver, B., Darzins, P., & Porter, M. M. (2008). Predicting driving performance in older adults: We are not there yet! Traffic Injury Prevention, 9(4), 336341.Google Scholar
Blanchard, R. A., & Myers, A. M. (2010). Examination of driving comfort and self-regulatory practices in older adults using in-vehicle devices to assess natural driving patterns. Accident Analysis and Prevention, 42(4), 12131219.Google Scholar
Canadian Medical Association. (2012). CMA driver’s guide: Determining medical fitness to operate motor vehicles (8th ed.). Ottawa, ON: Author.Google Scholar
Carr, D. B., Schwartzberg, J. G., Manning, L., & Sempek, J. (2010). Physician's guide to assessing and counseling older drivers (2nd ed.). Washington, DC.: National Highway Traffic Safety Administration.Google Scholar
Charlton, J. L., Koppel, S., Odell, M., Devlin, A., Langford, J., O'Hare, M., et al. (2010). Influence of chronic illness on crash involvement of motor vehicle drivers (2nd ed.). Clayton, Australia: Monash University Accident Research Centre.Google Scholar
Classen, S., Horgas, A., Awadzi, K., Messinger-Rapport, B., Shechtman, O., & Joo, Y. (2008). Clinical predictors of older driver performance on a standardized road test. Traffic Injury Prevention, 9(5), 456462.CrossRefGoogle ScholarPubMed
Crizzle, A. M., Myers, A. M., & Almeida, Q. J. (2013). Self-regulatory practices of drivers with Parkinson’s disease: Accuracy of patient reports. Parkinsonism and Related Disorders, 19(2), 176180.Google Scholar
Fidell, L. S., & Tabachnick, B. G. (2006). Using multivariate statistics. Boston, MA: Allyn & Bacon.Google Scholar
Folstein, M. F., Folstein, S. E., & McHugh, P.R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189198.Google Scholar
Gagnon, S., Marshall, S., Kadulina, Y., Man-Son-Hing, M., Korner-Bitensky, N., Gélinas, I., et al. (2012, June). Does self-selection of participants in longitudinal studies of older drivers jeopardize external validity? Lessons from the Candrive II study. Research presented at the International Conference on Aging, Mobility and Quality of Life, Ann Arbor, MI.Google Scholar
Jouk, A., et al. (2016). Psychosocial constructs as possible moderators of self-reported driving restrictions. Canadian Journal on Aging (this issue).CrossRefGoogle ScholarPubMed
Katzman, R., Brown, T., Fuld, P., Peck, A., Schechter, R., & Schimmel, H. (1983). Validation of a short Orientation-Memory-Concentration Test of cognitive impairment. The American Journal of Psychiatry, 140(6), 734739.Google Scholar
Kowalski, K., Love, J., Tuokko, H., MacDonald, S., Hultsch, D., & Strauss, E. (2012). The influence of cognitive impairment with no dementia on driving restriction and cessation in older adults. Accident Analysis and Prevention, 49, 308315.Google Scholar
Langford, J., Charlton, J. L., Koppel, S., Myers, A., Tuokko, H., Marshall, S., et al. (2013). Findings from the Candrive/Ozcandrive study: Low mileage older drivers, crash risk and reduced fitness to drive. Accident Analysis and Prevention, 61, 304310.Google Scholar
Lindstrom-Forneri, W., Tuokko, H., & Rhodes, R. E. (2007). “Getting Around Town”: A preliminary investigation of the theory of planned behavior and intent to change driving behaviors among older adults. Applied Gerontology, 26(4), 385398.Google Scholar
MacDonald, L., Myers, A. M., & Blanchard, R. A. (2008). Correspondence among older drivers’ perceptions, abilities and driving behaviors. Topics in Geriatric Rehabilitation, 24, 239252.CrossRefGoogle Scholar
Marshall, S. C., Man-Son-Hing, M., Bédard, M., Charlton, J., Gagnon, S., Gélinas, I., et al. (2013). Protocol for Candrive II/Ozcandrive, a multicentre prospective older driver cohort study. Accident Analysis and Prevention, 61, 245252.Google Scholar
Mathias, J. L., & Lucas, L. K. (2009). Cognitive predictors of unsafe driving in older drivers: A meta-analysis. International Psychogeriatrics/IPA, 21(4), 637653.Google Scholar
Mazer, B. L., Korner-Bitensky, N. A., & Sofer, S. (1998). Predicting ability to drive after stroke. Archives of Physical Medicine and Rehabilitation, 79(7), 743750.Google Scholar
Mercier, L., Hebert, R., Colarusso, R., & Hammill, D. (1997). Motor-free visual perception test-vertical format. Navoto, CA: Academic Therapy Publications.Google Scholar
Molnar, L. J., & Eby, D. W. (2008). The relationship between self-regulation and driving-related abilities in older drivers: An exploratory study. Traffic Injury Prevention, 9(4), 314319.Google Scholar
Molnar, L. J., Eby, D. W., Charlton, J. L., Langford, J., Koppel, S., Marshall, S., et al. (2013). Driving avoidance by older adults: Is it always self-regulation? Accident Analysis and Prevention, 57, 96104.Google Scholar
Moses, J. A. Jr. (2004). Test review – Comprehensive trail making test (CTMT). Archives of Clinical Neuropsychology, 19(5), 703708.Google Scholar
Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide. Los Angeles, CA: Muthén & Muthén.Google Scholar
Myers, A. M., Paradis, J. A., & Blanchard, R. A. (2008). Conceptualizing and measuring confidence in older drivers: Development of the day and night driving comfort scales. Archives of Physical Medicine and Rehabilitation, 89(4), 630640.Google Scholar
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., et al. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695699.Google Scholar
Oswanski, M. F., Sharma, O. P., Raj, S. S., Vassar, L. A., Woods, K. L., Sargent, W. M., et al. (2007). Evaluation of two assessment tools in predicting driving ability of senior drivers. American Journal of Physical Medicine & Rehabilitation, 86(3), 190199.Google Scholar
Porter, M. M., Smith, G. A., Cull, A. W., Myers, A. M., Bédard, M., Gélinas, I., et al. (2015). Older driver estimates of driving exposure compared to in-vehicle data in the Candrive II study. Traffic Injury Prevention, 16, 2427.Google Scholar
Rapoport, M. J., Naglie, G., Weegar, K., Myers, A., Cameron, D., Crizzle, A., et al. (2013). The relationship between cognitive performance, perceptions of driving comfort and abilities, and self-reported driving restrictions among healthy older drivers. Accident Analysis and Prevention, 61, 288295.Google Scholar
Reitan, R. M. (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271276.Google Scholar
Ross, L. A., Clay, O. J., Edwards, J. D., Ball, K. K., Wadley, V. G., Vance, D. E., et al. (2009). Do older drivers at-risk for crashes modify their driving over time? The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 64(2), 163170.Google Scholar
Rothman, K. J. (1990). No adjustments are needed for multiple comparisons. Epidemiology, 1, 4346.Google Scholar
Roy, M. & Molnar, F. (2013). Systematic review of the evidence for Trails B cut-off scores in assessing fitness to drive. Canadian Geriatrics Journal, 16(3), 120142.Google Scholar
Savitz, D. A., & Olshan, A. F. (1995). Multiple comparisons and related issues in the interpretation of epidemiologic data. American Journal of Epidemiology, 142, 904908.Google Scholar
Statistics Canada. (2008). Canadian Community Health Survey (CCHS HA) – Healthy Aging – 2008/2009, User Guide. Ottawa, ON: Author.Google Scholar
Tombaugh, T. (2004). Trail making Test A and B: Normative data stratified by age and education. Archives of Clinical Neuropsychology, 19(2), 203214.Google Scholar
Tuokko, H., McGee, P., & Rhodes, R. E. (2006). Decisional balance and readiness to change driving behavior in older adults: A pilot study. Physical and Occupational Therapy in Geriatrics, 24(3), 112.Google Scholar
Weschsler, D. (1987). Wechsler Memory Scale-Revised. San Antonio, TX: The Psychological Corporation.Google Scholar