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Older Driver Research - Current ProgramsMedical Conditions and drivingInfluence of Chronic Illness on Crash Involvement of Motor Vehicle DriversResearch Team: Charlton, J., Koppel, S., O’Hare, M., Andrea, D., Smith, G., Khodr, B., Langford, J., Odell, M. & Fildes, B. This aim of this project was to conduct a systematic review of the evidence for the influence of chronic illness and impairments on crash involvement of motor vehicle drivers. Eight conditions were found to have at least a moderately elevated risk of crash involvement (relative risk greater than 2.0) compared with their relevant control group. These were alcohol abuse and dependence, dementia, epilepsy, multiple sclerosis, psychiatric disorders (considered as a group), schizophrenia, sleep apnoea, and cataracts. The full report is available on www.monash.edu.au/muarc/reports/muarc213.html MUARC Report 213. Parkinson's disease and driving
Model Licence Re-assessment Procedure for Older and Disabled DriversResearch Team: Fildes, B., Charlton, J., Langford, J., Frith, W., Pronk, N., Oxley, J. and Koppel, S. In 1998, Austroads commissioned the Monash University Accident Research Centre to develop and trial a model licence re-assessment program for older drivers in Australasia. The proposed model represents a step away from mandatory age-based testing programs to a referral system whereby at-risk drivers undergo various levels of assessment, as required. A report on the model was published in 2000 (see www.austroads.com.au/). Stage 2 consists mainly of the validation of three off-road screening tests (GRIMPS, CALTEST and DriveABLE) against a range of driving performance measures . A report has been prepared and is also available from the Austroads website. Stage 3 of the project is currently underway in an Australian jurisdiction and comprises a large-scale process evaluation of the licensing model and a pilot case-control study (crash-involved and non crash-involved older drivers) aimed at validating a leading screening test of fitness to drive against crash involvement. Funding is currently being sought to extend the project into Stage 4, which will consist of a full-scale case-control study evaluating the screening test against crash involvement. Development of a Police Checklist for Identifying At-risk DriversResearch Team: Koppel, S., Langford, J., Charlton, J. & Fildes, B. Unlike General Practitioners and medical specialists who have guidelines and tools to assist in identifying at-risk older drivers (e.g. Austroads Assessing Fitness to Drive, 2003), police have no official guidelines to assist them. Referrals can be the result of a crash, police observation of poor driving or complaints from the public. This project has developed a police checklist based on a selection of “red flags” and is currently being trialled as part of the Stage 3 process evaluation of the Model Licence Re-Assessment Procedure for Older and Disabled Drivers. Visual Search Strategies Among Older and Younger DriversResearch team: Fildes, B., Charlton. J.L., Koppel, S., Andrea, D., (MUARC), Hammer, M. (Holden) This study investigated visual scanning and driving performance of 20 young (25-35 years) and 20 older drivers (65-75 years) in a high-level driving simulator that incorporated a range of complex and hazardous events known to be associated with older driver crashes. Preliminary results indicate that older drivers responded to hazardous events by travelling at a slower speed than younger drivers. They had a broader scanning pattern than younger drivers both laterally and vertically, were significantly slower in first fixating the hazard, spent less time looking at the hazard and a greater percentage of time looking at the speedometer. Further analyses will be conducted and a paper will be presented at the Vision in Vehicles conference, Dublin, July 2006. A three-year follow-up project on Vision Impairment and Fitness-to-Drive commenced in 2005 (see below). The project will examine the impact of visual impairments on driver scanning and the usefulness of various behavioural countermeasures and ITS solutions for older drivers and drivers with vision impairment. Vision Impairment and Fitness to DriveResearch team: Judith Charlton, Brian Fildes, Sjaanie Koppel, Jennie Oxley, Carlyn Muir, David Logan, Ashley Verdoon, Nebojsa Tomesavic, David Taranto, Anna Devlin ( MUARC); Morris Odell ( Victorian Institute of Forensic Medicine, Melbourne, Australia); Matthew Rizzo ( University of Iowa, Iowa City, USA); Justin O’Day and Jill Keeffe ( Royal Victorian Eye and Ear Hospital, Melbourne, Australia); Patricia Williams ( VicRoads, Melbourne, Australia); Bill Frith (Ministry of Transport, Wellington, New Zealand); Joanne Wood ( Queensland University of Technology, Kelvin Grove, Australia); Mike Hammer and Stu Smith ( GM Holden, Melbourne, Australia); Lars Englund ( Swedish Road Administration, Borlange, Sweden); Matthew Wensor ( Carl Zeiss Pty Ltd, Australia). A three-year collaborative research program (2005-2007), funded through the Australian Research Council Linkage Grants Scheme seeks to identify the way in which specific vision conditions affect driving performance. The study will examine the effects of visual field loss on drivers’ ability to monitor and respond to information in the driving environment. Many senior drivers have visual conditions that restrict their visual fields and potentially compromise driving performance, yet the basis of driving errors and the capacity of drivers to compensate remains poorly understood. Current procedures for assessing vision for licensing lack uniformity and a scientific basis for predicting at-risk status. This has implications for licensing decisions and may lead to unsafe drivers remaining on our roads and restricted mobility for drivers who have had their licence revoked unnecessarily. To address this, an international partnership has been assembled, supported by Australian Research Council funding, involving researchers in road safety psychology, human factors engineering, traffic medicine, ophthalmology, optometry and with substantial support and advice from the motor vehicle industry and road safety authorities. The study has three components: Phase 1 will identify current practices for assessing vision, including visual fields, in selected Australian and international jurisdictions. Licensing and medical review records and crash databases will be analysed to determine the prevalence of visual field defects amongst drivers referred to the licensing authority and licence outcomes for these drivers. Surveys and focus groups with clinicians will be used to identify decision-making processes for assessing visual fitness-to-drive. Phase 2 of the research involves simulator-based experiments using the MUARC advanced driving simulator and FaceLAB eye monitoring technologies to assess driving performance and visual search patterns associated with visual field loss. The results will be used as the basis for developing a detailed model of driver characteristics for predicting driving performance.The third phase of the study will identify selected interventions (driver-centered, in-vehicle technologies and road infrastructure) and evaluate their feasibility and efficacy for enhancing driver safety. Outcomes of the study will enable the development of evidence-based guidelines for assessing visual fitness-to-drive and effective countermeasure designs. Phases 1 and 2 are underway and a paper presenting some preliminary findings will be presented at the 20th World Congress of the International Traffic Medicine Association, in Melbourne, October 16-18, 2006. Exploring Older Drivers' Crash Risk LevelsResearch team: Langford, J., Koppel, S., Charlton. J., Oxley, S., Fildes, B. (MUARC) and others (various). This project consists of a collection of activities linked by a common concern with further exploring the mileage/crash association, particularly as demonstrated by older drivers. Data from an assortment of sources (Australian, New Zealand and Dutch travel surveys, as well as test performance and health data from other projects) have been used to show that: (a) low mileage drivers of any age have a higher crash involvement than drivers with higher mileages; (b) once different driving distances have been taken into account and in terms of per-kilometre crash rates, older drivers as a group are at least as safe as other age groups; (c) at least for older drivers, the low mileage/high crash association is more likely attributable to reduced fitness to drive rather than to higher levels of urban driving. This project has resulted in two publications in peer-reviewed journals:
The Elderly and MobilityResearch team: Oxley, J., Langford, J., Charlton, J., Fildes, B., Whelan, M., & Koppel, S. (MUARC) Driving offers an important mobility option for most elderly For many, particularly those with a decline in health status, driving cessation is likely to lead to an increase in depressive symptoms and a decline in out-of-home activity levels and community mobility. Driving status thus plays a critical role in the complex interactions between ageing, physical and psychological health, community mobility and use of health services. A good understanding of these relationships is required in order to enable older people to maintain economic and social participation and quality of life. A literature review, funded by the Swedish Road Administration (SRA), will assess the current state of knowledge with regard to the complex relationships between changing driving and travel patterns, ageing, health status, and reduced mobility and the impact on quality of life. The findings from the review will be used to compile a set of recommendations to effectively manage the safe mobility of elderly road users. Recent ProgramsDevelopment of a Referral Assessment Tool for Assessing Older and Functionally Impaired DriversResearch Team: Charlton, J., Fildes, B., Koppel, S., Oxley, P. & Newstead, S. The aim of this project was to design and evaluate a referral instrument intended for use by GPs and other health care professionals as a pre-screen to identify whether a driver poses a significant risk of being involved in a motor vehicle crash due to functional impairments. Based on the outcome of the pre-screen assessment, drivers may be referred for a more detailed off-road screening assessment or in-depth specialised assessment. Final Report: Charlton, J., Fildes, B., Koppel, S., Oxley, P. & Newstead, S. (2003). Health Screen for Drivers (HSD) referral instrument. Stage 3: Validation of HSD and evaluation of Victorian trial. VicRoads, Report GR2003 R+D871. Road Safety and Environment and Design for Older Drivers, Stage 2Research Team: Fildes, B., Oxley, J., Corben, B. and Langford, J. Sponsoring organisation: Austroads Stage 1 of this study reviewed the suitability of current road design requirements for older drivers in Australasia. The study included a literature review, a critical examination of the US Federal Highway Administration’s recently released “Older Driver Highway Design Handbook”, a one-day expert workshop, and an examination of older driver accident “black spots” in four Australasian jurisdictions. In Stage 2, a workshop format and associated support materials have been developed to improve road engineers’ understanding of older driver difficulties and to promote use of the road design recommendations. Stage 1 report (Report No. AP-R169) and Stage 2 report (Report No. AP-R261/04) are available at www.austroads.com.au A paper is being reviewed for inclusion in Transportation Research Part F: Traffic Psychology and Behaviour, forthcoming Special Issue on older road users. Effectiveness of Mandatory Licence Testing for Older Drivers in Reducing Crash Risk Among Urban Older Drivers in AustraliaResearch Team: Langford, J., Fitzharris, M., Newstead, S. & Koppel, S. The first study examined older driver fatal and serious injury crash rates across all Australian States, to determine a possible association with the different licensing procedures by comparing per population and per driver crash rates in Victoria (whether there is no age-based mandatory system) ] with rates in other jurisdictions which have such programs.. The second study compared the crash rates of older drivers in Melbourne (Victoria, no assessment) with older drivers in Sydney (New South Wales, both medical and on-road assessment), made on per population, per driver, per distance travelled and per time spent travelling bases. Neither study was able to show any road safety benefits associated with mandatory assessment programs Papers have been prepared for both studies: Accident Analysis and Prevention 36 (2004) 993-1001; and Traffic Injury Prevention 3 (2004) 326-335. Assessing Responsibility for Older Drivers' CrashesResearch Team: Langford, J., Andrea, D., Fildes, B., Williams, T. and Hull, M. This project sought to determine whether older drivers were overly responsible for any crashes in which they were involved. Based on both the available research and the analyses conducted as part of this report, it was concluded that older drivers are more likely to be judged as responsible for their crashes than other age groups. However it was also concluded that older drivers’ additional crash responsibility (as judged by police and others), while valuable in explaining ‘what went wrong’ in crashes, made only a small contribution to the overall road toll. A report on the project is available from the Austroads website www.austroads.com.au and a paper has been prepared and under review for inclusion in the Traffic Injury Prevention journal. Older Female DriversResearch Team: Oxley, J., Charlton, J., Fildes, B., Koppel, S, Scully, J., & Congiu, M. There are issues that are specific to the safe mobility of older female drivers including driving experience, confidence, exposure, trauma consequences and mobility consequences of premature driving cessation. However, little is known about the contributing factors to their crash and injury risk, travel patterns, driving experiences and transportation needs. A study of the safety and associated transportation issues of older female drivers and former drivers has been conducted to describe gender effects on crash rates and to gain in-depth information on the issues surrounding the mobility and safety of older female drivers, specifically the effect of driving experience, lack of confidence and mobility needs. A final report (Report 226) is available at www.monash.edu.au/muarc/reports/muarc226.html. A follow-up study has recently been completed to investigate the contributing factors to crash risk using two methodologies i) follow-up statistical analyses using existing survey data, and ii) a case-control study examining functional performance assessments of crash-involved and non-crash-involved participants. The full report is available on www.monash.edu.au/muarc/reports/muarc245.html MUARC Report 245. Older Pedestrians and CyclistsResearch Team: Oxley, J., Corben, B., Fildes, B., Rothengatter, T. and O’Hare, M. While car use is a dominant mode of transport for many older people, other forms of transport such as walking and cycling are still important transport modes, particularly for shorter trips. However, older pedestrians and cyclists are two of the most vulnerable road user groups. A literature review, funded by the Swedish Road Administration (SRA), was undertaken to assess the current state of knowledge in regard to the key issues affecting senior vulnerable road users (namely, older pedestrians and cyclists) and to identify a set of best-practice recommendations for managing the safety of these road user groups. A final report (Report No. 218) is available at www.monash.edu.au/muarc/reports/muarc218.html Effect of Cognitive Impairment on Pedestrian Behaviour and Crash RiskResearch Team: Oxley, J., Charlton, J., and Fildes, B. Pedestrian crashes make up about 15 percent of all road fatalities in Australia and a substantial proportion (37%) of these crashes involve older adults. It is often argued that their over-involvement in serious injury and fatal crashes is, in addition to their frailty, largely a consequence of their reduced ability to cope with certain traffic situations, particularly as a result of limited functional abilities. As a result of a Victorian Parliamentary Inquiry into Road Safety for Older Road Users, MUARC was commissioned by VicRoads to review the current state of knowledge with regard to the effect of cognitive impairment on pedestrian behaviour and crash risk and to make recommendations for countermeasure development and further research. The full report is available on www.monash.edu.au/muarc/reports/muarc244.html MUARC Report 244. Report on VicRoads' Older Driver Survey, 2004Research Team: Langford, J., Charlton, J., Fildes, B., Oxley, J., and Koppel, S. In June 2004, 2,000 older Victorian licence-holders were surveyed particularly to determine whether they were still active drivers. In addition, the survey questionnaire covered a range of aspects relating to driving patterns, including extent of crash involvement and amount of driving activity. This report presents the main findings relating to whether Victorian older licence-holders were active drivers at the time of the survey, social and demographic factors associated with driving status, key aspects of older licence-holders’ driving and travel patterns and some preliminary recommendations on best means to calculate older drivers’ crash propensity. The final report has been prepared and is available from VicRoads (R&D Project 830, 'Report on VicRoads older driver survey, 2004'). Self-Regulation of Older DriversResearch Team: Charlton, J., Oxley, J., Fildes, B. and Koppel, S. This study has examined the extent and nature of self-regulation amongst older drivers in Australia. The main research activity has involved a sequence of interviews with older drivers in the State of Victoria, to map age-associated changes in driving behaviours and attitudes. A comprehensive literature review of the topic has also been conducted and published. This report (Report No. AP-R221/03) is available at www.austroads.com.au. The interviews from the Victorian sample are completed and a final report (Report No. 208) is available at www.monash.edu.au/muarc/reports/muarc208.html. The study has been extended to provide a broader representation of drivers and former drivers from other jurisdictions in Australia, particularly those with different licensing procedures . The results of this study confirmed many of the findings from the previous study, i.e., evidence for age-related differences in changes in the amount of driving as well as avoidance of specific driving situations. The findings showed that self-regulators were more likely to be Victorian (living in a jurisdiction without mandatory age-based licence re-testing), aged 75 years or older, female, with lower overall health ratings, and lower confidence in risky driving situations, particularly rural drivers. The final report is available on this website: Self-regulatory driving practices of older drivers in the ACT and NSW - Report #254 [2006] |