The Effects of Medical Conditions on Driving Performance: a Literature Review and Synthesis


Book Description

One factor that distinguishes older drivers from their younger and middle-aged counterparts is a higher prevalence of medical conditions, and the medications used to treat them. Often, the medical conditions that are more prevalent among older people lead to impairments in visual, cognitive, or psychomotor functions needed to drive safely. Similarly, while some medications restore function and improve mobility for those who would otherwise be unable to drive, an array of potentially driver impairing (PDI) prescriptions and over-the-counter medications have been associated with a statistically significant increase in crash risk.The current understanding of how medical conditions can affect driving is based on the opinions of medical (including rehabilitation) professionals or traffic safety experts, or has been derived from simulation research. Other studies have compared the driving records of drivers whose licenses were restricted as a result of reported medical conditions to those of matched controls with the same conditions who had full driving privilege. However, there is a dearth of empirical data about the relationships between medical conditions common among older adults and either performance or safety outcomes of drivers under realistic driving situations. Further, few studies have explored how people with such conditions may limit their driving exposure.




Commercial Motor Vehicle Driver Fatigue, Long-Term Health, and Highway Safety


Book Description

There are approximately 4,000 fatalities in crashes involving trucks and buses in the United States each year. Though estimates are wide-ranging, possibly 10 to 20 percent of these crashes might have involved fatigued drivers. The stresses associated with their particular jobs (irregular schedules, etc.) and the lifestyle that many truck and bus drivers lead, puts them at substantial risk for insufficient sleep and for developing short- and long-term health problems. Commercial Motor Vehicle Driver Fatigue, Long-Term Health and Highway Safety assesses the state of knowledge about the relationship of such factors as hours of driving, hours on duty, and periods of rest to the fatigue experienced by truck and bus drivers while driving and the implications for the safe operation of their vehicles. This report evaluates the relationship of these factors to drivers' health over the longer term, and identifies improvements in data and research methods that can lead to better understanding in both areas.







Social Isolation and Loneliness in Older Adults


Book Description

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.







Individual Differences and the "high-risk" Commercial Driver


Book Description

TRB's Commercial Truck and Bus Safety Synthesis Program (CTBSSP) Synthesis 4: Individual Differences and the "High-Risk" Commercial Driver explores individual differences among commercial drivers, particularly as these differences relate to the "high-risk" commercial driver. The synthesis identifies factors relating to commercial vehicle crash risk and assesses ways that the high-risk driver can be targeted by various safety programs and practices, at both fleet- and industry-wide levels.




Handbook for the Assessment of Driving Capacity


Book Description

This is a resource for professionals involved in determining the driving capacity of individuals with neurological involvement and or trauma. While much work has been completed in this new and growing field, this is the first attempt to bring together clinical work on assessing driving capacity for different clinical populations and conditions. Specific topics include, traumatic brain injury, stroke, dementia, normal aging, medications, retraining, interventions, medical conditions, legal issues, practical issues, assessment instruments, simulators, research and epidemiology. Each chapter will address clinically relevant issues specific to the clinical population. This comprehensive compilation of driving assessment of cognitively compromised populations is the first of its kind and Dr. Schultheis is regarded as a leader in the field. The first definitive handbook about driving assessment of cognitively impaired populations, a growing area of research Addresses a myriad of clinical populations and conditions such as brain injured and elderly patients Written by nationally recognized leaders in their fields of expertise




Health-Care Utilization as a Proxy in Disability Determination


Book Description

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.