Older Drivers and Senior Mobility National Press Foundation Driving and Behavior June 13, 2005 T. Bella Dinh-Zarr, PhD, MPH National Director of Traffic Safety Policy AAA

About AAA Not-for-profit federation of 70 independent clubs in US and Canada Founded in 1902 to advocate for better and safer roads Service is integral to organization (and a requirement for AAA clubs) 48 Million Members (25% U.S. households)

A healthier aging population…

The older population is growing.

Even though overall crash rates for older drivers are relatively low…

Older people are more likely to die in crashes.

Older Driver Crash in Santa Monica

Driving = Independence Older drivers rely on their vehicles for: Social Activities Daily Responsibilities Vacations Medical Appointments

States with Medical Review Boards 35 states with Medical Review Boards (D.C.)

Special Provisions for Older Drivers (D.C.) 24 states and D.C

Two Important Aspects: The Public Health Perspective SAFETY = Physical Well-Being, Preventing deaths and injuries MOBILITY = Ability to get from one place to another Goal: To help seniors stay mobile for as long as safely possible

Road (senior-friendly road design) Vehicle (better crash protection, seat belt design, “fit” of vehicle) Driver (training, screening, supplemental transportation) 3 Elements of Traffic Safety

The ROAD Senior-Friendly Road Design Safety-oriented road design has the potential to greatly reduce death and injury to our aging population –intersection improvements; better signage, lighting, and road markings; and protected left-turn lanes Improvements will ultimately protect people of all ages

Reader’s Digest—July 2003 Reader’s Digest—July 2003 Focus on Senior-friendly Road Design

Michigan Road Improvement Demonstration Project – Model for Intersection Improvements Coordinated effort of public and private organizations Determined high risk intersections Identified needed solutions Evaluation yields promising results – reduced injuries by 46% and crashes by 26% Low-cost improvements – pavement markings; signal timing; left-hand turn lanes

The Left Turn! Crashes often occur at intersections in which the older person is attempting to make a left-hand turn. D.F.Preusser et al: Fatal Crash Risk for Older Drivers at Intersections: Insurance Institute for Highway Safety: Aug.1997

The VEHICLE “Senior-friendly” vehicles Better crash protection Effects of emerging in-vehicle technologies on older drivers – positive (crash avoidance technology) and negative (distraction) Ensuring vehicles “fit” aging bodies

The DRIVER

Crash Rate and Aging The crash rate for older drivers is related to physical and mental changes associated with aging  Impaired vision  Hearing Loss  Impaired joint mobility  Neurologic impairment Barbara J. Messinger-Rapport, How to assess and counsel the older driver: Cleveland Clinic Journal of Medicine. March Slide courtesy of Gisele Wolf-Klein, MD, FACP.

Effects of Eye Diseases on Vision Cataract Macular Degeneration New England College of Optometry: Implication of online renewal without vision screening(05/03) Normal Diabetic Retinopathy

Driving and Vision Normal Glaucoma Retinitis Pigmentosa New England College of Optometry: Implication of online renewal without vision screening: May,2003

Useful Field of View ®

Cognitive Skills Critical for Driving Memory Visual perception, visual processing, and visuospatial skills Selective and divided attention Executive skills

Trail-Making

Screening Measures - Validity & Reliability Visual Acuity – high contrast Visual Acuity – low contrast Useful Field of View ® Working Memory Visual Search Visualization of Missing Information Lower Limb Strength and Mobility Head-Neck Flexibility Based on research on nearly 2000 drivers years, seniors with a decline in any of the 8 areas were 2-5 times more at-risk of being in an at-fault crash (Staplin et al, JSR 2003)

R oadwise Review: A Tool to Help Seniors Drive Safely Longer State-of-the-Art Screening Tool developed by AAA CD-ROM Screens 8 factors important for driving Developed with TransAnalytics

INTRODUCTION

LOW CONTRAST VISUAL ACUITY

RESULTS PAGE

RESULTS

Supplemental Transportation Program Pilot in Pasadena SPONSOR the Beverly Foundation PARTNERSRIDERSDRIVERS Service Agencies Age 65+ Pasadena area Residents Friends of Riders recruitmentmaterialsrecruitment feedback rides feedback REIMBURSEMENT DOCUMENTATION Beverly Foundation and AAA Foundation project

Supplemental Transportation Programs (STPs) indicates location of “STAR” Search winners

What’s good for Seniors is good for ALL of us!

A Few Resources AAA: AAA Foundation for Traffic Safety: Area Agency on Aging: AAMVA GrandDriver: AARP: American Society on Aging:

Thank You! For more information: T. Bella Dinh-Zarr, PhD, MPH