Research Papers

The Candrive Older Driver Study: Prospective changes in health characteristics and impact on driving over 4 years

Version 1
Date added June 30, 2016
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Category 2016 CARSP XXVI Halifax
Tags Research and Evaluation, Session 2B
Author/Auteur Shawn Marshall
Stream/Volet Research and Evaluation

Slidedeck Presentation Only (no paper submitted)

2B - Marshall

Abstract

Background/Context: The CIHR Team in Driving in Older Persons (Candrive II) Research Program began enrolment of 928 older drivers in 2009 with the aim of prospectively following drivers over age 70 for 5 years. One of the primary aims of the Candrive study is to develop a risk stratification tool to help identify older drivers who are medically at risk for at-fault collision. The majority of older drivers enrolled in the Candrive study were active drivers in good health and it was anticipated that over time health status and driving patterns for these drivers would change and decline with advancing age.

Aims/Objectives: The aim of this research is to describe the health related function and quality of life changes in older drivers from their baseline assessment to 4 years post enrollment.

Methods/Target Group: Originally 928 drivers age 70 and older were recruited across 6 Canadian sites (Montreal, Ottawa, Toronto, Hamilton, Thunder Bay, Winnipeg and Victoria). Participants underwent a comprehensive 2 to 3 hour baseline assessment including measures of health, driving attitudes, habits and comfort, physical and cognitive screening measures. Participants were followed every 4 months for updates on health changes and collision history with comprehensive assessments completed annually. Participant vehicles were instrumented with in car recording devices to capture driving exposure and driving pattern data. For the purposes of this study, only those participants who remained in the study at the 5th assessment period were included (Winnipeg data was not available for the purposes of this study). Parametric statistics including the paired t-test were used to compare continuous variables and the Chi square test was used for categorical variable comparisons.

Results/Activities: Of the potential 805 participants, 568 (71%) were still enrolled in the study at the 4 year (5th assessment) mark. Participants demonstrated significant changes in health status with increased number of health conditions reported (p<0.001) and number of medications used (p<0.001). There were declines on tests of physical functioning including the Rapid Pace Walk Test (p<0.001). Overall quality of life as measured by the Short Form 36 instrument also revealed declining quality of life.

Discussion/Deliverables: At a time point 4 years post enrollment the Candrive cohort demonstrates changes consistent with decline in overall health status, and physical functioning. These changes would be typically anticipated for an aging population and may have implications for medical fitness to drive.

Conclusions: As expected, health changes occur with time and this may have implications for medical fitness to drive. Future Candrive research will focus on identifying specific predictor variables to be used in the development of a driving risk stratification tool.

Shawn Marshall