The number of older drivers is increasing. Mileage-adjusted crash rates, as well as the risk of injury and death following a crash, are higher for older drivers. However, older persons rely on the automobile for transportation. Limiting or stopping driving can adversely affect independence and mobility, and result in decreased activity levels and increased depressive symptoms. Consequently, identifying factors associated with driving difficulties and developing interventions to correct or compensate for these may enhance safety, independence, and mobility. The primary aims of the study are to determine whether a multicomponent physical conditioning program directed at axial and extremity flexibility, coordination, and reaction time can enhance driving performance and the physical abilities relevant to driving performance. The secondary aims are to determine: 1) if the improvements in driving performance are mediated by changes in physical ability; 2) if the magnitude of treatment effect is moderated by driving confidence and treatment adherence; and 3) if intervention reduces crash and moving violation involvement. To accomplish these aims, 150 consenting drivers age 70 years and older who meet eligibility and screening criteria (absence of severe visual and cognitive impairments; presence of physical impairments associated with driving performance), will undergo a detailed assessment of physical ability and driving performance and be randomized to intervention or control groups. The intervention group will be trained in a graduate physical conditioning program targeted to physical impairments and performed daily at home for 6 months. Adherence will be monitored by a daily check-off sheet that will be reviewed monthly. The control group will receive a series of educational modules in their homes directed at vehicle, home, and environmental safety. Driving performance and physical ability will be reassessed at 6 months by therapists not involved in the intervention and blinded to treatment group. Quaterly phone contacts will be made for two years to ascertain changes in driving patterns, crashes, and moving violatins. This study is an essential step in the process of determining whether driving safety can be enhanced by improving function. The long-term objective is to integrate the findings of this study with interventions directed at visual and cognitive abilities in a multifactorial intervention program in an effort to enhance driving safety and the independence and mobility of older persons.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Comprehensive Center (P60)
Project #
5P60AG010469-08
Application #
6200991
Study Section
Project Start
1999-08-01
Project End
2000-07-31
Budget Start
1997-10-01
Budget End
1998-09-30
Support Year
8
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Yale University
Department
Type
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Kumashiro, Naoki; Yoshimura, Toru; Cantley, Jennifer L et al. (2013) Role of patatin-like phospholipase domain-containing 3 on lipid-induced hepatic steatosis and insulin resistance in rats. Hepatology 57:1763-72
Tinetti, Mary E; Baker, Dorothy I; King, Mary et al. (2008) Effect of dissemination of evidence in reducing injuries from falls. N Engl J Med 359:252-61
Fortinsky, Richard H; Baker, Dorothy; Gottschalk, Margaret et al. (2008) Extent of implementation of evidence-based fall prevention practices for older patients in home health care. J Am Geriatr Soc 56:737-43
Marottoli, Richard A; Allore, Heather; Araujo, Katy L B et al. (2007) A randomized trial of a physical conditioning program to enhance the driving performance of older persons. J Gen Intern Med 22:590-7
Baker, Dorothy I; Gottschalk, Margaret; Bianco, Luann M (2007) Step by step: integrating evidence-based fall-risk management into senior centers. Gerontologist 47:548-54
Chou, William C; Tinetti, Mary E; King, Mary B et al. (2006) Perceptions of physicians on the barriers and facilitators to integrating fall risk evaluation and management into practice. J Gen Intern Med 21:117-22
Belcher, Vernee N; Fried, Terri R; Agostini, Joseph V et al. (2006) Views of older adults on patient participation in medication-related decision making. J Gen Intern Med 21:298-303
Levy, Becca R; Slade, Martin D; May, Jeanine et al. (2006) Physical recovery after acute myocardial infarction: positive age self-stereotypes as a resource. Int J Aging Hum Dev 62:285-301
Baker, Dorothy I; King, Mary B; Fortinsky, Richard H et al. (2005) Dissemination of an evidence-based multicomponent fall risk-assessment and -management strategy throughout a geographic area. J Am Geriatr Soc 53:675-80
Brown, Cynthia J; Gottschalk, Margaret; Van Ness, Peter H et al. (2005) Changes in physical therapy providers' use of fall prevention strategies following a multicomponent behavioral change intervention. Phys Ther 85:394-403

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