A Qualitative Exploration of Self-Regulation Behaviors Among Older Drivers

While much of the research on aging and driving has focused on sensory and motor changes, little is known about older drivers and the actual self-regulation adjustments they employ to continue driving safely. This research looks at how older drivers have made changes to driving patterns and behaviors that have allowed them to continue to drive without compromising their perceived safety, independence, and quality of life. Nine focus groups were held with older men and women aged 58 to 89 years. Some of the major themes that emerged were the following: older adults are very aware of age-related changes to driving; they perceive that self-regulation behaviors change with age; and they view transportation alternatives as limited or nonexistent. Policy implications include developing functional transit programs for older adults and car manufacturer training workshops to educate older adults on the safety features of newly purchased automobiles.     

Older adults' perspectives on driving cessation

Relinquishing the privilege to drive is a difficult issue for older adults. To better understand factors that influence driving decisions and to identify approaches that could help ease the transition to a non-driving status, we conducted focus groups with elders who had recently stopped driving. Results demonstrate that the decision to stop driving is reluctantly made by elders on their own or after prompting from others. While all have other means of transportation, a sense of loss of independence remains. Participants urged policy makers to address older driver issues and were proponents of developing procedures to identify at-risk drivers. They also stressed the importance of making plans for retirement from driving. Findings suggest that while there is “life after driving,” efforts are needed to help older drivers, and their families develop a plan for driving cessation that includes identifying the appropriate time to stop and acceptable transportation alternatives to driving.     

Older Drivers Retiring From the Road: An Application of the Selection,Optimization, and Compensation Model

Purpose: This study uses the selection, optimization, and compensation (SOC) model to compare older adults who have given up driving, those who still drive, and those who drive less to identify differences in the three groups. Design and Methods: This cross-sectional study of 281 older adults is part of the Naturally Occurring Retirement Community Demonstration Project. Study participants completed interviews that included questions on demographics, health and functioning, mental health, social support, and current levels of engagement in activities including current driving status. Results: Data suggest that driving retirement is a process and that a substantial number of people are in the transitional stage, where they are less functional than those who still drive and more similar to those who have retired from the road. Implications: Given the similarity of those who drive less to those who have given up driving, front-line professionals and policy makers must work together to ease the transition to driving retirement for those without adequate ability to effectively compensate for their inability to continue to drive safely.     

Best practices for physical activity programs and behavior counseling in older adult populations

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The purpose of this paper is to identify key practices for promoting physical activity in older adults, with a focus on older adults with chronic disease or low fitness and those with low levels of physical activity. Key practices identified in promotion activity in older adults include: (1) a multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (2) principles of behavior change, including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement, enhance adherence; (3) management of risk by beginning at low intensity but gradually increasing to moderate physical activity which has a better risk/benefit ratio should be the goal for older adults; (4) an emergency procedure plan is prudent for community-based programs; and (5) monitoring aerobic intensity is important for progression and for motivation. Selected content reviews of physical activity programming from major organizations and institutions are provided. Regular participation in physical activity is one of the most effective ways for older adults, including those with disabilities, to help prevent chronic disease, promote independence, and increase quality of life in old age.Publication Note All National Blueprint Publications are in the public domain and can be freely reproduced without copyright. This article has been previously published in Medicine Science and Sports and Exercise and the Journal of Aging and Physical Activity. Individuals or organizations who wish to publish National Blueprint articles should contact the National Blueprint Office for permission.     

A literature review of major perceptual, cognitive, and/or physical test batteries for older drivers

Driving is one of the most complex tasks that humans perform on a regular basis, placing significant demands on human perceptual, cognitive, and motor capabilities, so age-related declines in these capabilities negatively affect driving performance. Although older adults create a risk on the road because of their high crash rates, it is important to note that not all older drivers have impaired driving performance or high crash risk. Thus researchers have developed test batteries to identify at-risk older drivers. The literature pertaining to the development and testing of at-risk driver assessment tools, including major assessment tools and evidence supporting their use is reviewed.     

Naturalistic observation of drivers' interactions while overtaking on an undivided road

Current models of driving behavior and designs of driver support systems are not taking adequately into account the interactions between drivers. Although a driver's intended maneuver may not be physically possible at a specific time point, it may still be safely executed if the driver's intention is successfully communicated to and interpreted by another driver, who alters the own future trajectory so as to enable the maneuver execution. This paper presents some empirical findings relevant to communicative and cooperative interactions between drivers along naturalistic overtaking maneuvers on an undivided road. The cues used by drivers to interpret other drivers' intention and the drivers' interactions were extracted through video observations of the maneuvers together with the frequency of such interactions per level of traffic risk. The findings show that drivers use formal and informal cues to anticipate other drivers' intention. A significant percentage of maneuvers were performed after facilitation by other drivers. Future studies should focus on this phenomenon while future models of driving behavior should incorporate communicative and cooperative interactions among drivers, so as to design adequate cooperative support systems to enhance road safety.     

Does yoga engender fitness in older adults? A critical review

Interest in yoga is growing, especially among older adults. This review critically summarizes the current literature to investigate whether physical fitness and function benefits are engendered through the practice of yoga in older adults. A comprehensive search yielded 507 studies; 10 studies with 544 participants (69.6 ± 6.3 yr, 71% female) were included. Large variability in yoga styles and measurement outcomes make it challenging to interpret results across studies. Studies reported moderate improvements for gait (ES = 0.54, 0.80), balance (ES = 0.25-1.61), upper/lower body flexibility (ES = 0.25, 0.70), lower body strength (ES = 0.51), and weight loss (ES = 0.73, 0.99).Yoga may engender improvements in some components of fitness in older adults. However, more evidence is needed to determine its effectiveness as an alternative exercise to promote fitness in older adults. Further investigation into yoga as an exercise activity for older adults is warranted.     

Best practices for physical activity programs and behavior counseling in older adult populations

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The article identifies key practices for promoting physical activity in older adults, with a focus on those with chronic disease or low fitness and those with low levels of physical activity. Key practices identified: (a) A multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (b) principles of behavior change including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement enhance adherence; (c) manage risk by beginning at low intensity but gradually increasing to moderate physical activity, which has a better risk:benefit ratio and should be the goal for older adults; (d) an emergency procedure plan is prudent for community-based programs; and (e) monitoring aerobic intensity is important for progression and motivation. Selected content review of physical activity programming from major organizations and institutions is provided.     

Exercise can improve speed of behavior in older drivers

The main aim of this research was to study the effects of a specific exercise program on the speed of behavior of older adults during on-the-road driving. Twenty-six drivers (55-78 yr old) were randomly assigned to either an exercise group or a control group. The exercise program (3 sessions of 60 min/wk for 8 wk) incorporated tasks that induced the participants to respond quickly to challenging situations. On-the-road driving tasks (under single- and dual-task conditions) included measures of simple and choice reaction time, movement time, and response time. Significant positive effects were found at follow-up resulting from participation in the exercise program: Improvements were found for several measures in all driving tasks, and a composite score reflected a better general drivers' speed of behavior. These results show that exercise can enhance speed of behavior in older drivers and should therefore be promoted.     

Mandatory Testing of Drivers on the Basis of Age and Degenerative Diseases: Stakeholder Opinions

Concerns about the driving competence of older drivers have led to policy discussions about mandatory aged-based and disorder-based assessments. This study explored the attitudes, beliefs, and preferences of older adults, law enforcement officers, and licensing authorities toward reexamination of driving skills for persons with Alzheimer's disease (AD) and Parkinson's disease (PD) and at varying ages. With few exceptions, participants across all groups supported retesting drivers with AD. Moderate support was given for further evaluation of 90-year-olds and those with PD. Least endorsement was given for reassessment of 70-year-old drivers. Findings have implications for legislative changes to address drivers with AD and PD and at older ages.     

DriveID: safety innovation through individuation

The driving task is highly complex and places considerable perceptual, physical and cognitive demands on the driver. As driving is fundamentally an information processing activity, distracted or impaired drivers have diminished safety margins compared with non- distracted drivers (Hancock and Parasuraman, 1992; TRB 1998 a & b). This competition for sensory and decision making capacities can lead to failures that cost lives. Some groups, teens and elderly drivers for example, have patterns of systematically poor perceptual, physical and cognitive performance while driving. Although there are technologies developed to aid these different drivers, these systems are often misused and underutilized. The DriveID project aims to design and develop a passive, automated face identification system capable of robustly identifying the driver of the vehicle, retrieve a stored profile, and intelligently prescribing specific accident prevention systems and driving environment customizations.     

How shall we design the future vehicle for Chinese market

Surface transportation system is developing very fast in China and the number of vehicles is increasing quickly as well. This development creates a lot of problems on traffic safety and the number of accident is also increasing. In this paper, we made deep analysis of different possible causes of safety problems through three aspects: the traffic environment and infrastructure, in-vehicle information system design and the characteristics of drivers. There are many factors in each aspects may contribute to the transportation safety problems. Problems with infrastructure design and traffic design contribute over 50% of the traffic accident. Another important factor is that people has very little traffic safety concept and very weak on understanding the important of right behavior on the road. This paper has pointed the urgent needs to study the human factors in road and transportation system and vehicle HMI design, as there are very few such studies available in literature based on Chinese situation. The paper also proposed the needs to develop proactive educational system that can promote driver's understanding of traffic safety and to take the right action during drive.     

The Social and Policy Predictors of Driving Mobility Among Older Adults

This research was designed to identify the impact of state driver's license renewal requirements on the driving mobility (i.e., the reduction or cessation of driving) of older (70 years or older) drivers in the United States. Nationally representative data from four waves (1993–2000) of the Asset and Health Dynamics of the Oldest Old study were linked to state policies on relicensing and used in a longitudinal logistic regression analysis. The author assessed the driving behaviors of a sample of 9,638 men and women. The findings demonstrate that the driving mobility of older people is influenced by state relicensing policies. The analysis indicates that five policies—accelerated renewal, mental testing, peripheral vision testing, renewal in person at age 70+ (as opposed to renewal by mail or online), and restricted licensing—have a significant effect on an older driver's decision to reduce or cease driving. The driving patterns of older adults are influenced not only by their health and socioeconomic backgrounds, but also by state relicensing policies. In terms of public policy, this result shows that there is a mechanism for extending the years of independent mobility for older people: restricted licensing.     

Assessing driver's mental representation of Adaptive Cruise Control (ACC) and its possible effects on behavioural adaptations

The introduction of Adaptive Cruise Control (ACC) could be very helpful for making the longitudinal driving task more comfortable for the drivers and, as a consequence, it could have a global beneficial effect on road safety. However, before or during the usage of the device, due to several reasons, drivers might generate in their mind incomplete or flawed mental representations about the fundamental operation principles of ACC; hence, the resulting usage of the device might be improper, negatively affecting the human-machine interaction and cooperation and, in some cases, leading to negative behavioural adaptations to the system that might neutralise the desirable positive effects on road safety. Within this context, this paper will introduce the methodology which has been developed in order to analyse in detail the topic and foresee, in the future, adequate actions for the recovery of inaccurate mental representations of the system.     

Relationships Among Active Engagement in Life Activities and Quality of Life for Assisted-Living Residents

This cross-sectional research explored the relationships between active engagement in life activities (leisure, social, and instrumental activities of daily living) and quality of life for seniors aged 65 and older residing in assisted living facilities. It is increasingly recognized that active participation in diverse physical, cognitive, and social activities can promote older adults’ quality of life, including physical and mental health, but there is limited information about this in the population of residents in assisted living facilities. It is estimated that there are one million older adults residing in assisted living facilities, making assisted living facilities a rapidly growing segment of senior housing. Older adults who relocate to assisted living facilities commonly experience lifestyle changes, often related to their altered physical and social environment, reduced demands regarding household chores and meal preparation, and new opportunities for recreation and socialization. In this study, interviews were conducted with 131 ambulatory residents from assisted living facilities in the New York City metropolitan area using the 55-Item Activity Checklist, SF-36v2, Life Satisfaction Index-Z, and demographic questions. Results found significant low to moderate correlations between retained engagement in life activities (leisure, social, and instrumental activities of daily living) and life satisfaction, and several quality of life domains, including physical functioning, mental health, general health, and vitality. Older adults continued to engage in a greater percentage of everyday life activities they identified as important. This data supports exploration of client-centered activity programs to promote participation of residents in assisted living facilities in diverse activities to both maintain resident functional abilities and manage functional decline.     

The social and policy predictors of driving mobility among older adults

This research was designed to identify the impact of state driver's license renewal requirements on the driving mobility (i.e., the reduction or cessation of driving) of older (70 years or older) drivers in the United States. Nationally representative data from four waves (1993-2000) of the Asset and Health Dynamics of the Oldest Old study were linked to state policies on relicensing and used in a longitudinal logistic regression analysis. The author assessed the driving behaviors of a sample of 9,638 men and women. The findings demonstrate that the driving mobility of older people is influenced by state relicensing policies. The analysis indicates that five policies--accelerated renewal, mental testing, peripheral vision testing, renewal in person at age 70+ (as opposed to renewal by mail or online), and restricted licensing--have a significant effect on an older driver's decision to reduce or cease driving. The driving patterns of older adults are influenced not only by their health and socioeconomic backgrounds, but also by state relicensing policies. In terms of public policy, this result shows that there is a mechanism for extending the years of independent mobility for older people: restricted licensing.     

Willingness to Use Formal Long-Term Care Services by Korean Elders and Their Primary Caregivers

This study examined predictors of older adults' and primary caregivers' willingness to use formal long-term care (LTC) services to understand possible use patterns of mandatory public LTC insurance programs in Korea. It focused on views regarding who (adult children or the government) should bear the responsibility for older adults' care. Logistic regression models were estimated using data from 1,168 older Korean adults aged 65 or older and their primary caregivers from a national survey. The results showed that older adults' and their caregivers' views on care responsibility were a dominant predictor of their willingness to use both formal home care services and nursing home care services. Both older adults and their family caregivers' willingness to use LTC services should be considered when predicting demand for LTC services. Efforts should promote the perspective that formal LTC services are an acceptable social norm.     

The relevance of situation awareness in older adults’ cognitive functioning: a review

Age-related declines in cognition may have detrimental effects on older adults’ ability to complete everyday activities that young- and middle-aged individuals perform automatically. Theories of cognitive aging have found deficits in older adults’ fluid intelligence, capacity for inhibition, number of processing resources, and speed of processing, and in recent years, studies have proposed cognitive strategies to ameliorate these declines. However, few strategies directly train the cognitive strategies necessary to improve performance in dynamic environments and physical activities. One such strategy may be the enhancement of situation awareness, the capability to perceive and understand one’s environment. Although the term has typically been applied to pilots and other expert performers, situation awareness may also be relevant to cognitive aging, where older adults’ perception and comprehension of their environment become critical to everyday functioning and physical activities. If older adults’ situation awareness can be facilitated, then it may be possible to reduce the impact of age-related cognitive declines, allowing older adults to successfully participate in dynamic situations and sports where the environment is constantly changing (e.g., driving and tennis). The following review outlines cognitive deficits in aging, details their relation to situation awareness, and discusses how training in situation awareness may reduce cognitive declines. Portions of this paper were reported at the annual meeting of the North American Society for the Psychology of Sport and Physical Activity in June, 2005.     

Exercises for mental wellness. Couldn't we all benefit?

For most of us, our cognitive functioning could be improved in many ways. Many of us struggle with our thinking skills at times, especially during times of stress and information overload. Some of the research that supports the use of prescribed cognitive exercises to slow cognitive decline in older adults may ultimately prove to be beneficial for all of us. Mental health nurses should encourage regular daily mental workouts, along with aerobic physical exercises, for everyone, not just older adults. Personal fitness training should focus not only on physical fitness, but also on mental fitness.     

Briefly Noted

Almost 70% of Americans think it's unlikely a driver will get caught for driving while impaired by marijuana, according to a survey released last month by the AAA Foundation for Traffic Safety. And 14.8 million drivers themselves report driving within an hour of using marijuana — and engaging in this activity within the past month. According to research, the impairing effects of marijuana occur within the first one to four hours after smoking, and marijuana users who drive while intoxicated are more than twice as likely to be involved in a crash. “Marijuana can significantly alter reaction times and impair a driver's judgment. Yet, many drivers don't consider marijuana‐impaired driving as risky as other behaviors like driving drunk or talking on the phone while driving,” said Dr. David Yang, executive director of the AAA Foundation for Traffic Safety. “It is important for everyone to understand that driving after recently using marijuana can put themselves and others at risk.” In the AAA Foundation survey, almost 14% of millennials report driving within one hour after using marijuana in the past 30 days; 10% of Generation Z reports doing this. “It's time to face the facts. Any driver who gets behind the wheel high can be arrested and prosecuted,” said Jake Nelson, AAA director of traffic safety and advocacy. “Law enforcement officials are getting more sophisticated in their methods for identifying marijuana‐impaired drivers and the consequences are not worth the risk.” AAA recommends all motorists avoid driving while impaired by marijuana or any other drug (including alcohol) to avoid arrest and keep the roads safe. Just because a drug is legal does not mean it is safe to use while operating a motor vehicle. Drivers who get behind the wheel while impaired put themselves and others at risk.