Maintaining Safe Mobility in an Aging Society

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ISBN: 9781420064537 | 1420064533
Cover: Hardcover
Copyright: 12/22/2008

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As the baby-boomer generation ages, so too does the amount of senior drivers, leading to complex concerns regarding traffic safety and mobility for older adults. This groundbreaking work serves as a complete resource for those providing services to seniors as well as those responsible for transportation policy. It takes a hard look at the skills related to safe driving and how they can be compromised by aging, and provides a comprehensive description of assessment practices, issues, and tools. It includes information to help older adults transition from full driving to driving cessation, and explores various means by which aging individuals can maintain safe mobility.

Series Foreword	p. xiii
Preface	p. xv
Acknowledgments	p. xvii
Authors	p. xix
Introduction	p. 1
Population Trends	p. 1
Driving Trends	p. 2
Dependence on the Personal Automobile	p. 2
Driver's License Holding	p. 2
Changes in Annual Driving Distances	p. 3
Behavioral Adaptations	p. 3
Traffic Safety	p. 5
Crash Risk	p. 5
Crash Types	p. 7
Mobility Needs	p. 8
Age-Related Declines in Abilities	p. 11
Introduction	p. 11
Psychomotor Abilities	p. 11
Reaction Time	p. 12
Flexibility	p. 12
Coordination	p. 13
Strength	p. 13
Visual Abilities	p. 14
Anatomic Changes	p. 14
Eye Movements	p. 15
Visual Acuity	p. 16
Contrast Sensitivity	p. 17
Sensitivity to Light	p. 17
Dark Adaptation	p. 17
Visual Field	p. 18
Space Perception	p. 18
Motion Perception	p. 19
Three-Dimensional Structure from Motion	p. 20
Cognitive Abilities	p. 20
Attention	p. 20
Memory	p. 21
Problem Solving	p. 23
Spatial Cognition	p. 23
Conclusions	p. 24
Critical Driving Skills	p. 25
Introduction	p. 25
Driving Task Analysis	p. 25
A Hierarchical Model of Driver Skills and Control	p. 26
Strategic Level	p. 27
Tactical Level	p. 27
Operational Level	p. 27
Critical Driving Skills Most Salient for Older Drivers	p. 28
Adding Driver Motives into Michon's Model	p. 29
Conclusions	p. 33
Medical Conditions and Driving	p. 35
Introduction	p. 35
Visual Perception	p. 36
Cataracts	p. 36
Color Vision Deficits	p. 36
Diabetic Retinopathy	p. 37
Glaucoma	p. 37
Monocular Vision	p. 38
Age-Related Macular Degeneration (ARMD)	p. 39
Auditory Perception	p. 40
Cardiovascular	p. 40
Coronary Heart Disease	p. 40
Arrhythmia	p. 41
Congestive Heart Failure	p. 41
Abnormal Blood Pressure	p. 41
Cerebrovascular	p. 42
Transient Ischemic Attack	p. 42
Stroke	p. 42
Neurological	p. 43
Syncope	p. 43
Epilepsy/Seizures	p. 43
Sleep Apnea	p. 44
Multiple Sclerosis	p. 44
Parkinson's Disease	p. 45
Dementia	p. 46
Metabolic	p. 47
Diabetes Mellitus	p. 48
Thyroid (Hypothyroidism)	p. 49
Respiratory	p. 49
Asthma	p. 49
Chronic Obstructive Pulmonary Disease	p. 49
Musculoskeletal	p. 50
Arthritis	p. 50
Psychiatric	p. 51
Depression	p. 51
Conclusions	p. 51
Medications and Driving	p. 53
Introduction	p. 53
Prevalence of Drug Use Among Older Adults	p. 55
Prescription Medications	p. 55
Inappropriate Prescription Medication Use	p. 55
Nonprescription Medications	p. 57
Medications and Driving Safety	p. 58
Benzodiazepines	p. 58
Antihistamines	p. 60
Opioid Analgesics	p. 61
Antidiabetic Medications	p. 62
Conclusions	p. 62
Screening	p. 65
Introduction	p. 65
Self-Screening	p. 67
Family Screening	p. 68
Screening by Physicians	p. 68
The Physician's Guide to Assessing and Counseling Older Drivers	p. 69
Determining Medical Fitness to Operate Motor Vehicles: CMA Driver's Guide	p. 70
Driving and Dementia Toolkit/Safe Drive	p. 70
CanDrive	p. 71
Screening by Other Health Professionals	p. 72
Screening at Licensing Agencies	p. 72
Model Driver Screening and Evaluation Program	p. 72
California Three-Tiered System	p. 73
Conclusions	p. 74
Assessment	p. 75
Introduction	p. 75
Clinical Assessment	p. 75
The Interview	p. 76
Assessing Functional Abilities	p. 77
On-Road Assessment	p. 78
Route Selection	p. 78
Assessment of Critical Driving Skills	p. 79
Postevaluation Recommendations	p. 80
Driver Assessment Team	p. 81
Conclusions	p. 81
Licensing, Legal, and Policy Issues	p. 83
Introduction	p. 83
Driver's License Renewal	p. 84
Physician Reporting of At-Risk Drivers	p. 89
Approaches to Strengthening Licensing Policy	p. 90
Licensing Agencies as Part of a Systems Approach to Safe Mobility	p. 92
Conclusions	p. 92
Education and Rehabilitation	p. 95
Introduction	p. 95
Education	p. 95
For the Driver	p. 96
Driver Self-Awareness Tools	p. 99
For the Family and Friends	p. 101
For the Health Professional	p. 102
Rehabilitation	p. 103
Fitness	p. 103
Cognitive	p. 103
Conclusions	p. 104
Vehicles and Advanced Technology	p. 107
Introduction	p. 107
Automobile Design	p. 107
Currently Available Features	p. 110
Vehicle Adaptations	p. 110
Advanced Technology	p. 111
Route Guidance	p. 113
Night Vision Enhancement	p. 114
Crash Warning Systems	p. 115
Forward Collision Warning	p. 115
Adaptive Cruise Control	p. 115
Lane Departure Warning	p. 116
Automatic Crash Notification	p. 117
Conclusions	p. 117
Roadway Design	p. 119
Introduction	p. 119
Traffic Control Devices	p. 120
Signage	p. 121
Pavement Markings	p. 123
Signals	p. 125
Intersections	p. 125
Roundabouts	p. 127
Pedestrians	p. 129
Roadway Work Zones	p. 130
Promising Approaches	p. 131
Conclusions	p. 133
Driving Retirement	p. 135
Introduction	p. 135
Reasons for Driving Cessation	p. 136
The Process of Driving Cessation	p. 138
Self-Regulation by Older Drivers	p. 139
Smoothing the Process of Driving Retirement	p. 141
Conclusions	p. 143
Other Community Mobility Options	p. 145
Introduction	p. 145
Existing Community Mobility Options	p. 146
Traditional Public Transit	p. 146
Paratransit	p. 147
Private Transit	p. 148
Supplemental Transportation Programs	p. 149
Walking and Bicycling and Other Forms of Transportation	p. 150
Creating More Senior-Friendly Community Mobility Options	p. 150
Transportation Coordination	p. 151
Conclusions	p. 153
Appendix Driver Evaluation Tools	p. 155
Introduction	p. 155
Perceptual Evaluation Tools	p. 155
Dynamic Visual Acuity	p. 155
Structure from Motion	p. 155
Moving "E" Test	p. 156
Static Visual Acuity	p. 156
Contrast Sensitivity	p. 156
Visual Field	p. 156
Color Vision/Discrimination	p. 157
Stereoacuity	p. 157
Visual Attention	p. 157
Useful Field of View	p. 157
Number Cancellation Task	p. 158
Hearing	p. 158
Cognitive Evaluation Tools	p. 158
Visuospatial Abilities	p. 158
Hooper Visual Organization Test	p. 158
Embedded Figures Test	p. 159
Rey-Osterreith Complex Figures Test	p. 159
Block Design Test	p. 159
Letter Cancellation Test	p. 160
Benton Judgment of Line Orientation	p. 160
Wisconsin Card Sorting Test	p. 160
Maze Navigation Test	p. 160
Visual Form Discrimination Test	p. 161
Motor Free Visual Perception Test	p. 161
Executive Function	p. 161
Clock Drawing Test	p. 161
Controlled Oral Word Association Test	p. 162
Trail Making Test (Parts A and B)	p. 162
Benton Visual Retention Test	p. 162
The Stroop Neuropsychological Screening Test	p. 163
Divided Attention	p. 163
Simultaneous Capacity Test	p. 163
Selective Attention	p. 163
Zimmermann/Fimm's Incompatibility Test	p. 163
Dot Counting Task	p. 164
Sustained Attention	p. 164
Adaptation of Mackworth Clock Test	p. 164
Working Memory	p. 164
Wechsler Memory Scale-Visual Reproduction	p. 164
Wechsler Adult Intelligence Scale-Digit Symbol	p. 165
Wechsler Adult Intelligence Scale-Digit Span	p. 165
Short Blessed Test	p. 165
Word Recall Memory Test	p. 165
Mini-Mental Status Examination	p. 166
Clinical Dementia Rating	p. 166
Mattis Organic Mental Syndrome Screening Examination	p. 166
Traffic Sign Recognition Test	p. 167
Psychomotor Evaluation Tools	p. 167
Movement Speed	p. 167
Grooved Pegboard Test	p. 167
Symbol Digit Modalities Test	p. 167
Range of Motion	p. 168
Foot Tap Test	p. 168
Neck Flexibility	p. 168
Rapid Pace Walk	p. 168
Arm Reach Test	p. 168
Reaction Time	p. 169
Simple Reaction Time Test	p. 169
Doron Cue Recognition	p. 169
Upper/Lower Body Muscle Strength	p. 169
Manual Muscle Test	p. 169
Dynamometer Grip Strength	p. 169
References	p. 171
Index	p. 217
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Maintaining Safe Mobility in an Aging Society

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