{"id":13404,"date":"2017-12-13T10:09:30","date_gmt":"2017-12-13T17:09:30","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=13404"},"modified":"2024-08-05T13:16:09","modified_gmt":"2024-08-05T19:16:09","slug":"understanding-how-physical-and-behavioral-health-medications-and-many-other-factors-influence-seniors-ability-to-drive-safely","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/understanding-how-physical-and-behavioral-health-medications-and-many-other-factors-influence-seniors-ability-to-drive-safely\/","title":{"rendered":"Study steers toward goal of keeping seniors in the driver\u2019s seat"},"content":{"rendered":"
<\/div>
\"Ruby
Ruby Vianzon, a professional research assistant with the CU School of Medicine\u0092s Emergency Department leads Gayle Craun through a contrast-sensitivity eye test in the Clinical and Translational Research Center in UCHealth University Colorado Hospital\u0092s Leprino Building.<\/figcaption><\/figure>\n

Pig, horse, sheep, lynx, tiger, lion, bear, sheep, snake, buffalo, cow, elephant, giraffe, hippopotamus, rhino, gazelle, and 11 other critters large and small.<\/p>\n

That\u2019s what Gayle Craun came up with during a morning in which she named animals, placed and removed pegs, stood on one foot, craned her neck, assessed weird shapes, sat and stood and sat and stood, all in the name of science.<\/p>\n

Craun, 70, had 60 seconds to evoke as many animals as she could. Whether the 27 she came up with in that short span was good or bad is, broadly speaking, irrelevant (though it seemed pretty darn good). She was, in a sense, playing against herself \u2013 herself of two years ago, when she joined the $12 million, five-plus year LongROAD study<\/a> not long after it launched in August 2015. The Anschutz Medical Campus is one of five study sites, and is now tracking 601 of the 3,000 seniors participating across the country.<\/p>\n

LongROAD stands for Longitudinal Research on Aging Drivers, and its goal is to understand how physical and behavioral health, medications and many other factors influence seniors\u2019 ability to drive safely. The AAA Foundation for Traffic Safety is paying for it. The study\u2019s not about taking keys away from grandmas and grandpas \u2013 quite the opposite, says Dr. Marian (Emmy) Betz, MD, MPH<\/a>, a UCHealth University of Colorado Hospital Emergency Department physician and co-lead of University of Colorado\u2019s LongROAD study site.<\/p>\n

Tough recovery<\/strong><\/h2>\n

With more and more baby boomers hitting retirement (the oldest of them reached age 65 in 2011), the numbers of senior drivers is rising. A better understanding of the connections between aging and driving could lead to a sharper understanding of what can affect driving and, in turn, ways to keep seniors safely on the road. In this car-centric culture of ours, that means staying independent longer. Betz said her interest in understanding how aging and the physical, sensory and cognitive decline that accompanies it affects driving was itself driven by her experiences as an emergency room doctor.<\/p>\n

\u201cWe don\u2019t want people to think older drivers are unsafe, because on the whole they\u2019re actually safer than young drivers. But when they get in crashes, they don\u2019t do very well,\u201d Betz said.<\/p>\n

\"Gayle
The LongROAD study\u0092s onsite testing, done every other year, ranges from the medical to the cognitive to the physical. Here, Craun does a balance test as Vianzon looks on.<\/figcaption><\/figure>\n

Car accidents deliver more young people than old to the UCHealth University of Colorado Hospital Emergency Department, she added. But the older patients get hurt worse and recover more slowly \u2013 if they recover.<\/p>\n

Dr. \u00a0Carolyn DiGuiseppi, MD, MPH, PhD<\/a>, a professor in the Colorado School of Public Health and the co-lead for the CU LongROAD site, summed it up this way: \u201cOur ultimate goal is to help older adults stay safe and independent in the community. We hope what we learn will contribute to that.\u201d<\/p>\n

She, Betz and colleagues are collecting much more information than they could capture, distill, and publish in peer-reviewed journals in a single career. The idea, Betz said, is to gather a lot of data on a lot of people. Then researchers in the near and distant future can tap into the data to answer questions they don\u2019t know how to ask just yet. Ideally, Betz said, LongROAD will become a sort of Framingham Heart Study<\/a> on wheels.<\/p>\n

Early returns<\/strong><\/h2>\n

That\u2019s not to say that Betz, DiGuiseppi and colleagues don\u2019t have questions and aren\u2019t already looking for answers. Betz is working on a study connecting the medical conditions to driving habits. She found that about 11 percent of drivers had reduced their driving in the past year, and that nearly one in three of those who cut back on driving cited musculoskeletal problems such as neck, back or joint pain; arthritis; neuropathy; or broken bones as the reasons why. Even that may be understated, she said, given that the study\u2019s cutoff age is 79.<\/p>\n

\u201cIf you were to look at the general older-adult population, it\u2019s probably higher,\u201d she said.<\/p>\n

DiGuiseppi\u2019s first LongROAD study involves looking at marijuana and how using it affects driving habits.<\/p>\n

\u201cWe\u2019ve had very, very few participants report that they have used marijuana and driven soon after,\u201d DiGuiseppi said. \u201cBut quite a few do use marijuana, so we\u2019re looking for differences in driving among people who use marijuana and those who don\u2019t.\u201d<\/p>\n

Keep on truckin\u2019<\/strong><\/h2>\n

Age-associated decline and\/or disability needn\u2019t force someone to hang up their keys. UCHealth occupational therapist Karen Hookstadt, OT, said physical and occupational therapy as well as even modifications to vehicles can help extend the freedoms of the road. Vehicle adaptions may include bracket adaptations to ease transferring in\/out of the vehicle, panoramic rear view mirrors, left foot accelerators, hand controls, adaptions to accessory controls such as adjusting the placement of turn signals, steering wheel adaptations to enable one-handed driving, and prescription prisms to increase the field of vision, she said.<\/p>\n

\"Eleanor
Eleanor Mills, an Emergency department professional research assistant, checks out Craun\u0092s wheels. She looks for everything from driver-assist technologies to tire pressure.<\/figcaption><\/figure>\n

\u201cWe\u2019re not trying to take away their driver\u2019s license \u2013 we\u2019re trying to do the opposite. What\u2019s needed to keep this person safe behind the wheel and maintain independence and the activities of daily living?\u201d asked Hookstadt. She is proposing a formal UCHealth program with specialized hardware to assess senior drivers, patients with neurological diseases such as Parkinson\u2019s, multiple sclerosis, stroke, brain injury, stroke and tumor resections, among others.<\/p>\n

Craun, who needs no such help, has made scientific contributions well beyond animal-naming. She spent a solid two hours doing a physical exam and answering raft of questions about her use of medications, drugs and alcohol, and her driving habits. Does she get angry with other drivers? Use her horn? Pass on the right? Does she use the phone or eat while driving? Does she avoid driving at night or in bad weather? Are friends or family available to help with driving? How would she handle being told she couldn\u2019t drive anymore? Does she use Uber or Lyft?<\/p>\n

Craun, who used to teach defensive driving for the National Safety Council, had good answers.<\/p>\n

\u201cThere\u2019s the old saying: what does it mean when somebody\u2019s left turn signal is blinking?\u201d Craun asked. \u201cThe answer is their left turn signal is blinking. You don\u2019t know what they\u2019re going to do.\u201d<\/p>\n

In the garage<\/strong><\/h2>\n

Then came the physical tests \u2013 balance, grip strength (using a silvery item that looks like a spaceman\u2019s pistol but is in fact something called a hydraulic hand dynamometer), reaction time (on a computer) \u2013 and cognitive ones, including a tricky memory test that had her repeat a series of random nouns (woman, rock, blood, corner, shoes, letter, girl\u2026) right after Professional Research Assistant Ruby Vianzon said them. Then again a few minutes and a couple of totally unrelated tasks later, to Craun\u2019s surprise, Vianzon asked her to recall them again.<\/p>\n

Meanwhile, in the Leprino garage, Eleanor Mills, a professional research assistant with the Emergency Department, was checking out Craun\u2019s wheels, a 2005 Jeep Liberty.<\/p>\n

Mills noted the mileage and the state of the headlights, turn signals and tail and brake lights (one of those was out, she would tell Craun), tire pressure and other things. She looked for scratches and dents, noting here only \u201cinsanely minor scratches on the driver\u2019s side and front bumper.\u201d She recorded no driver-assist advanced technologies such as lane-departure warnings. She checked to see that the onboard-diagnostic plugin Craun\u2019s car has carried during the study was working. In addition to GPS tracking \u2013 which adds objective data to the participants\u2019 survey answers \u2013 it provides an array of vehicle diagnostics.<\/p>\n

\"Gayle
Cognitive tests include reaction time, memory, and object recognition, among others. Here, Craun does a nasty twist on connect-the-dots as Vianzon times her. The results of the tests will be compared to baseline testing doing the same things, which Craun did two years ago when she joined the LongROAD study.<\/figcaption><\/figure>\n

\u201cI know cars way too well,\u201d Mills quipped.<\/p>\n

DiGuiseppi said the data aren\u2019t used to track movements in real-time, but rather aggregated over time and used to understand not only speeds driven and things like sudden stops, but also what she called \u201cdriving space,\u201d or the area in which a person typically drives. \u201cDoes it contract as you age? Do you avoid driving longer distances?\u201d she asked.<\/p>\n

The study already provided a serious short-term benefit for one participant.<\/p>\n

\u201cHe had his car stolen. His wife called us and asked if we could find out where it was,\u201d Betz said. \u201cWe were able to get the GPS coordinates, the police used them to find his car, and he got his car back.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Pig, horse, sheep, lynx, tiger, lion, bear, sheep, snake, buffalo, cow, elephant, giraffe, hippopotamus, rhino, gazelle, and 11 other critters large and small. That\u2019s what Gayle Craun came up with during a morning in which she named animals, placed and removed pegs, stood on one foot, craned her neck, assessed weird shapes, sat and stood […]<\/p>\n","protected":false},"author":23,"featured_media":13416,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6],"tags":[708,4781,9171],"class_list":["post-13404","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","tag-adults-65-plus","tag-research-in-health-care","tag-senior-care"],"acf":[],"yoast_head":"\nStudy steers toward goal of keeping seniors in the driver\u2019s seat - UCHealth Today<\/title>\n<meta name=\"description\" content=\"The question is often asked: When should seniors stop driving. 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