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At least 217 records · Page 12Linked to original sources
PubMed1999

The driving habits of adults aged 60 years and older.

OBJECTIVES: We describe the driving habits of adults aged 60 years and older who were interviewed in the context of a community survey focused on mental disturbances. Our goal was to identify clinical cues that might signal driving difficulty in older adults who might present to the primary care physician for health care. DESIGN: A population-based survey. SETTING: Continuing participants in a follow-up study of community-dwelling adults who were living in East Baltimore in 1981. PARTICIPANTS: Subjects were 1920 continuing participants of the Baltimore sample of the Epidemiologic Catchment Area Program; 589 were aged 60 years and older and provided information on driving habits. MEASUREMENTS: Respondents were asked about their driving status: had they made adaptations to driving and had they experienced any adverse driving events in the 2 years before the interview. Driving behaviors were assessed in relation to chronic disease, sensory impairment, functional status, and mental status. RESULTS: Former drivers were more likely to be older, female, and nonwhite. Diabetes, vision impairment, functional impairment, and making an error on the copy design task of the Mini-Mental State Examination (MMSE) were associated with no longer driving. Women were more likely to report having made adaptations to driving, as were persons with heart disease, arthritis, vision impairment, and those who made an error on the copy design task of the MMSE. Heart disease and hearing impairment were associated with report of an adverse driving event. In multivariate models that included terms for potentially influential characteristics such as age, gender, and miles driven, only the copy design task was associated with driving status, and only heart disease was associated with driving adaptation and adverse driving events. CONCLUSION: Simple tests that tap visuospatial ability, such as the copy design task of the MMSE, may warrant additional study for use in driving assessment of older adults in primary care. The results underscore the importance of making an inquiry about driving as a separate and independent component of functional assessment.

Accidents, Traffic↗
PubMed1974

Marijuana and driving in real-life situations.

It is evident that the smoking of marijuana by human subjects does have a detrimental effect on their driving skills and performance in a restricted driving area, and that this effect is even greater under normal conditions of driving on city streets. The effect of marijuana on driving is not uniform for all subjects, however, but is in fact bidirectional; whether or not a significant decline occurs in driving ability is dependent both on the subject's capacity to compensate and on the dose of marijuana. For those subjects who improved their performance, the explanation may lie in overcompensation and possibly the sedative effect of the drug. Whereas the street portion of this study approximated normal driving conditions, it should be emphasized that the context of the driving experience een on city streets was experimental. the design of this study maximal safeguards in terms of a dual control vehicle and a driver observr; in addition, the subjects were proffessionally screened and, with rare exception, they were emotionally stable. Given the experimental setting and set, the safeguards, and the nature of the study sample, idiosyncratic behaviour that might occure under normal driving condition would be less likely to occur in a study such as this. Other identified factors might lead to more stringent conclussions regarding the effects of marijuana on driving.The first is night driving, which may be more stressful. But an even more important unanswered question is the cumulative effect of alcohol and marijuana on driving (64 percent of the study sample reported alcohol in combination with marihjuana before driving). Third, the doses of marijuana used in this study were within the range of social marijuana usage(1); more heroic doses might be taken before driving. Fourth, the effect of marijuana on reactions and decision during high speed is still another unknown. What are the recommendations that emarge from this study? Driving under the influence of marijuana should be avoided as much as should driving under the influence of alcohol. More investigation is urgently required-and high priority should be given to studies that approximate normal conditions of driving and in which alcohol and marijuana are administered to the same subjects.

Adult↗
PubMed1991

Young drivers' evaluation of driving impairment due to alcohol.

Ninety-six college students, 18-20 years of age, were selected from three drinking categories (abstain-light, moderate, and heavy) based on their self-reported drinking habits. Subjects rated the relative importance of three driving components (attention, control/maneuvering, and emergency responses) for safe driving and the impairment each component and overall driving ability would sustain after driver drinking. Impairment ratings were made of the effects of drinking the number of drinks that would have resulted in the rater having blood alcohol concentrations (BACs) of .05%, .10%, and .15%. Subjects also estimated the number of drinks that they could consume in one hour and then safely drive after after different time periods, the time they should wait before driving after drinking various amounts of alcohol, and the number of beer, wine, wine cooler, and whiskey drinks that would cause them to reach a .10% BAC. While the driving components were rated to be of approximately equal importance for safe driving, the emergency responses component was judged to be more impaired following alcohol consumption than any of the other components, or overall driving ability. Heavy drinkers judged that there was significantly less driving impairment due to alcohol than did light or moderate drinkers in the case of overall driving ability and all of the driving components except emergency responses. Heavy drinkers also judged it safe to consume a number of drinks before driving that would result in higher mean BACs than those of light and moderate drinkers. Both drinking category and gender differences were found in the estimated BAC values that would have occurred at the time of driving after waiting periods judged by subjects to be sufficient for safe driving.

Adolescent↗
PubMed2002

Predictors of driving outcome after traumatic brain injury.

OBJECTIVE: To examine predictors of driving status and fitness to drive after traumatic brain injury (TBI). DESIGN: Retrospective and prospective follow-up of a cohort ranging from 4 months to 10 years post-TBI. SETTING: A Midwestern, urban university-affiliated rehabilitation hospital. PARTICIPANTS: Seventy-one pairs of adults who had sustained a TBI and their significant others. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Driving status (whether the patient resumed driving), driving frequency (estimated miles driven per week), and postinjury driving records compiled by the Department of Motor Vehicles. RESULTS: Logistic and hierarchical regression analyses indicated that the significant other's perceptions of the patient's fitness to drive were the strongest predictor of patients' driving status and driving frequency. However, years postinjury, disability at discharge, and current neuropsychologic functioning best predicted postinjury driving safety as measured by actual incidents. The relation between perception of patients' fitness and actual driving incidents, however, was modest. CONCLUSIONS: Neuropsychologic and medical information available by traditional methods showed unique value in predictive driving safety. However, caregiver perception of patients' fitness was the overwhelming determinant of whether and how much patients drive. The bases on which caregivers form their opinions affect the safety of patients and the public. The rehabilitation setting is a unique resource for family education regarding abilities essential to safe driving.

Adolescent↗
PubMed2006

The role of personality characteristics in young adult driving.

BACKGROUND: Motor vehicle injury is the major cause of mortality among young adults. Information about the individual characteristics of those who drive dangerously could enhance traffic safety programs. The goal of this research was to examine the association between various personality-related characteristics and risky driving behaviors. METHODS: Young adults in Michigan, USA (n = 5,362) were surveyed by telephone regarding several personality factors (risk-taking, hostility, aggression, tolerance of deviance, achievement expectations) and driving behaviors (competitive driving, risk-taking driving, high-risk driving, aggressive driving, and drink/driving). Michigan driver records were obtained to examine offenses, serious offenses, driving offense points, crashes and serious crashes in the three pre-interview years. Multivariate regression analyses, adjusting for age, race, and marital status were conducted separately by sex to identify personality factors related to driving. RESULTS: For men and women, greater risk-taking propensity, physical/verbal hostility, aggression, and tolerance of deviance were significant predictors of a competitive attitude toward driving, risk-taking driving, high-risk driving, driving aggression, and drink/driving. Greater risk-taking propensity, physical/verbal hostility, aggression, and to a small degree, expectations for achievement predicted higher numbers of offenses, serious offenses, and points. CONCLUSION: Traffic safety policies and programs could be enhanced through recognition of the role personality factors play in driving behavior and the incorporation of this knowledge into the design and implementation of interventions that modify the behaviors associated with them.

Accidents, Traffic↗
PubMed2003

Exploring the use of computer games and virtual reality in exposure therapy for fear of driving following a motor vehicle accident.

Specific phobia, situational type-driving, induced by accident (accident phobia) occurs in 18-38% of those involved in a vehicular accident of sufficient severity to warrant referral to the emergency departments of a general hospital. The objective is to investigate, in an open study, the effectiveness of the combined use of computer generated environments involving driving games (game reality [GR]) and a virtual reality (VR) driving environment in exposure therapy for the treatment of driving phobia following a motor vehicle accident (MVA) program. Fourteen subjects who met DSM-IV criteria for Simple Phobia/Accident Phobia and were referred from the emergency department of a general hospital were exposed to a Virtual Driving Environment (Hanyang University Driving Phobia Environment) and computer driving games (London Racer/Midtown Madness/Rally Championship). Patients who experienced "immersion" (i.e., a sense of presence with heightened anxiety) in one of the driving simulations (defined as an increase in SUD ratings of 3 and/or an increase of heart rate > 15 BPM in a 1-h trial session of computer simulation driving) were exposed to a cognitive behavioral program of up to 12 1-h sessions involving graded driving simulation tasks with self-monitoring, physiological feedback, diaphragmatic breathing and cognitive reappraisal. Subjects were assessed at the beginning and end of therapy with measurements of: physiological responsivity (heart rate), subjective ratings of distress (SUD), rating scales for severity of fear of driving (FDI), Posttraumatic Stress Disorder (CAPS) and depression (HAM-D) and achievement of target behaviors. Of all patients 7/14 (50%) became immersed in the driving environments. This immersed group (n = 7) completed the exposure program. Pre- and post-treatment comparisons showed significant post treatment reductions on all measures SUDS (p = 0.008), FDI (p = 0.008), CAPS (p = 0.008), HR (p = 0.008), CAPS (p = 0.008), HAM-D (p = 0.031). Further analysis of the FDI showed significant reductions in all three subscales: travel distress (p = 0.008), travel avoidance (p = 0.008), and maladaptive driving strategies (p = 0.016). The findings of this study suggest that VR and GR may have a useful role in the treatment of driving phobia post-accident even when co-morbid conditions such as post-traumatic stress disorder and depression are present.

Accidents, Traffic↗
PubMed1999

The effects of age and alcohol intoxication on simulated driving performance, awareness and self-restraint.

AIMS: To investigate whether, compared with middle-aged men (aged 30-50), older men (age > or =60) (i) perform more poorly on a driving simulator and (ii) are more sensitive to the effects of ethanol in terms of blood alcohol concentration (BAC) and driving performance, but more aware of their driving difficulties, and therefore exercise better driving judgement. METHODS: 14 Healthy middle-aged men (mean age 36 years) were compared with 14 healthy older men (mean age 69 years) on an interactive driving simulator, while sober and while legally intoxicated (BAC >80 mg/dl). RESULTS: Older age was associated with poorer driving performance on the simulator. While sober, older men exhibited more improper braking, slower driving, greater speed variability, fewer appropriate full stops and more crashes, and spent more time executing left turns (across oncoming traffic); all values < or =0.02. BACs > or =80 mg/dl were associated with impaired driving, with more inappropriate braking, fewer appropriate full stops and more time executing left turns (all values > or =0.02) and trends towards more speed variability, more low speed collisions and more wrong turns (values <0.1). However, similar ethanol consumption did not produce higher peak BAC or more driving impairments in older drivers. While there were no differences between age groups in terms of awareness of intoxication or driving difficulties, older men were unwilling to drive while legally intoxicated because of fear of physical injury, whereas middle-aged men were more likely to avoid driving when intoxicated due to fear of legal ramifications. CONCLUSION: While both age and legal intoxication affected driving performance, older men were no more sensitive to ethanol in terms of peak BACs, driving performance or awareness/judgement than middle-aged men.

Adult↗
PubMed1999

Older drivers and cataract: driving habits and crash risk.

BACKGROUND: Cataract is a leading cause of vision impairment in older adults, affecting almost half of those over age 75 years. Driving is a highly visual task and, as with other age groups, older adults rely on the personal automobile for travel. The purpose of this study was to examine the role of cataract in driving. METHODS: Older adults (aged 55-85 years) with cataract (n = 279) and those without cataract (n = 105) who were legally licensed to drive were recruited from eye clinics to participate in a driving habits interview to assess driving status, exposure, difficulty, and "space" (the distance of driving excursions from home base). Crash data over the prior 5 years were procured from state records. Visual functional tests documented the severity of vision impairment. RESULTS: Compared to those without cataract, older drivers with cataract were approximately two times more likely to report reductions in days driven and number of destinations per week, driving slower than the general traffic flow, and preferring someone else to drive. Those with cataract were five times more likely to have received advice about limiting their driving. Those with cataract were four times more likely to report difficulty with challenging driving situations, and those reporting driving difficulty were two times more likely to reduce their driving exposure. Drivers with cataract were 2.5 times more likely to have a history of at-fault crash involvement in the prior 5 years (adjusted for miles driven/week and days driven/week). These associations remained even after adjustments for the confounding effects of advanced age, impaired general health, mental status deficit, or depression. CONCLUSIONS: Older drivers with cataract experience a restriction in their driving mobility and a decrease in their safety on the road. These findings serve as a baseline for our ongoing study evaluating whether improvements in vision following cataract surgery expand driving mobility and improve driver safety.

Accidents, Traffic↗
PubMed2005

Unsafe driving in North American automobile commercials.

BACKGROUND: Motor-vehicle crashes (MVCs) are a leading cause of death of young Americans and Canadians. Aggressive driving and driving at high speed are frequently cited as contributing to crashes. Consumer and safety associations have raised concern that driving behaviour portrayed in automobile commercials may influence consumer-driving behaviour. However, the prevalence of aggressive driving in automobile commercials has not been systematically evaluated. OBJECTIVES: To identify the prevalence and types of unsafe driving that are portrayed in United States and Canadian televised automobile commercials as well as the use of safety promotion and disclaimers. DESIGN: All English language automobile and truck commercials (>or=30 seconds in length), airing nationally on major broadcast and cable networks in either the United States or Canada during January or July between 1998 and 2002 were assessed by three independent raters for the presence and type of unsafe driving activity, presence of safety promotion and the use of written disclaimers in each commercial. RESULTS: Of 250 total commercials, 113 (45 per cent) contained an unsafe driving sequence as determined by at least two of three raters. Unanimous agreement as to the presence of an unsafe driving sequence was found in 63 (25 per cent) commercials. Aggressive driving accounted for 85 per cent of the unsafe driving sequences, including 56 per cent with speed violations. Safety promotion was present in 30 (12 per cent) commercials. Of 141 commercials in which the gender /sex of the driver was shown, 115 (81 per cent) displayed a male driver. CONCLUSION: Unsafe driving is prevalent in North American automobile commercials. Given the extent to which MVCs are a public health and economic concern, this finding seems in conflict with responsible advertising. The degree to which the portrayal of driving in automobile commercials affects consumer-driving behaviour should be an area of further investigation.

Accidents, Traffic↗
PubMed2006

Driving plastered: who does it, is it safe and what to tell patients.

BACKGROUND: The number and safety of patients who drive in an upper limb fracture cast has been largely untested. This study investigates the proportion of persons who drive in their casts and the capability of a casted persons driving is also assessed. The stance of government and insurance bodies is reviewed. The aim is to provide a guide for when a doctor should advise a patient not to drive while wearing an upper limb fracture cast. METHODS: Patients attending fracture clinic in upper limb casts were anonymously surveyed and asked (along with demographics) if they drove while in a cast and if they believed it illegal or covered by insurance to drive. Driving tests of the author wearing upper limb fracture casts were undertaken. The Queensland police traffic branch, the Queensland Department of Transport and the RACQ insurance company were contacted to review the legal and insurance issues involved. RESULTS: Two-thirds of male and one-third of female patients (half overall) were found to drive while in an upper limb cast. The author failed driving instructor tests in all casts and occupational therapist driving assessments while wearing long arm casts. The author passed occupational therapy driving assessments in left and right short arm casts. CONCLUSIONS: According to these results, a doctor's advice should be to patients not to drive in a long arm upper limb fracture cast and to consider concomitant patient factors when advising patients in short arm casts. Although we do not suggest that patients drive while wearing any cast, we have found a large proportion do. Our limited study has found that a young, fit and pain-free person may be able to drive well enough to pass a driving test while wearing a short arm cast.

Adult↗
PubMed1997

Driving patterns and medical conditions in older women.

OBJECTIVES: To describe driving patterns (e.g., driving frequency) in older women drivers and to evaluate the impact of medical conditions and comorbidity on driving patterns. DESIGN: Cross-sectional examination of the association between medical conditions and driving patterns. SETTING: Population-based cohort from the Pittsburgh Center of the Study of Osteoporotic Fractures (SOF). PARTICIPANTS: A total of 1768 women aged 71 years or older. MAIN MEASUREMENTS: Driving information was obtained through a driving questionnaire, including driving status, weekly mileage, longest trip in the past year, etc. Data for demographics, lifestyle behavior, and medical conditions were collected through the SOF study. RESULTS: Among the participants, 1103 (62.3%) were current drivers, 337 (19.1%) had stopped driving, and 329 (18.6%) had never driven in their lifetime. The proportion reporting driving cessation and decline in driving amount increased with age. The prevalence of most medical conditions was higher among former drivers than in current or never drivers. Even after controlling for age and other demographic variables, fractures, heart disease, diabetes, self-reported poor vision or hearing, as well as comorbidity were found to be associated independently with decreased driving amount, including driving cessation, decline in mileage, and avoiding long trips. CONCLUSION: Both individual medical conditions and comorbidity influence driving patterns in older drivers. Because it is common for older people to have several medical conditions simultaneously, comorbidity might be a more comprehensive measure of medical impact on driving.

Activities of Daily Living↗
PubMed2006

Parkinson's disease and driving ability.

OBJECTIVES: To explore the driving problems associated with Parkinson's disease (PD) and to ascertain whether any clinical features or tests predict driver safety. METHODS: The driving ability of 154 individuals with PD referred to a driving assessment centre was determined by a combination of clinical tests, reaction times on a test rig and an in-car driving test. RESULTS: The majority of cases (104, 66%) were able to continue driving although 46 individuals required an automatic transmission and 10 others needed car modifications. Ability to drive was predicted by the severity of physical disease, age, presence of other associated medical conditions, particularly dementia, duration of disease, brake reaction, time on a test rig and score on a driving test (all p<0.001). The level of drug treatment and the length of driving history were not correlated. Discriminant analysis revealed that the most important features in distinguishing safety to drive were severe physical disease (Hoehn and Yahr stage 3), reaction time, moderate disease associated with another medical condition and high score on car testing. CONCLUSIONS: Most individuals with PD are safe to drive, although many benefit from car modifications or from using an automatic transmission. A combination of clinical tests and in-car driving assessment will establish safety to drive, and a number of clinical correlates can be shown to predict the likely outcome and may assist in the decision process. This is the largest series of consecutive patients seen at a driving assessment centre reported to date, and the first to devise a scoring system for on-road driving assessment.

Age Factors↗
PubMed1999

Medical restrictions to driving: the awareness of patients and doctors.

The study was set up to investigate the awareness of elderly patients and medical doctors of medical restrictions to driving. Separate questionnaires were completed by patients and doctors. All were interviewed face-to-face, without prior warning and their immediate answers were recorded. In total, 150 elderly patients from the acute elderly care wards, rehabilitation wards and day hospital, and 50 doctors (including all grades from consultant to junior house officer) were interviewed. The main outcome measures were numbers of patients currently driving and previously driving; patients' awareness of how their medical condition affected their ability to drive; doctors' spontaneous knowledge of medical conditions which restrict driving, current licensing policy, and restrictions for five specific medical conditions (epilepsy, myocardial infarction, stroke, 5-cm abdominal aortic aneurysm, and diabetes). Only 21 patients were current drivers, and six of these should not have been driving. While 103 perceived themselves eligible to drive, 46 had medical restrictions to driving. Seventeen of the 47 patients who perceived themselves not eligible to drive possibly did not have restrictions to driving. Doctors' knowledge of the current licensing policy and action to be taken if a patient was not eligible to drive was very poor. Knowledge of medical restrictions to driving was scanty, with few doctors giving the correct driving restrictions for the five specific conditions. We recommend that education of doctors regarding medical restrictions to driving should begin at an undergraduate level and be continued throughout their postgraduate career.

Age Factors↗
PubMed1996

The Driving Expectancy Questionnaire: development, psychometric assessment and predictive utility among young drink-drivers.

OBJECTIVE: The primary objective of this research was to develop a Driving Expectancy Questionnaire (DEQ) that reflects a model in which a distinction is made between driving skill and driving style. The second objective was to study young drivers across the spectrum of drink-driving practices, from non-drivers to convicted drink-drivers, and to examine the relationship between their expectancies about driving and their drink-driving practices. METHOD: The data from two separate samples, recruited through availability sampling, were used for the purpose of exploratory (n = 224; 122 men) and confirmatory factor analyses (n = 191; 101 men), respectively. RESULTS: The results revealed two factors of expectancies, driving skill and driving style, supporting the proposed model. The reliability, internal validity and relative independence of the factors were largely confirmed. Furthermore, criterion-related validity was demonstrated: expectancies about driving varied with drink-driving practices. Expectancies also contributed additional predictive power in relation to drink-driving practices beyond that afforded by several well-validated variables. CONCLUSIONS: The results are encouraging in terms of the ability of the DEQ to identify individual differences in expectancies about driving skill and driving style that are closely related to variations in drink-driving practices. The practical implications of these findings, as well as the potential research possibilities, are discussed.

Adolescent↗
PubMed1999

Factors associated with planned avoidance of alcohol-impaired driving in high-risk men.

OBJECTIVE: This study examines the factors associated with planning to avoid alcohol-impaired driving and successful avoidance in high-risk young men. METHOD: A targeted telephone survey was conducted with male drivers aged 21-35 years who consume alcohol and live in areas of the country where alcohol-related traffic fatalities occur frequently (N = 750). Heavy episodic drinking drivers (i.e., report driving after consuming five or more drinks) were oversampled (N = 230). Respondents were surveyed to assess their attitudes, behavior and social support regarding drinking-driving. RESULTS: Multiple logistic regression revealed that men who believe they can consume six drinks or more before it is too dangerous for them to drive were 45% less likely to report planning to avoid drinking-driving. Men who believe they can drive safely after heavy episodic drinking were 61% less likely to be successful in avoiding drinking-driving. Having friends who disapprove of driving after heavy episodic drinking and believing a close friend would be successful in preventing drinking-driving were significantly associated with making plans to avoid drinking-driving, although this association was less strong for successful avoidance. Men who had their wife/girlfriend along when they were out drinking were two and one-half times more likely to make plans to avoid drinking-driving. The presence of a wife or girlfriend was an even stronger predictor (multivariate odds ratio = 3.74) of successful avoidance. CONCLUSIONS: Attitude and social factors are associated with drinking-driving avoidance in a group of young men at risk for alcohol-related driving fatalities. Friends and wives/girlfriends appear to influence drinking-driving avoidance behavior in high-risk drinking drivers.

Adult↗
PubMed1998

Estimates of driving abilities and skills in different conditions.

OBJECTIVES: This research was a preliminary effort to determine whether various driving situations seemed to require different driving skills and abilities and to identify the relative demands of specific physical, perceptual, cognitive, behavioral, and operational skills and abilities in different driving situations. METHOD: Experienced driver evaluators and trainers estimated the magnitude of driving abilities and skills for different photographed driving situations. Pictures of driving scenarios were counterbalanced for road type, traffic condition, and weather condition. RESULTS: A multifactorial analysis of variance of the total score for each scenario revealed significant main effects for road type and traffic condition but not for weather condition. Highway and city driving were rated as significantly more demanding overall than residential driving, but no difference was found between city and highway driving. Estimates of the overall demands for driving in heavy traffic were significantly greater than in light traffic. However, driving in inclement weather was not regarded as significantly more demanding than driving in sunny weather. Additionally, significant interaction effects were found for road type by weather condition and traffic by weather condition but not for road type by traffic condition. Through multivariate methods to evaluate the significance of individual abilities and skills across conditions, significant main and interactive effects were found for road type, traffic condition, and weather condition. Post hoc analyses showed the impact of these effects on such abilities and skills as scanning, attention and concentration, information-processing speed, and others. CONCLUSION: Evaluators' quantified estimates of driving demands showed driving as a complex task that (a) requires high levels of abilities and skills in all situations; (b) demands greater abilities in some situations than in others; and (c) involves different kinds and various degrees of abilities and skills, depending on the demand characteristics of the situation.

Adult↗
PubMed2001

Driving mishaps and hypoglycaemia: risk and prevention.

Driving is a complex, multi-task activity that can be affected by cognitive impairment resulting from episodes of severe hypoglycaemia. Intensive insulin therapy increases the likelihood of severe hypoglycaemia but there have been few studies examining effects on driving skills. A survey carried out recently indicated that patients with type 1 diabetes had twice the incidence of driving accidents than their non-diabetic spouses or patients with type 2 diabetes. The motor accidents were associated with more frequent low blood glucose while driving and less frequent self-monitoring. In driving simulation tests it was found that driving has an intrinsic metabolic demand that can contribute to hypoglycaemia. Driving performance began to deteriorate at around 3.6 mmol/l but drivers frequently did not recognise and failed to treat the hypoglycaemia. Those who did self-treat had more driving relevant symptoms and less neuroglycopenia quantified by EEG alpha-theta differences. Patients should be recommended not to begin driving if blood glucose is below 4.5 mmol/l and should not continue to drive if they suspect that blood glucose has fallen below 4 mmol/l while driving. If hypoglycaemia is suspected patients should immediately pull off the road, measure blood glucose if possible, treat themselves as necessary and not resume driving until glucose and cognitive-motor function return to normal. The problems of driving and hypoglycaemia should be discussed with patients with diabetes and behavioural interventions instigated. To this end, Blood Glucose Awareness Training (BGAT) and Hypoglycaemia Anticipation, Awareness and Treatment Training (HAATT) have been developed and shown to markedly reduce incidence of driving mishaps.

Accidents, Traffic↗
PubMed1995

Factors related to driving in persons with an implantable cardioverter defibrillator.

A study of 97 persons (mean age = 66 yrs, 79% male) with an ICD for an average of 2.2 years was conducted to determine whether patients resume driving (N = 72) post-ICD insertion despite instructions not to do so. Those who had resumed were queried about their driving habits, the presence of symptoms associated with arrhythmias, the occurrence of shocks in the previous year, and the importance of driving to maintenance of lifestyle. Our assumption was that patients return to driving to maintain their pre-ICD lifestyle of functional independence, and to resume social roles such as provider for the family. Seventy-four percent of subjects reported driving an average of 60 mi/week despite being instructed not to drive by their physician or other health care provider. Of those who resumed driving, > 4% had received a shock while driving. Over 86% of subjects believe driving was an important part of maintaining one's lifestyle. Reasons for driving included necessity (62%), such as to work or a physician appointment, or social (58%), such as driving to the store or church. Symptoms such as dizziness, palpitations and lightheadedness were experienced by 80% of subjects, with 43% receiving a shock from their ICD within the previous year. There were significant correlations between driving and the importance of driving to maintaining one's lifestyle (p < .05), driving for necessity (p < .01), for social reasons (p < .01) and being the primary driver in the family (p < .05).

Activities of Daily Living↗