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End of the RoadDung Hoang

End of the Road (continued)

While acknowledging such experiences, public health researchers say it is also important to try to keep competent older drivers on the road. Studies have shown that those who stop driving are five times more likely to enter long-term-care facilities and four to six times more likely to die within three years. In part, Rebok says, that’s probably because many drivers quit as their health declines. But he also says that the depression, isolation and loss of control that come with giving up driving may—by themselves—cause health problems. In a 2009 study of 690 current and former drivers published in the Journal of Gerontology, Rebok and other researchers found that at the point older motorists quit driving, they reported a sharp, immediate drop in their physical functioning, social activities and general health. Quitting also accelerated the rate at which their health was declining.

Experts say research is needed into the relationship between giving up driving and household activities, including studies to identify and test coping strategies.

When it comes to cognitive problems, some researchers say new training programs may be able to help older drivers stay safe longer. AARP and AAA offer behind-the-wheel courses designed to help older drivers sharpen their skills. Several commercial firms have produced so-called “brain-training” programs designed to improve driver performance.

In a widely cited study published in Nature in 2010, one team of researchers concluded that thousands of volunteers ages 18 to 60 who played brain-training games online for six weeks did not improve their overall memory or reasoning. Instead, the study found, they improved their skill at taking a particular test.

But Rebok and others believe that an intensive cognitive training program can produce changes that carry over into real life. He is part of a team of researchers participating in a large, long-term, multicenter study called ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly), which in 2006 reported finding evidence that a 10-week program could improve memory, reasoning and speed of mental processing in older adults. In the study of 2,832 volunteers, participants on average reported improvements in their performance of everyday tasks, including driving, that with booster sessions persisted for up to five years after the training ended. The ACTIVE study’s 10-year follow-up was completed last year and the results have not been published, but Rebok says that the training program had a significant impact on cognitive fitness through at least five years.

“I think the results we were getting with the speed of processing in particular shows a lot of promise in terms of extending driver life spans, letting people stay on the road longer and more safely, and shows evidence of actually reducing crashes,” he says. On the other hand, Rebok says, the severely cognitively impaired may reach a point where “there may not be much you can do to bring [them] back to where they can safely operate a motor vehicle.”

A year after Nathan Krasnopoler’s death, the “ghost bike” that his family bought for $30 and painted white still sits chained to a signpost under an elm tree on the sidewalk a few steps from the driveway where he was injured. Walke, now 84, did not respond to a request for an interview, but her lawyer, Robert H. Bouse Jr., says she was deeply affected by Nathan’s death. “It devastated her, it truly did,” he says.

Walke was cited for negligent driving and failing to yield the right of way to a rider in a bike lane, court records show. She pleaded guilty and was fined $220. The Krasnopolers filed a $10 million lawsuit that Walke settled for what the Krasnopolers’ lawyer called a “substantial” sum. The family says they took legal action only after they learned Walke had continued to drive after the accident, and they insisted she surrender her license as part of the settlement.

Now Cohen has left her job with the state Attorney General’s office and plans to use the money from the lawsuit to set up a nonprofit foundation called Safe Roads USA. Cohen says she will dedicate the rest of her life to an effort to promote research, education and legislation to address the problem of older motorists and traffic safety. “I plan to go for laws across this nation,” she says.

Comments

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  • Isabelle Kargon

    Baltimore, MD 10/11/2012 10:48:47 AM

    The only really efficient solution is the implementation of a decent public transportation system and a shift away from this country's car-based culture.

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Driving Older

Driving Older

Researcher Vanya Jones seeks the best ways to help older adults prepare to “retire” from driving.

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