Driving with pets and motor vehicle collision involvement among older drivers: A prospective population-based study

ObjectiveDistracted driving is a major cause of motor vehicle collision (MVC) involvement. Pets have been identified as potential distraction to drivers, particularly in the front. This type of distraction could be worse for those with impairment in the cognitive aspects of visual processing. The purpose of this study is to evaluate the association between driving with pets and rates of motor vehicle collision involvement in a cohort of older drivers.MethodsA three-year prospective study was conducted in a population-based sample of 2000 licensed drivers aged 70 years and older. At the baseline visit, a trained interviewer asked participants about pet ownership, whether they drive with pets, how frequently, and where the pet sits in the vehicle. Motor vehicle collision (MVC) involvement during the three-year study period was obtained from the Alabama Department of Public Safety. At-fault status was determined by the police officer who arrived on the scene. Participants were followed until the earliest of death, driving cessation, or end of the study period. Poisson regression was used to calculate crude and adjusted rate ratios (RR) examining the association between pet ownership, presence of a pet in a vehicle, frequency of driving with a pet, and location of the pet inside with vehicle with any and at-fault MVC involvement. We examined whether the associations differed by higher order visual processing impairment status, as measured by Useful Field of View, Trails B, and Motor-free Visual Perception Test.ResultsRates of crash involvement were similar for older adults who have ever driven with a pet compared to those who never drove with their pet (RR = 1.15, 95% CI 0.76–1.75). Drivers who reported always or sometimes driving with their pet had higher MVC rates compared to pet owners who never drive with a pet, but this association was not statistically significant (RR = 1.39, 95% CI 0.86–2.24). In terms of location, those reporting having a pet frequently ride in the front of the vehicle had similar rates of MVC involvement compared to those who did not drive with a pet in the front. A similar pattern of results was observed for at-fault MVCs. This association was not modified by visual processing impairment status.ConclusionThe current study demonstrates a positive but non-significant association between frequently driving with pets and MVC involvement. More research is needed, particularly on restraint use and whether the pet was in the car at the time of the crash, to help characterize the public safety benefit of regulations on driving with pets.     

Impact of mandating a driving lesson for older drivers at license renewal in Japan

In Japan, a driving lesson consisting of a lecture, a driver aptitude test, on-road driving assessment and a discussion session was added to the driving license renewal procedure for drivers aged 75 years or older in 1998 and for drivers aged 70 years or older in 2002. We investigated whether these additions contributed to a reduction in at-fault motor vehicle collisions (MVCs) by examining the trend of the at-fault MVC rates per licensed driver and the rate ratios of the older drivers relative to those aged 65–69 years for the years 1986–2011. All data were derived from nationwide traffic statistics. If the introduction of the lesson was effective in reducing at-fault MVCs of older drivers, the rate ratio should have declined, given that the lesson targeted only the older drivers. We found this was not the case, i.e., there was no declining trend in the at-fault MVC rate ratios of both drivers aged 75 years or older and drivers aged 70 years or older, relative to drivers aged 65–69 years, after the driving lesson at license renewal became mandatory for these older drivers. Therefore, the mandatory lesson for the older drivers at license renewal needs to be reconsidered.     

Ambulance transport rates after motor vehicle collision for older vs. younger adults: A population-based study

Older adults are at greater risk than younger adults for life-threatening injury after motor vehicle collision (MVC). Among those with life-threatening injury, older adults are also at greater risk of not being transported by emergency medical services (EMS) to an emergency department. Despite the greater risk of serious injury and non-transportation among older adults, little is known about the relationship between patient age and EMS transportation rates for individuals experiencing MVC. We describe transport rates across the age-span for adults seen by EMS after experiencing MVC using data reported to the North Carolina Department of Motor Vehicles between 2008 and 2011. Of all adults aged 18 years and older experiencing MVC and seen by EMS (n = 484,310), 36.3% (n = 175,768) were transported to an emergency department. Rates of transport for individuals seen by EMS after MVC increased only a small amount with increasing patient age. After adjusting for potential confounders of the relationship between patient age and the decision to transport (patient gender, patient race, air bag deployment, patient trapped or ejected, and injury severity), transport rates were: age 18–64 = 36.0% (95% confidence interval [CI], 35.9–36.2%); age 65–74 = 36.6% (95% CI, 36.0–37.1%); age 75–84 = 37.3% (95% CI, 36.5–38.1%), and age 85–94 = 38.2% (95% CI, 36.7–39.8%). In North Carolina between 2008 and 2011, the transportation rate was only slightly higher for older adults than for younger adults, and most older adults experiencing MVC and seen by EMS were not transported to the emergency department. These findings have implications for efforts to improve the sensitivity of criteria used by EMS to determine the need for transport for older adults experiencing MVC.     

Predictors of injury among younger and older adults in fatal motor vehicle crashes

With 2003 Fatality Analysis Reporting System data, we examined relationships among predictors of motor vehicle injury/fatality outcomes for younger (35–54 years) and older (65 years and older) drivers. Using the Precede-Proceed Model of Health Promotion as an organizing framework, we classified variables into person, vehicle and environment domains and conducted a multinomial logistic regression.Significant risk factors for older driver injuries were impact crashes at 1–3 o’clock (OR = 1.65; CI: 1.05–2.59), 7–9 o’clock angles (OR = 2.59; CI = 1.45–4.63), and driving with one passenger (OR = 2.25; CI: 1.58–3.20). Previous other motor vehicle convictions were significantly associated with reduced risk of injury (OR = 0.55; CI = 0.34–0.90). The 7–9 o’clock angle (OR = 3.06; CI: 1.83–5.12), and driving in daylight hours were risk factors for fatality among older drivers.Many risk factors (e.g., female gender, non-seatbelt use, rollover crashes, and vehicle body type), and protective factors (e.g., number of lanes and non-airbag deployment) were relevant for younger and older drivers. Findings showed relevant factors for drivers from both age groups, with some pointing to older adults, and set the stage for further research to develop injury and fatality prevention programs.     

Reducing older driver motor vehicle collisions via earlier cataract surgery

Older adults who undergo cataract extraction have roughly half the rate of motor vehicle collision (MVC) involvement per mile driven compared to cataract patients who do not elect cataract surgery. Currently in the U.S., most insurers do not allow payment for cataract surgery based upon the findings of a vision exam unless accompanied by an individual's complaint of visual difficulties that seriously interfere with driving or other daily activities and individuals themselves may be slow or reluctant to complain and seek relief. As a consequence, surgery tends to occur after significant vision problems have emerged. We hypothesize that a proactive policy encouraging cataract surgery earlier for a lesser level of complaint would significantly reduce MVCs among older drivers. We used a Monte Carlo model to simulate the MVC experience of the U.S. population from age 60 to 89 under alternative protocols for the timing of cataract surgery which we call “Current Practice” (CP) and “Earlier Surgery” (ES). Our base model finds, from a societal perspective with undiscounted 2010 dollars, that switching to ES from CP reduces by about 21% the average number of MVCs, fatalities, and MVC cost per person. The net effect on total cost – all MVC costs plus cataract surgery expenditures – is a reduction of about 16%. Quality Adjusted Life Years would increase by about 5%. From the perspective of payers for healthcare, the switch would increase cataract surgery expenditure for ages 65+ by about 8% and for ages 60–64 by about 47% but these expenditures are substantially offset after age 65 by reductions in the medical and emergency services component of MVC cost. Similar results occur with discounting at 3% and with various sensitivity analyses. We conclude that a policy of ES would significantly reduce MVCs and their associated consequences.     

Impact of age and cognitive demand on lane choice and changing under actual highway conditions

Previous research suggests that drivers change lanes less frequently during periods of heightened cognitive load. However, lane changing behavior of different age groups under varying levels of cognitive demand is not well understood. The majority of studies which have evaluated lane changing behavior under cognitive workload have been conducted in driving simulators. Consequently, it is unclear if the patterns observed in these simulation studies carry over to actual driving. This paper evaluates data from an on-road study to determine the effects of age and cognitive demand on lane choice and lane changing behavior. Three age groups (20–29, 40–49, and 60–69) were monitored in an instrumented vehicle. The 40's age group had 147% higher odds of exhibiting a lane change than the 60's group. In addition, drivers in their 60's were less likely to drive on the leftmost lane compared to drivers in their 20's and 40's. These results could be interpreted as evidence that older adults adopt a more conservative driving style as reflected in being less likely to choose the leftmost lane than the younger groups and less likely to change lanes than drivers in their 40's. Regardless of demand level, cognitive workload reduced the frequency of lane changes for all age groups. This suggests that in general drivers of all ages attempt to regulate their behavior in a risk reducing direction when under added cognitive demand. The extent to which such self-regulation fully compensates for the impact of added cognitive demand remains an open question.     

Self-rated driving performance among elderly drivers referred for driving evaluation

PURPOSE: To explore whether elderly drivers of varying driving skill levels (1) differ in their perception of their driving evaluation performance and (2) determine if self-rated driving evaluation performance is related to cognitive ability. METHODS: One hundred and fifty-two drivers aged 65 years or older and referred for a driving evaluation were enrolled into the study. Subjects were asked the question, "how well do you think you will perform today on your driving evaluation compared to others your own age?" Subjects also completed the Mini-Mental State Exam and a 30-min drive on a STISIM Drivetrade mark simulation (Systems Technology, Inc., Hawthorne, CA). Only 47 subjects completed both the simulated drive and self-rated item. RESULTS: Sixty-five percent of drivers rated themselves as performing better on a driving test than others of their age. Another 31.9% felt they would perform the same as others of their age on a driving test. A 50.0% of those considering themselves "a little better" and 52.9% of those considering themselves "a lot better" had an unsafe driving performance. As self-rated driving evaluation performance increased, there was a significantly increased risk of unsafe driving (p=0.02) in the study population. Drivers who considered themselves at least a little better than others of their age were over four times more likely to be unsafe drivers compared to others who believed they were comparable to or worse than other drivers of their age (RR=4.13, 95% CI=1.08-15.78). There was no significant difference in MMSE between self-rating groups (p=0.76). CONCLUSION: Older drivers assign high ratings to their driving performance, even in the presence of suspected skill decline. Cognitive ability was not related to self-rated driving evaluation performance.     

Legal consequences for alcohol-impaired drivers injured in motor vehicle collisions: A systematic review

Background

The treatment of alcohol-impaired drivers injured in a motor vehicle collision (MVC) is a complex public health issue. We conducted a systematic review to describe the legal consequences for alcohol-impaired drivers injured in a MVC and taken to a hospital or trauma center. Methods We searched MEDLINE, Embase, and CINAHL databases from inception until August 2014. We included studies that reported legal consequences including charges or convictions of injured drivers taken to a hospital or trauma center after a MVC with a blood alcohol concentration (BAC) exceeding the legal limit.Results Twenty-six studies met inclusion criteria; twenty studies were conducted in the USA, five in Canada, and one in Sweden. All were cohort studies (23 retrospective, 3 prospective) and included 11,409 patients overall. A total of 5,127 drivers had a BAC exceeding the legal limit, with legal consequences reported in 4937 cases. The median overall DUI/DWI conviction rate was 13% (range 0–85%). The median percentage of drivers with a previous conviction on their record for driving under the influence (DUI) or driving while intoxicated (DWI) was 15.5% (range 6–40%). The median percentage of drivers convicted again for DUI/DWI during the study period was 3.5% (range 2–10%). Heterogeneity between study designs, legal jurisdictions, institutional procedures and policies for obtaining a legally admissible BAC measurement precluded a meta-analysis. Conclusions The majority of intoxicated drivers injured in MVCs and seen in the emergency department are never charged or convicted. A substantial proportion of injured intoxicated drivers had more than one conviction for DUI/DWI on their police record.     

Acceptability and concurrent validity of measures to predict older driver involvement in motor vehicle crashes: an Emergency Department pilot case-control study

INTRODUCTION: Older drivers have one of the highest motor vehicle crash (MVC) rates per kilometer driven, largely due to the functional effects of the accumulation, and progression of age-associated medical conditions that eventually impact on fitness-to-drive. Consequently, physicians in many jurisdictions are legally mandated to report to licensing authorities patients who are judged to be medically at risk for MVCs. Unfortunately, physicians lack evidence-based tools to assess the fitness-to-drive of their older patients. This paper reports on a pilot study that examines the acceptability and association with MVC of components of a comprehensive clinical assessment battery. OBJECTIVES: To evaluate the acceptability to participants of components of a comprehensive assessment battery, and to explore potential predictors of MVC that can be employed in front-line clinical settings. METHODS: Case-control study of 10 older drivers presenting to a tertiary care hospital emergency department after involvement in an MVC and 20 age-matched controls. RESULTS: The measures tested were generally found to be acceptable to participants. Positive associations (p相似文献   

Risky driving habits and motor vehicle driver injury

Risky driving is an important cause of motor vehicle injury, but there is a lack of good epidemiological data in this field, particularly data comparing risky driving in younger drivers to those of other age groups. We examined the relationship between risky driving habits, prior traffic convictions and motor vehicle injury using cross-sectional data amongst 21,893 individuals in New Zealand, including 8029 who were aged 16-24 years. Those who reported frequently racing a motor vehicle for excitement or driving at 20 km/h or more over the speed limit, and those who had received traffic convictions over the past 12 months, were between two and four times more likely to have been injured while driving over the same time period. Driving unlicensed was a risk factor for older but not younger drivers, and driving at 20 km/h or more above the speed limits was a stronger risk factor for younger (<25 years) than older drivers. These results confirm the need for interventions targeting risky driving and suggest that different strategies may be required for different high-risk groups.     

An examination of the environmental,driver and vehicle factors associated with the serious and fatal crashes of older rural drivers

Motor vehicle crashes involving rural drivers aged 75 years and over are more than twice as likely to result in a serious or fatal injury as those involving their urban counterparts. The current study examined some of the reasons for this using a database of police-reported crashes (2004–2008) to identify the environmental (lighting, road and weather conditions, road layout, road surface, speed limit), driver (driver error, crash type), and vehicle (vehicle age) factors that are associated with the crashes of older rural drivers. It also determined whether these same factors are associated with an increased likelihood of serious or fatal injury in younger drivers for whom frailty does not contribute to the resulting injury severity. A number of environmental (i.e., undivided, unsealed, curved and inclined roads, and areas with a speed limit of 100 km/h or greater) and driver (i.e., collision with a fixed object and rolling over) factors were more frequent in the crashes of older rural drivers and additionally associated with increased injury severity in younger drivers. Moreover, when these environmental factors were entered into a logistic regression model to predict whether older drivers who were involved in crashes did or did not sustain a serious or fatal injury, it was found that each factor independently increased the likelihood of a serious or fatal injury. Changes, such as the provision of divided and sealed roads, greater protection from fixed roadside objects, and reduced speed limits, appear to be indicated in order to improve the safety of the rural driving environment for drivers of all ages. Additionally, older rural drivers should be encouraged to reduce their exposure to these risky circumstances.     

Age differences in simulated driving performance: Compensatory processes

In the context of driving, the reported experiment examines compensatory processes for age-related declines in cognitive ability. Younger (26–40 years) and older (60+ years) participants (n = 22 each group) performed a car following task in a driving simulator. Several performance measures were recorded, including assessments of anticipation of unfolding traffic events. Participants also completed a range of measures of cognitive ability – including both fluid and crystallised abilities. Three examples of age-related compensation are reported: (i) older drivers adopted longer headways than younger drivers. Data were consistent with this being compensation for an age-related deficit in complex reaction time; (ii) older drivers with relatively higher cognitive ability anticipated traffic events more frequently, whereas the reverse pattern was found for younger drivers; and, (iii) older drivers with greater crystallised ability were less reliant on spatial ability to maintain lane position. Consistent with theories of ‘cognitive reserve’, interactions between crystallised ability and age for self-report workload suggested that compensation for age-related cognitive ability deficits required investment of additional effort. Results are considered in the context of the prospects of further assessment of older drivers.     

The relationship between cognitive ability,insight and self-regulatory behaviors: Findings from the older driver population

Self-regulation is often promoted as a coping strategy that may allow older drivers to drive safely for longer. Self-regulation depends upon drivers making an accurate assessment of their own ability and having a willingness to practice self-regulatory behaviors to compensate for changes in ability. The current study explored the relationship between older drivers’ cognitive ability, their driving confidence and their use of self-regulation. An additional study aim was to explore the relationship between these factors and older drivers’ interest in driving programs. Seventy Australian drivers aged 65 years and over completed a questionnaire about their driving and a brief screening measure of cognitive ability (an untimed Clock Drawing Test). While all participants reported high levels of confidence regarding their driving ability, and agreed that they would continue driving in the foreseeable future, a notable proportion performed poorly on the Clock Drawing Test. Compared to older drivers who successfully completed the Clock Drawing Test, those who failed the cognitive test were significantly less likely to report driving self-regulation, and showed significantly less interest in being involved in driving programs. Older drivers with declining cognitive abilities may not be self-regulating their driving. This group also appears to be unlikely to self-refer to driving programs.     

Cognitive problems,self-rated changes in driving skills,driving-related discomfort and self-regulation of driving in old drivers

Ageing in general is associated with functional decline that may have an adverse effect on driving. Nevertheless, older drivers have been found to show good judgement and to self-regulate their driving, which may enable them to continue driving safely despite functional decline. The process of the self-monitoring of driving ability and the awareness of functional decline, and its association with the self-regulation of driving is, however, not fully understood. The aim of the present study was to examine the perceived changes in driving skills, the discomfort experienced in driving, and the self-regulation of driving as measured by the avoidance of certain driving situations by older drivers with different levels of self-rated cognitive problems. Eight hundred and forty Danish drivers aged 75–95 completed a structured telephone interview. The results showed that the recognition of cognitive problems was associated with an experience of improvement in higher level driving skills but also of a decline in lower level driving skills. Moreover, cognitive problems recognised by drivers were associated with discomfort in, and avoidance of, driving situations. Finally, a linear relationship between discomfort in driving and avoidance was found and this tended to be stronger for drivers recognising cognitive problems. The results indicate that older drivers who recognise problems with cognitive functions display good self-assessment of changes in their driving skills. In addition, the results suggest that driving-related discomfort is an important factor affecting the self-regulation of driving. Finally, the findings indicate that driving-related discomfort functions as an indirect self-monitoring of driving ability and may contribute to the safe driving performance of Danish older drivers.     

A brief peripheral motion contrast threshold test predicts older drivers’ hazardous behaviors in simulated driving

Our research group has previously demonstrated that the peripheral motion contrast threshold (PMCT) test predicts older drivers’ self-report accident risk, as well as simulated driving performance. However, the PMCT is too lengthy to be a part of a battery of tests to assess fitness to drive. Therefore, we have developed a new version of this test, which takes under two minutes to administer. We assessed the motion contrast thresholds of 24 younger drivers (19–32) and 25 older drivers (65–83) with both the PMCT-10 min and the PMCT-2 min test and investigated if thresholds were associated with measures of simulated driving performance. Younger participants had significantly lower motion contrast thresholds than older participants and there were no significant correlations between younger participants’ thresholds and any measures of driving performance. The PMCT-10 min and the PMCT-2 min thresholds of older drivers’ predicted simulated crash risk, as well as the minimum distance of approach to all hazards. This suggests that our tests of motion processing can help predict the risk of collision or near collision in older drivers. Thresholds were also correlated with the total lane deviation time, suggesting a deficiency in processing of peripheral flow and delayed detection of adjacent cars. The PMCT-2 min is an improved version of a previously validated test, and it has the potential to help assess older drivers’ fitness to drive.     

Drug and alcohol use among drivers admitted to a Level-1 trauma center

The purpose of this research was to determine the incidence and prevalence of drug use, alcohol use, and the combination of drug and alcohol use among motor vehicle crash (MVC) victims admitted to a Level-1 trauma center. In a 90-day study, nearly two-thirds of trauma center admissions were victims of motor vehicle crashes. Blood and urine was collected from 168 MVC victims of whom 108 were identified as the driver in the crash. Toxicology results indicated that 65.7% of drivers tested positive for either commonly abused drugs or alcohol. More than half of the drivers tested positive for drugs (50.9%) other than alcohol, with one in four drivers testing positive for marijuana use. About one-third of those using drugs had also been drinking, but alcohol was detected in only 30.6% of all injured drivers. Within the total MVC patient pool, passenger drug/alcohol use was equivalent to the driver population; however, injured pedestrians had higher rates of alcohol only than other MVC victims. There were no significant differences in drug and alcohol use between MVCs and trauma admissions of other causes. Of the patients with positive toxicology results, less than half (42%) were referred for evaluation for substance abuse disorders.     

A comparison of diagnostic related group length of stay outliers: motor vehicle crash versus penetrating injuries

The incidence and degree to which patients injured by motor vehicle crashes (MVCs) and penetrating wounds remain in the hospital beyond the diagnostic related group (DRG) mean length of stay (LOS) are compared. During a 12-month period, records for consecutive patients admitted to eight hospitals (including three trauma centers) were studied. Patients aged 13 or younger, staying less than 48 hours, or with major burns or only distal fractures were excluded. In that time, 2,914 patients were eligible. Twenty percent of injuries were penetrating; 27% were MVC injuries; and, 53% were blunt injuries from other causes. Patients injured in MVCs and with penetrating injuries were compared with respect to mean LOS, incidence of DRG outliers, number of hospital days beyond the DRG mean LOS, and demographic variables. Patients injured in MVCs had a greater proportion of DRG LOS outliers and higher mean numbers of DRG excess days than did patients with penetrating wounds (p less than 0.01, for both). Injuries were distributed among relatively more DRGs for MVC patients. The DRG scheme may lack sufficient attention to factors more likely to affect MVC patients, such as multiplicity of injuries, incidence of CNS injuries, ICU requirements, and older age. In structuring more appropriate reimbursement for trauma care, special attention must be paid to patients injured in MVCs.     

Fragility versus excessive crash involvement as determinants of high death rates per vehicle-mile of travel among older drivers

Using multiple national data systems, the roles of fragility (susceptibility to injury) versus excessive crash involvement in the increased fatality risk of older drivers per vehicle-mile of travel (VMT) were estimated. For each age and gender group, deaths per driver involved in a crash (a marker of fragility) and drivers involved in crashes per VMT (a marker of excessive crash involvement) were computed. Compared with drivers ages 30-59, those younger than 20 and those 75 or older both had much higher driver death rates per VMT. The highest death rates per mile driven, 13-fold increases, were observed among drivers age 80 or older, who also had the highest death rates per crash. Fragility began to increase at ages 60-64 and increased steadily with advancing age, accounting for about 60-95% of the excess death rates per VMT in older drivers, depending on age group and gender. Among older drivers, marked excesses in crash involvement did not begin until age 75, but explained no more than about 30-45% of the elevated risk in this group of drivers; excessive crashes explained less of the risk among drivers ages 60-74. In contrast, crash over-involvement was the major factor contributing to the high risk of death among drivers younger than 20, accounting for more than 95% of their elevated death rates per VMT. Although both fragility and crash over-involvement contributed to the excess death rates among older drivers per VMT, fragility appeared to be of over-riding importance. These findings suggest that measures to improve the protection of older vehicle occupants in crashes should be vigorously pursued.     

Crossing county lines: the impact of crash location and driver's residence on motor vehicle crash fatality

INTRODUCTION: Studies have demonstrated that the fatality risk for motor vehicle crashes (MVCs) is higher in rural than urban areas. The purpose of this study was to quantify the risk of a fatal outcome associated with a crash by the urban/rural classification of the driver's county of residence and the county of crash before and after adjusting for potentially confounding factors. METHODS: County of crash and driver's county of residence were classified as urban or rural for 514,648 Utah crash participants. Multivariate regression analysis was used to assess the impact of rural versus urban crash location on fatality outcomes for both urban and rural drivers. RESULTS: Before adjusting for confounding factors the relative risk of fatality in a rural versus urban crash was 9.7 (95% CI: 8.0-11.7) for urban drivers and their passengers compared to 1.8 (95% CI: 1.3-2.6) for rural residents. Adjustment for behavioral, road, and crash characteristics reduced risk estimates to 2.8 (95% CI: 2.2-3.5) and 1.2 (95% CI: 0.8-1.7), respectively. CONCLUSION: Urban and rural drivers may have distinct risk factors for MVC fatality in rural areas. Interventions to reduce the risk of fatality in rural areas should evaluate the needs of both urban and rural drivers.     

Older drivers and rapid deceleration events: Salisbury Eye Evaluation Driving Study

Drivers who rapidly change speed while driving may be more at risk for a crash. We sought to determine the relationship of demographic, vision, and cognitive variables with episodes of rapid decelerations during five days of normal driving in a cohort of older drivers. In the Salisbury Eye Evaluation Driving Study, 1425 older drivers aged 67–87 were recruited from the Maryland Motor Vehicle Administration's rolls for licensees in Salisbury, Maryland. Participants had several measures of vision tested: visual acuity, contrast sensitivity, visual fields, and the attentional visual field. Participants were also tested for various domains of cognitive function including executive function, attention, psychomotor speed, and visual search. A custom created driving monitoring system (DMS) was used to capture rapid deceleration events (RDEs), defined as at least 350 milli-g deceleration, during a five day period of monitoring. The rate of RDE per mile driven was modeled using a negative binomial regression model with an offset of the logarithm of the number of miles driven. We found that 30% of older drivers had one or more RDE during a five day period, and of those, about 1/3 had four or more. The rate of RDE per mile driven was highest for those drivers driving <59 miles during the 5-day period of monitoring. However, older drivers with RDE's were more likely to have better scores in cognitive tests of psychomotor speed and visual search, and have faster brake reaction time. Further, greater average speed and maximum speed per driving segment was protective against RDE events. In conclusion, contrary to our hypothesis, older drivers who perform rapid decelerations tend to be more “fit”, with better measures of vision and cognition compared to those who do not have events of rapid deceleration.