Potentially Inappropriate Medication Use and Hard Braking Events in Older Drivers

Yuqing Xue; Stanford Chihuri; Howard F Andrews; Marian E Betz; Carolyn DiGuiseppi; David W Eby; Linda L Hill; Vanya Jones; Thelma J Mielenz; Lisa J Molnar; David Strogatz; Barbara H Lang; Tara Kelley-Baker; Guohua Li

doi:10.3390/geriatrics6010020

Potentially Inappropriate Medication Use and Hard Braking Events in Older Drivers

Geriatrics (Basel). 2021 Feb 20;6(1):20. doi: 10.3390/geriatrics6010020.

Authors

Yuqing Xue¹, Stanford Chihuri², Howard F Andrews^{3

4}, Marian E Betz^{5

6}, Carolyn DiGuiseppi⁷, David W Eby^{8

9}, Linda L Hill¹⁰, Vanya Jones¹¹, Thelma J Mielenz^{1

12}, Lisa J Molnar^{8

9}, David Strogatz¹³, Barbara H Lang², Tara Kelley-Baker¹⁴, Guohua Li^{1

2}

Affiliations

¹ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
² Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University,New York, NY 10032, USA.
³ Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
⁴ Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
⁵ Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA.
⁶ VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO 80045, USA.
⁷ Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
⁸ University of Michigan Transportation Research Institute, Ann Arbor, MI 48109, USA.
⁹ Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, MI 48109, USA.
¹⁰ School of Public Health, University of California San Diego, La Jolla, CA 92093, USA.
¹¹ Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
¹² Center for Injury Science and Prevention, Columbia University Irving Medical Center, New York, NY 10032, USA.
¹³ Bassett Research Institute, Cooperstown, NY 13326, USA.
¹⁴ AAA Foundation for Traffic Safety, Washington, DC 20005, USA.

Abstract

Potentially inappropriate medications (PIMs) identified by the American Geriatrics Society should generally be avoided by older adults because of ineffectiveness or excess risk of adverse effects. Few studies have examined the effects of PIMs on driving safety measured by prospectively and objectively collected driving data. Data for this study came from the Longitudinal Research on Aging Drivers study, a multisite naturalistic driving study of older adults. Multivariable negative binominal modeling was used to estimate incidence rate ratios and 95% confidence intervals of hard braking events (proxies for unsafe driving behavior defined as events with a deceleration rate ≥0.4 g) associated with PIM use among older drivers. The study sample consisted of 2932 drivers aged 65-79 years at baseline, including 542 (18.5%) who used at least one PIM. These drivers were followed through an in-vehicle recording device for up to 44 months. The overall incidence of hard braking events was 1.16 per 1000 miles. Use of PIMs was associated with a 10% increased risk of hard braking events. Compared to drivers who were not using PIMs, the risk of hard braking events increased 6% for those using one PIM, and 24% for those using two or more PIMs. Use of PIMs by older adult drivers is associated in a dose-response fashion with elevated risks of hard braking events. Reducing PIM use in older adults might help improve driving safety as well as health outcomes.

Keywords: aging; driving safety; hard braking events; potentially inappropriate medications.

Grants and funding

Contract No. 51178B/AAA Foundation for Traffic Safety