MOTOR-VEHICLE COLLISION INJURIES AND SENSORY IMPAIRMENTS OF OLDER DRIVERS

To determine whether ocular disease, impaired vision, or diminished he aring might increase the risk of motor vehicle collision injuries in o lder drivers, we conducted a population-based case-control study at a large Health Maintenance Organization (HMO). All study subjects were H MO members who were licensed drivers age 65 or over. Cases were driver s treated for injuries sustained in a police-reported collision that o ccurred in 1987 or 1988. Controls were drivers who experienced no such injury during the study years and were matched to cases by age, sex, and county of residence. We found no clear evidence that ocular diseas es or impaired visual acuity, as customarily recorded in the medical r ecord, increased the risk of an injury collision. Although there was n o significant association between impaired hearing and injury collisio n, we found that subjects who used hearing aids while driving had abou t twice the risk of others (adjusted RR 2.1; 95% CI 1.2-3.8). We concl ude that mild reductions in static visual acuity have little effect on the risk of injury collisions for older drivers. Moreover, the types of vision tests needed to identify elderly drivers at increased risk a re not those that are generally administrered during routine optometry examinations or at the time of licence renewal. Further research is n eeded to verify a possible increase in risk among elderly drivers usin g hearing aids.