MEDICAL CONDITIONS AND MOTOR-VEHICLE COLLISION INJURIES IN OLDER ADULTS

Objective To determine whether medical conditions that can impair sens ory, cognitive, or motor function increase the risk of injury due to m otor vehicle collision in older drivers. Design Case-control study. Se tting Group Health Cooperative of Puget Sound, a large prepaid health plan. Participants Group Health members age 65 or older who were licen sed drivers in 5 counties. Cases were injured while driving during 198 7 or 1988. Controls were matched to cases on age, gender, and county o f residence but experienced no such injury during the study years. Mea surements The outcome was injury requiring medical care due to a polic e-investigated motor vehicle collision. Risk factors evaluated include d selected medical conditions active within the previous 3 years, as d etermined from the medical record. Main Results Injury risk was 2.6-fo ld higher in older diabetic drivers (95% CI: 1.4-4.7), especially thos e treated with insulin (odds ratio [OR] = 5.8, 95% CI: 1.2-28.7) or or al hypoglycemic agents (OR = 3.1, 95% CI: 1.7-8.7), and those with bot h diabetes and coronary heart disease (OR = 8.0, 95% CI: 1.7-37.7). In creases were also found for older drivers with coronary artery disease (OR = 1.4), depression (OR = 1.7), alcohol abuse (OR = 2.1), or falls (OR = 1.4), but these associations could easily have arisen by chance . Conclusions Counseling about driving risks may be warranted for cert ain elderly diabetic drivers. Further research is needed to determine whether transient hypoglycemia or long-term complications explain thes e effects.