Association of falls and fear of falling with objectively-measured driving habits among older drivers: LongROAD study
DOI: 10.1016/j.jsr.2022.08.007
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Summary
This study investigates the association between a history of falls and fear of falling (FOF) with objectively measured driving habits among older adults, addressing the gap in literature where previous research relied on self-reported behaviors or small, restricted samples. The motivation stems from the known link between falls and increased motor vehicle crash risk, with the hypothesis that changes in driving behavior may mediate this relationship. The research utilized data from the AAA LongROAD study, a multi-site prospective cohort of 2,990 active drivers aged 65–79 in the United States. Participants were enrolled between 2015 and 2017. Primary exposures included self-reported falls in the past 12 months and FOF, measured via the Short Falls Efficacy Scale-International (categorized as low or high). Driving outcomes were objectively measured over a 12-month follow-up period using in-vehicle Global Positioning System devices that tracked exposure (miles, days, trips), driving space (distance from home), avoidance of difficult conditions (e.g., rush hour, night), and unsafe driving (hard braking and speeding events). Statistical analysis involved linear and logistic regression models, adjusting for sociodemographics, health status, and medication use. Results indicated that 28.2% of participants reported a fall in the past year, while 18.6% reported high FOF. Drivers with a past-year fall history exhibited a modestly higher rate of hard braking events compared to those without falls; however, this difference was attenuated and became statistically non-significant after adjusting for cognitive concerns and central nervous system (CNS) medication use. No significant differences were found in driving exposure, space, or avoidance based on fall history. In contrast, participants with high FOF drove significantly fewer miles, days, and trips, and traveled closer to home compared to those with low FOF. They also demonstrated more hard braking events. While high FOF was initially associated with avoiding morning rush hour, these differences in driving exposure, space, and unsafe driving were largely accounted for by differences in health, physical function, and medication use. Specifically, individuals with high FOF had poorer physical function and higher use of cardiovascular and CNS medications. The findings suggest that while FOF is associated with reduced driving mobility—driving less often and for shorter distances—this is primarily a marker for underlying health declines and perceived functional deficits rather than a direct behavioral consequence of the fear itself. Similarly, fall history does not significantly alter driving habits once health and medication factors are controlled. The study implies that falls and FOF serve as indicators of age-related health changes that impact community mobility, highlighting the need to address underlying health conditions to maintain safe and independent driving among older adults.
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | author_sweep | — | — | 3 | 2026-05-28 |
| archive | success | manual_pmc_pow_fetch | — | — | 25 | 2026-08-22 |
| extract | success | cached | — | — | 4 | 2026-08-23 |
| clean | success | clean | — | — | 1 | 2026-06-04 |
| chunk | success | chunk | — | — | 1 | 2026-06-04 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-04 |
| enrich | skipped | — | — | — | 3 | 2026-06-04 |
| promote | success | — | — | — | 1 | 2026-06-04 |
| summarize | success | llm | qwen3.8-27b-gittensor | summ-v5 | 2 | 2026-08-23 |
| tag | success | vector_similarity | — | — | 15 | 2026-06-11 |
Summary generated by qwen3.8-27b-gittensor on 2026-08-23; verification: pending re-verification.
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- Empirical Findings: observational prevalence, crash risk outcomes