To study the risk factors associated with exposure, aging, and other characteristics of elderly drivers, a case-control survey of 557 licensed drivers was conducted among residents of medium-sized, small towns and rural areas in Quebec, Canada. The subjects, aged 68 and over, were selected from the database of the provincial Automobile Insurance Board. The case group was chosen on the basis of performance, either accidents or violations, during the preceding three years. Cases were matched to a control group (blank file for the last three years) on a stratification basis (age, gender, region) in the proportion of two controls for one case. The survey which was conducted through a mail questionnaire achieved a participation rate of nearly 60%. The logistic regression method was used to assess the risk (odds ratios). The results of this study reveal that risk is proportional to the frequency of daily vehicle use or annual kilometrage. The hypothesis that elderly drivers who rarely expose themselves are at more risk is thus rejected. Vulnerable subgroups were the most elderly (> 77), city or suburban residents, the unmarried, and white collars (during active life).
This article measures the survival rate and explores the changes in functional autonomy among both men and women over a one-year period in a sample of 272 subjects aged 80-85.
Data were taken from the Quebec Longitudinal Study on Aging, a multi-cohort prospective study focusing on health and quality of life. The sample comprises two sub-groups, namely disabled and autonomous subjects. Eligible participants were selected from the Quebec Health Insurance Plan (QHIP) file. However, to obtain the required number of participants, the sample was completed from eligible subjects who volunteered in response to TV, billboard and newspaper advertising about the project. The Functional Autonomy Measurement System (SMAF) was used to assess disability. The SMAF assesses functional disability in 5 domains: activities of daily living (ADL), mobility, instrumental activities (IADL), communication, and mental functioning.
After one year, nearly 5% of the subjects had died and 72.5% were still autonomous, i.e., they had a score under 4.5 on the SMAF. The annual incidence of the onset of disability (including death, lengthy hospitalization, functional incapacities and cognitive deficits) was 20%. However, no difference was found between the sexes in regard to the risk of losing autonomy. The main areas where disability occurred among the previously autonomous subjects were, in order of importance, domestic tasks, mobility and communication. The study confirmed that it is possible to recover autonomy, even at this advanced age, particularly for women (11.2%), but less so for men (3.6%).
This phenomenon of recovering functional autonomy suggests that octogenarians have a residual potential and confirms the effectiveness of preventive and curative measures and the benefits of interventions by community and family networks.