title: Driver self-regulation and depressive symptoms in cataract patients awaiting surgery: a cross-sectional study.
abstract: BACKGROUND
  Cataract is an extremely common visual condition of ageing. Evidence suggests that visual impairment influences driving patterns and self-regulatory behavior among older drivers. However, little is known about the psychological effects of driver self-regulation among older drivers. Therefore, this study aimed to describe driver self-regulation practices among older bilateral cataract patients and to determine the association between self-regulation and depressive symptoms.
  
  
  METHODS
  Ninety-nine older drivers with bilateral cataract were assessed the week before first eye cataract surgery. Driver self-regulation was measured via the Driving Habits Questionnaire. Depressive symptoms were assessed using the 20-item Center for Epidemiological Studies Depression Scale. Visual, demographic and cognitive data were also collected. Differences between self-regulators and non self-regulators were described and linear regression modeling used to determine the association between driver self-regulation and depressive symptoms score.
  
  
  RESULTS
  Among cataract patients, 48% reported self-regulating their driving to avoid at least one challenging situation. The situations most commonly avoided were driving at night (40%), on the freeway (12%), in the rain (9%) and parallel parking (8%). Self-regulators had significantly poorer contrast sensitivity in their worse eye than non self-regulators (p = 0.027). Driver self-regulation was significantly associated with increased depressive symptoms after controlling for potential confounding factors (p = 0.002).
  
  
  CONCLUSIONS
  Driver self-regulation was associated with increased depressive symptoms among cataract patients. Further research should investigate this association among the general older population. Self-regulation programs aimed at older drivers may need to incorporate mental health elements to counteract unintended psychological effects.
authors.affiliation: Curtin-Monash Accident Research Centre (C-MARC), School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. l.meuleners@curtin.edu.au.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Fraser
authors.forename: Lynn B
authors.initials: LB
authors.lastname: Meuleners
authors.forename: Jonathon Q
authors.initials: JQ
authors.lastname: Ng
authors.forename: Nigel
authors.initials: N
authors.lastname: Morlet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000523:psychology*; D002386:Cataract / Q000523:psychology*; D015350:Contrast Sensitivity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D020377:Self Efficacy; D011795:Surveys and Questionnaires
references.citation: Arch Ophthalmol. 2001 Jun;119(6):881-7
references.pmid: 11405840
references.citation: J Cataract Refract Surg. 2003 May;29(5):941-8
references.pmid: 12781280
references.citation: Optom Vis Sci. 2005 Aug;82(8):755-64
references.pmid: 16127342
references.citation: Accid Anal Prev. 2011 May;43(3):1003-9
references.pmid: 21376894
references.citation: Hum Factors. 2002 Fall;44(3):482-94
references.pmid: 12502165
references.citation: Traffic Inj Prev. 2011 Dec;12(6):568-75
references.pmid: 22133332
references.citation: Accid Anal Prev. 2006 Sep;38(5):1038-45
references.pmid: 16725099
references.citation: Accid Anal Prev. 2010 Mar;42(2):515-22
references.pmid: 20159075
references.citation: J Gerontol B Psychol Sci Soc Sci. 2001 Nov;56(6):S343-51
references.pmid: 11682595
references.citation: J Health Psychol. 2000 Jul;5(4):441-56
references.pmid: 22049188
references.citation: Eye (Lond). 2007 Jun;21(6):702-7
references.pmid: 16518364
references.citation: Am J Ophthalmol. 1982 Jul;94(1):91-6
references.pmid: 7091289
references.citation: Ophthalmic Physiol Opt. 1999 Jan;19(1):34-40
references.pmid: 10615437
references.citation: J Am Geriatr Soc. 1997 Feb;45(2):202-6
references.pmid: 9033520
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Accid Anal Prev. 2008 Mar;40(2):719-24
references.pmid: 18329426
references.citation: Invest Ophthalmol Vis Sci. 2008 Jan;49(1):1-6
references.pmid: 18172067
references.citation: Accid Anal Prev. 2003 May;35(3):393-400
references.pmid: 12643956
references.citation: Invest Ophthalmol Vis Sci. 2009 Jan;50(1):107-13
references.pmid: 18719088
references.citation: J Gerontol A Biol Sci Med Sci. 2009 Dec;64(12):1290-5
references.pmid: 19675177
references.citation: Accid Anal Prev. 2000 Nov;32(6):735-44
references.pmid: 10994600
references.citation: Geriatrics. 2003 Dec;58(12):12
references.pmid: 14682092
references.citation: Br J Ophthalmol. 2006 Oct;90(10):1277-80
references.pmid: 16825273
references.citation: J Gerontol B Psychol Sci Soc Sci. 2000 Nov;55(6):S334-40
references.pmid: 11078110
references.citation: J Safety Res. 2011 Oct;42(5):351-8
references.pmid: 22093569
references.citation: Annu Proc Assoc Adv Automot Med. 2003;47:181-94
references.pmid: 12941225
references.citation: Accid Anal Prev. 2010 Jul;42(4):1213-9
references.pmid: 20441834
references.citation: J Gerontol A Biol Sci Med Sci. 1999 Apr;54(4):M203-11
references.pmid: 10219012
references.citation: Clin Exp Ophthalmol. 2003 Jun;31(3):233-6
references.pmid: 12786774
references.citation: J Gerontol A Biol Sci Med Sci. 2005 Mar;60(3):399-403
references.pmid: 15860482
references.citation: Perception. 2008;37(8):1269-75
references.pmid: 18853561
references.citation: J Safety Res. 2009;40(3):221-6
references.pmid: 19527817
references.citation: J Aging Soc Policy. 2008;20(3):323-39
references.pmid: 19024031
references.citation: Br J Ophthalmol. 1999 Jan;83(1):62-5
references.pmid: 10209437
references.citation: Gerontologist. 2007 Apr;47(2):215-23
references.pmid: 17440126
references.citation: Accid Anal Prev. 2012 Nov;49:322-9
references.pmid: 23036412