title: Driving Self-Restriction and Age: A Study of Emergency Department Patients.
abstract: BACKGROUND
  Driving self-restriction is a well-documented among older drivers but might also occur among younger drivers. Little is known about the driving patterns of emergency department (ED) patients, who may be a high-risk population for motor vehicle crashes (MVCs). We sought to compare the driving patterns and MVCs of younger and older adult ED patients in order to inform development of injury prevention interventions in EDs.
  
  
  METHODS
  We surveyed English-speaking younger adult (age 25-64) and older adult (age ≥65) ED patients, excluding non-drivers and those who were cognitively-impaired or too sick to participate. We compared drivers by age group and used logistic regression with adjustment for driving frequency to examine factors associated with driving self-restriction.
  
  
  RESULTS
  Of those eligible, 82% (n=178) of younger adult and 91% (n=134) of older adult patients participated; approximately half were women. Similar proportions of younger and older adult patients reported driving everyday/almost everyday (80%) but also self-restricting driving in inclimate weather (48%), heavy traffic (27%), in unfamiliar places (21%), when travelling with passengers (1.6%) or when alone (1.3%). Fewer younger adult than older adult patients avoided driving at night (22% versus 49%) or on highways (6.7% versus 26%). In multivariable logistic regression, factors significantly associated self-imposed driving restriction in ≥1 driving situation were female gender (Odds Ratio [OR] 2.40; 95%CI 1.42-4.05) and ever feeling "confused, nervous or uncomfortable" while driving (OR 1.87; 95% CI 1.03-3.39). There was a non-significant trend for differences in proportions between younger adult (11%) and older adult (6.8%) drivers reporting ≥1 MVC as a driver in the past 12 months.
  
  
  CONCLUSIONS
  Similar proportions of younger and older adult ED patients self-restrict driving, albeit in different situations, which has implications for behavioral interventions for injury prevention and for education of patients and medical providers.
authors.affiliation: Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Marian E
authors.initials: ME
authors.lastname: Betz
authors.affiliation: Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Carpenter
authors.affiliation: Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado ; VISN 19 Mental Illness Research, Education and Clinical Center, Denver VAMC, Denver, CO.
authors.forename: Emma
authors.initials: E
authors.lastname: Genco
authors.affiliation: Division of Geriatrics and Nutritional Science, Department of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: David B
authors.initials: DB
authors.lastname: Carr
keywords: avoidance; driving; emergency department; older driver; self-restriction