Literature Review of Polypharmacy and Older Drivers: Identifying Strategies to Study Drug Usage and Driving Functioning Among Older Drivers

摘要

This research product updates the state-of-the-knowledge regarding key factors that bear on NHTSAs ability to investigate the effects of multiple medications on safe driving among older people. First, the prevalence of medication use by older people in the population, the physiological/metabolic effects of specific drugs and drug classes, and the known effects on driving abilityprincipally for single substancesare reviewed. Next, the strengths and weakness of various methods that may be used to learn which prescription and over-the-counter drugs are being taken by older adults are described and contrasted; a consideration of which factors most strongly affect compliance with a medication regime, and which factors influence older people willingness to participate in studies aimed at obtaining such information, complements this discussion. The remaining section in this review examines on-road, closed course, and simulation methods that have been applied in this arena, highlighting those that appear to hold the greatest promise for evaluating the effects of drugs on driving performance while also acknowledging shortcomings and limitations that have been reported in the literature. For the most part, this review concentrates on recent (since 2001) studies accessed through print and electronic media. A bibliography containing over 200 citations is included, plus an appendix identifying potentially inappropriate medications commonly prescribed for older, community-dwelling individuals.