The close relationship between ADHD and car crashes in older drivers

A recent study conducted by researchers at Columbia University Mailman School of Public Health has shed light on a pressing issue: the prevalence of attention-deficit/hyperactivity disorder (ADHD) and its impact on crash risk among older adult drivers. This study reveals a significant finding – older adult drivers with ADHD face a considerably higher crash risk compared to their counterparts without this condition. While research on ADHD and driving safety has primarily focused on children and young adults, this study delves into the underexplored territory of ADHD among older adults. The results of this study have been published online in JAMA Network Open.

The close relationship between ADHD and car crashes in older drivers 1

Alarming Findings and the Call for Interventions

The study’s findings are nothing short of alarming. Older adult drivers with ADHD were found to be over twice as likely as those without ADHD to report their involvement in traffic ticket events and vehicular crashes. This translates to 22 incidents versus 10 per million miles driven for traffic ticket events and 27 versus 13.5 per million miles driven for vehicular crashes. Yuxin Liu, MPH, a researcher at Columbia Mailman School of Public Health and the first author of the study, stresses the urgency of effective interventions to enhance the diagnosis and clinical management of ADHD among older adults. The aim is to promote safe mobility and healthy aging among this demographic.

Understanding ADHD and Its Impact

ADHD is a chronic neurodevelopmental condition characterized by symptoms like inattentiveness, impulsivity, and hyperactivity. While it is commonly associated with childhood, it can persist into adulthood, affecting the daily lives of older adults. In the United States, the reported prevalence of ADHD is 9% to 13% in children under 17 years and 8% in adults aged 18 to 44. Recent years have witnessed an increase in reported ADHD prevalence in adults due to improved diagnosis. Generally, the prevalence of ADHD decreases as individuals age.

The study involved 2,832 active drivers aged between 65 and 79 years. Among them, 75 (2.6%) had ADHD, with the prevalence of ADHD reaching 7.2% among older adults with anxiety or depression. Even after adjusting for demographic factors and comorbidities, ADHD was associated with a 7% increased risk of hard-braking events, a 102% increased risk of self-reported traffic ticket events, and a 74% increased risk of self-reported vehicular crashes.

This critical research was conducted between July 2022 and August 2023 using data from primary care clinics and residential communities in five U.S. locations: Ann Arbor, Michigan; Baltimore, Maryland; Cooperstown, New York; Denver, Colorado; and San Diego, California. Study participants were active drivers aged 65 to 79, enrolled in the Longitudinal Research on Aging Drivers (LongROAD) project, and were tracked through in-vehicle data recording devices and annual assessments.

The study’s senior author, Dr. Guohua Li, expressed the significance of this research, emphasizing its contributions to understanding healthy and safe aging. Dr. Li points out that this study fills a critical gap in epidemiological data concerning ADHD in older adults and provides compelling evidence of the substantially higher crash risk for older adult drivers with ADHD. This study is part of the LongROAD Project, initiated in 2014 by Dr. Li and colleagues to address the safe mobility needs of older adult drivers.

The implications of this study are profound. With the aging population, the number of older adult drivers is on the rise, expected to reach 63 million by 2030. The valuable data from the LongROAD project will facilitate a comprehensive examination of the role of medical, behavioral, environmental, and technological factors in driving safety during the aging process. Dr. Li, the founding director of the Columbia Center for Injury Science and Prevention, underscores the importance of this research in ensuring the safety and well-being of older adult drivers in the United States.


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