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Adult ADHD Linked With Increased Motor Vehicle Crash Risk
Attention-deficit/hyperactivity disorder (ADHD) was associated with a significantly increased crash risk in older adult drivers compared to drivers without ADHD, according to a cohort study recently published in JAMA Network Open.
“Older adult drivers with ADHD may be at elevated risks of hard-braking events, traffic ticket events, and vehicular crashes,” lead author Yuxin Liu, MPH, Columbia University, New York, and co-authors noted. “As aging of the driver population continues, effective interventions to improve the diagnosis and clinical management of ADHD among older adults are warranted to promote safe mobility and healthy aging.”
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The study was conducted between July 2015 and March 2019 in 5 locations in the United States (Ann Arbor, Michigan; Baltimore, Maryland; Cooperstown, New York; Denver, Colorado; and San Diego, California). Study participants were drivers aged 65 to 79 years who were enrolled in the Longitudinal Research on Aging Drivers project (LongROAD) and were studied for up to 44 months through in-vehicle data recording devices and annual assessments.
A total of 2,832 older adult drivers were studied—53% women with a mean age of 71 years—and approximately 2.6% reported a lifetime history of ADHD. Researchers found that older adults with ADHD had a significantly higher incidence of risky driving behaviors compared to those without ADHD. In terms of hard-braking events, older adults with ADHD had an incidence rate of 1.35 per 1000 miles, while those without ADHD had a rate of 1.15. Moreover, older adults with ADHD were more likely to report traffic ticket events and vehicular crashes per million miles driven.
After adjusting for baseline characteristics, researchers found that older adults with ADHD faced a 7% increased risk of hard-braking events, 102% increased risk of self-reported traffic ticket events, and a 74% increased risk of self-reported vehicular crashes compared to those without ADHD.
“Given its association with driving safety alone, ADHD in older adults merits greater attention,” researchers concluded.
Authors noted that patient ADHD status was based solely on self-reports, which may have limited results. Moreover, participants sourced from the LongROAD project do not represent a national sample, as they are largely non-Hispanic White with high levels of educational attainment and household income. “Therefore, our findings may not be generalizable to the US older adult driver population,” authors noted.
