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Self-Reported Driving Problems Predict Future Traffic Crashes in Older Men: Prevalence and Determinants of Unrecognized Imminent Risk.

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Title: Self-Reported Driving Problems Predict Future Traffic Crashes in Older Men: Prevalence and Determinants of Unrecognized Imminent Risk.
Authors: Han JW; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea., Kim TH; Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea., Kwak KP; Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea., Kim BJ; Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea., Kim SG; Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea., Kim JL; Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea., Moon SW; Department of Psychiatry, Konkuk University Chungju Hospital, Chungju, Korea., Park JH; Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea., Ryu SH; Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea., Lee DW; Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea., Lee SB; Department of Psychiatry, Dankook University Hospital, Cheonan, Korea., Lee JJ; Department of Psychiatry, Dankook University Hospital, Cheonan, Korea., Jhoo JH; Department of Psychiatry, Kangwon National University, College of Medicine, Chuncheon, Korea., Kim KW; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea.; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea.
Source: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2026 Jul; Vol. 74 (7), pp. 2011-2020. Date of Electronic Publication: 2026 May 15.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Blackwell Science Country of Publication: United States NLM ID: 7503062 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-5415 (Electronic) Linking ISSN: 00028614 NLM ISO Abbreviation: J Am Geriatr Soc Subsets: MEDLINE
Imprint Name(s): Publication: Malden, MA : Blackwell Science
Original Publication: New York [etc.]
MeSH Terms: Accidents, Traffic*/statistics & numerical data , Automobile Driving*/statistics & numerical data , Automobile Driving*/psychology , Self Report*, Republic of Korea/epidemiology ; Humans ; Male ; Aged ; Prospective Studies ; Middle Aged ; Longitudinal Studies ; Prevalence ; Risk Assessment ; Risk Factors
Abstract: Background: Older drivers exhibit elevated crash risk per distance driven, yet accurately identifying high-risk individuals without unjustly restricting mobility remains challenging. Whether older drivers can accurately assess their own driving-related risks remains controversial, and educational attainment-as a proxy for cognitive reserve-may influence this capacity for self-assessment.
Methods: This population-based prospective cohort study included 1673 male drivers aged 60 years and older from the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD). Participants were classified into four risk phenotypes based on concordance between baseline self-reported driving concerns and subsequent crash occurrence: Drivers with inherent safety (DIS), drivers with regulated safety (DRS), drivers with recognized risk (DRR), and drivers with unrecognized risk (DUR). Self-reported and informant-reported driving problems were assessed using the driving risk questionnaire (DRQ). Crash records were obtained from the Korean National Police Agency (KNPA) over a 2-year follow-up.
Results: Of 290 drivers involved in crashes, 179 (61.7%) had reported baseline concerns (DRR), while 111 (38.3%) had not, representing 'silent' at-risk drivers-those who reported no driving concerns at baseline but subsequently experienced crashes (DUR). Lower baseline Self-Informant Discrepancy (mean SID: -0.05 in the unrecognized risk group vs. 3.15 in the recognized risk group; p < 0.001) characterized the unrecognized risk group, while informant reports showed a floor effect (94.3% zero) and did not predict crashes, necessitating objective screening. Among drivers without self-reported concerns, lower education (≤ 9 years) combined with slower TMT-B performance (≥ 180 s) identified a high-risk subgroup with a crash rate of 20.9% (OR, 2.04; 95% CI, 1.29-3.22; p = 0.002).
Conclusions: Self-reported driving concerns demonstrate predictive validity for future crashes, but a substantial minority of crash-involved drivers remain undetected by self-report. Education and TMT-B performance may serve as clinically actionable markers for identifying these "silent" at-risk drivers.
(© 2026 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)
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Grant Information: RS-2020-KH095941 Korea Dementia Research Project through the Korea Dementia Research Center (KDRC); RS-2023-KH135260 Korea Dementia Research Project through the Korea Dementia Research Center (KDRC); RS-2025-02223212 Korea Dementia Research Project through the Korea Dementia Research Center (KDRC); HI09C1379 Korean Health Technology R&D Project
Contributed Indexing: Keywords: driving safety; older adults; self‐report validity; trail making test; unrecognized risk
Entry Date(s): Date Created: 20260515 Date Completed: 20260729 Latest Revision: 20260731
Update Code: 20260731
PubMed Central ID: PMC13418772
DOI: 10.1111/jgs.70521
PMID: 42138370
Database: MEDLINE
Description
ISSN:1532-5415
DOI:10.1111/jgs.70521