Evaluation and Modification of the Multifactorial Model of Driving Safety Among Older Adults

Background and Objectives: Cognitive, visual, and physical performance are associated with driving safety. However, there are few comprehensive models that empirically evaluate how such factors together affect driving safety in older adults. The present study used structural equation modeling (SEM) to evaluate Anstey’s original Multifactorial Model of Driving Safety (MMDS) (2005) as well as a modified MMDS that incorporates recent research. Research Design and Methods: We used the baseline data from the Advanced Cognitive Training for Independent and Vital Elderly study. Participants (n = 2,391) were drivers with a reported mean age of 73.28 (SD = 5.70; range 65–91), 75.7% White, and 73.3% women. Results: Using SEM, Anstey’s original MMDS did not achieve adequate fit (CFI = 0.850, TLI = 0.777, RMSEA = 0.074). However, the modified MMDS had a good fit (CFI = 0.961, TLI = 0.934, RMSEA = 0.040). We found that better physical function was correlated with less driving avoidance (β = 0.28, p < .01) and a lower crash risk (β = −0.14, p < .01). Better cognitive abilities were associated with less driving avoidance (β = 0.08, p <.01) and better self-reported driving quality (β = 0.19, p < .01). Driving avoidance partially mediated the relationship between physical function and crash. Discussion and Implications: This study highlights the importance of cognition and physical function in older adults safe driving. Implications for future directions and public policy considerations are discussed. Future research should examine possible dynamic changes between these predictors and driving in a longitudinal model.