Eleni Karagiannidou - RoSPA

68th ROAD SAFETY CONGRESS 

Safer Driving 

Reducing Risks, Crashes & Casualties 

3 - 5 March 2003 

CONGRESS PROCEEDINGS 

THE IMPACT OF KEEPING 

A DRIVING DIARY ON OLDER DRIVERS 

Eleni Karagiannidou 

Department of Psychology 

University of Strathclyde 

RoSPA in association with

RoSPA Road Safety Congress 3 - 5 March 2003 

“The Impact of Keeping a Driving Diary on Older Drivers” 



THE IMPACT OF KEEPING A DRIVING DIARY ON OLDER DRIVERS 


& 

Hugh Foot 


Department of Psychology, University of Strathclyde 

Introduction 

Populations of elderly people have been growing steadily in western societies. According to 

the statistics of the Office for National Statistics, for 2000, the over 60’s consisted 20.4% of 

the total population, though over 65’s consisted 15.59% of the total population of the U.K.. In 

addition, a Help the Aged report estimates that by 2021, 1 in 3 people in the UK will be aged 

over 60. 

This increase is mainly due to lower birth rates as well as increased longevity and is followed 

by a rise in the driving populations of older people. Driving is a major means of mobility in 

this population. The growing need for mobility reflects the great importance it plays in the 

lives of older people. Mobility is related to greater life satisfaction and is an important 

contributor to perceived quality of life. Driving is a complex task, and requires the coordination 

of several psycho-motor functions. For example, some of the physical and mental 

functions that are used when driving are eyesight and hearing (for the recognition of 

environmental situations), judgment (judgment of the situations -which is a multi-dimensional 

function) and reaction (a course of action taken based on the judgments made). 

Ageing brings cognitive, perceptual, functional and psychomotor limitations (such as, vision, 

attention, perception, memory, decision-making, reaction time and physical fitness), which 

may be accompanied by medical conditions that impair driving. The functional limitations 

caused by these, and quite often the medication used to treat them, result in deteriorating 

driving abilities. 

RoSPA Road Safety Congress 2003 Page 1 of 9





Despite the fact that for many occasion the level of impairment on the driving task has not yet 

been identified, as people grow older their ability to drive a car safely may be compromised 

and ageing may be accompanied by “riskier” driving. This is revealed by elderly people’s 

accident involvement. Research has revealed that when mileage is taken into account the 

risk of being injured in traffic is higher for drivers over 65, compared to driving in the 25-64 

age band. 

In all these traffic accidents, the human as well as the financial costs are issues that require 

careful consideration. According to the Road Accidents Scotland 2001 report, the average 

cost per casualty for the U.K. in 2001 prices is between £1,194,240 (fatalities), £134,190 

(serious injuries), and £10,350 (slight injuries). These figures include lost output, 

medical/ambulance, pain/grief/suffering, police/administration, and damage to property costs. 

Recognising the effect of ageing on driving performance, policies have been developed in 

many countries. In the U.K. there is the requirement of a medical record signed by the driver, 

when completing the 70 th year of age, and every 3 years thereafter. In other countries, it is up 

to the older person’s physicians or GP to decide whether their clients are capable to continue 

driving. Still other countries have introduced medical assessments and/or road tests. The 

large deviation of laws and policies between different countries reveals that it is not quite 

clear yet what constitutes an appropriate assessment of fitness to drive. Taking into account 

the increase in the projected number of elderly drivers and in their accident rates, it becomes 

obvious that more research is needed on these issues. 

Many older drivers are aware of their failing capacities and the impact on their driving 

performance. 






To diminish the difficulties they face they may ‘compensate’ for their deteriorating abilities by 

adapting self-limiting and self-regulating techniques: in other words, limiting their driving to 

only those situations they feel comfortable driving under. When they feel psychological 

ready, they eventually give up driving altogether. Nonetheless, others are not aware of the 

limitations which they incur progressively and very slowly, and others are unwilling to admit 

any deterioration (e.g., those who have no alternative transportation). There may of course 

be psychological factors, such as reduced confidence, which may result in quitting driving 

prematurely. 

The difference in older drivers’ perceptions about when they will limit or stop driving may 

reflect a difference in self-awareness. Previous research has shown that the higher their 

mileage the more likely older people were to rate themselves as being better drivers than 

their peers. However, other research findings reveal that on-road driving performance and 

history of adverse driving events are not related to drivers’ ratings of self-confidence. These 

discrepancies may reflect lack of awareness. In addition, other research has revealed that 

older drivers think they will be the first to know when they should stop driving, and that many 

of them have not considered the possibility that they may not realise when it is time for them 

to quit driving. The present research was designed to uncover differences in self-awareness. 

Present study 

Although age-related impairment may increase risk, self-awareness and the use of selfprotective 

behaviours (e.g., driving slower) can confound the relationship between risk and 

involvement in adverse driving events, by reducing exposure to them. In the present study, 

factors that contribute to becoming psychologically ready to engage in self-protective 

behaviours were investigated, as were the ways in which senior citizens interact with the 

traffic environment. The theoretical models that were utilised in the present study were the 

models of Health Behaviour & Self-protective Behaviours, known as value-expectancy 

models or Social Cognition Models. One of the main objectives of the current study was to 

raise older drivers’ self-awareness through self-monitoring, and encourage the adoption of 

self-protective behaviours and the avoidance of risky situations 






The study was conducted in four stages: a) Focus groups, which were exploratory and the 

findings of which were used in order to identify the main themes to be investigated and to 

construct the consequent measures; b) Driving Experiences Questionnaire (DEQ), an 

extensive questionnaire (pre-test), which explored, among other issues, older people’s 

driving history, experiences, difficulties and stresses, self-reported accidents, and selfperceptions 

about their health and driving; c) Driving Diary (DD), that is a diary of 30 

consecutive journeys that was designed to raise older drivers’ self-awareness by monitoring 

their day-to-day driving performance; unique information on traffic exposure of elderly drivers 

was also obtained by the DD; d) and finally, the Post-Diary Questionnaire (PDQ), that was 

designed to capture direct and indirect measures of changes on driving performance, 

awareness, and confidence (post-test). 

A total of 221 drivers of drivers aged between 56.5 and 88 years of age (mean age=70.6, 

sd=6.2) completed the DEQ. Of these, 61, 34 men and 27 women, completed the DD (mean 

age=72.2, sd=5.8). The PDQ was completed by 154 drivers, who were the “diary group” and 

a further 93 in the “non-diary” group, a sub-sample that consisted of 52 men and 41 women 

(mean age=69.4,sd=6.1). In relation to demographic characteristics of the sample: 64.5% 

were married, 85.5% were retired or unemployed, 63% were living in town suburbs, 93% 

were living in a private house, 35.3% had completed only compulsory education, while the 

remaining went further in education, and finally, 44.7% had a monthly income of £500-1000. 

In relation to their driving, all but 3 participants were still drivers (three had quitted less than 6 

months ago), and all but three were experienced, with driving experience for over 15 years. 

Very few of them (8%) have been professional drivers. 

Results 

DEQ Results 

The results from the DEQ concern the whole sample of 221 drivers. In relation to their health 

status, the mean number of conditions reported by the drivers was 0.9, with 45% of the 

sample being condition-free. Among the most prevalent conditions reported were: arthritis or 

fall (significant), hearing and vision impairment. It was found that the older the person the 

more likely they were to report these conditions. The vast majority (90.5%) of the drivers 

reported that their health conditions had not affected their driving. Only 21 drivers reported 

that some of their health conditions (vision, arthritis, diabetes mellitus, hypertension, sleep 

disorder) had affected their driving performance. 






Turning into driving-related finding, older drivers drove mostly for social-related purposes 

(96.5% of the sample reported that), in order to complete everyday errands (95%) and some 

drove for medical appointments (60% of the sample). 

It was generally found that men drove more miles and more hours than women. When asked 

how their driving abilities were in relation to when they were younger, 80.2% reported their 

abilities were good or excellent and for the comparison with other people of their age, 87.1% 

said again that their driving was good or excellent. However, half of the sample (50.3%) 

reported that they expect their driving to be only fair or good in the future. 

Findings in relation to traffic incidents and accidents revealed that 9.6% of the sample was 

involved in at least one major accident in the past 2-3 years, 24% in at least one minor 

accident and 57% in at least one near miss. In addition, men and ‘younger’ older drivers 

reported more near misses than women and ‘older’ older drivers, respectively. Further 

analysis revealed that the older the person, the fewer the reported near misses, but the more 

the minor accidents and the reported stress. Also, drivers who reported major accidents were 

more likely to report at least one minor accident as well. In addition, the better the selfreported 

driving abilities the fewer the minor accidents reported; however, self-reported 

driving abilities did not correlate with major accidents or near misses 

The reasons that older drivers would consider quitting driving were analysed: doctor’s advice 

or medical assessment (95.9% of the sample reported this reason), deteriorated health 

(81.4% of the sample), loss of their confidence (80%), car being unavailable (77.6%), 

feelings of nervousness or uneasiness (56.4%), no need to drive any more (48.7%), family’s 

or friends’ advice (47.6%), and a traffic accident or incident (28.3% of the sample reported 

this reason). Women were more likely to report an accident/incident as a reason, and 

‘younger’ older drivers were more likely to report that family’s or friends’ advice would 

contribute to their decision to quit driving some time in the future, more than ‘older’ older 

drivers. 






With regard to the self-reported stress under various driving situations, results showed that 

‘finding that other drivers in front of you’, ‘driving on wet or icy roads’, and driving ‘unfamiliar 

routes’ were the most stressful situations, reported by 75.9%, 73.5% and 71.8% of the 

drivers, respectively. In addition, driving ‘in a hurry’, ‘in heavy traffic’, coming across 

‘unfamiliar signs’, and ‘switching lanes in heavy traffic’, were also stressful, and were 

reported by 66.6%, 65.4%, 62.1% and 59.4% of the drivers, respectively. Furthermore, 

results showed that women generally reported more stress than men, and especially when: 

‘switching lanes in heavy traffic’, ‘finding that drivers in front of you suddenly brake’, ‘driving 

on wet or icy roads’, ‘dealing with unfamiliar signs’, ‘driving somebody else's car’, and 

‘parking on busy roads with limited parking space’. Moreover, ‘older’ older drivers reported 

higher stress when driving on wet or icy roads, but lower stress when dealing with unfamiliar 

signs than ‘younger’ older drivers. 

Among the potentially risky situations that drivers now frequently avoided were: driving when 

feeling tired or sleepy or ill, at rush hours, under adverse weather conditions, long distances, 

parking on busy roads or narrow spaces. They also sometimes avoided driving: at night, 

when somebody else is driving, unfamiliar routes at junctions and on motorways. It was also 

found that women and ‘older’ older drivers more often avoided driving: on motorways, at 

junctions and complicated crossroads, unfamiliar routes, parking in busy roads or narrow 

spaces (women); under adverse weather conditions (both women and ‘older’ older drivers); 

under poor lighting conditions, at rush hours and long distances (‘older’ older drivers). 

PDQ Results: the Diary and the Non-Diary Groups 

In relation to the avoidance of risky situations in the DEQ and the PDQ from both the diary 

and the non-diary groups, some significant differences were found. More specifically, drivers 

in the diary group avoided driving at rush hours, when tired/sleepy/ill, parking in busy roads 

and narrow spaces, and driving at night less frequently in the PDQ, than in the DEQ, and 

these were all significant differences. (For the non-diary group only driving at rush hours and 

driving when tired/sleepy/ill produces significant differences in the DEQ and PDQ.) 






In addition, regarding the experienced stress under various situations, the diary group 

reported more stress in the PDQ for all the following situations: having conversations with 

passengers, driving in a hurry, driving somebody else’s car, parking in a multi-storey car park 

with limited space, coming across unfamiliar signs, and finding that other drivers in front of 

you suddenly brake. Only for one situation, keeping up with the speed of other drivers, the 

self-reported stress decreased. 

It was also found that, after the diary, drivers’ confidence in relation to how it was when they 

were younger decreased. However, their beliefs of being more skilful than their peers 

became stronger. Furthermore, in relation to how drivers that kept the diary and those that 

did not rated their driving abilities before and after the diary, the following were found: 

judgment of driving abilities in relation to peers was similar for both groups in the DEQ and 

PDQ, with the diary group reporting slightly higher ratings. However, self-perceived driving 

abilities in relation to how they were in the past, were significantly weakened after the diary, 

and the diary group this time reported slightly lower ratings than the non-diary group. 

Furthermore, regression analysis was used to identify the factors that may predict avoidance 

of potentially risky situations. Some preliminary results revealed that self-reported stress, 

self-perceived driving abilities and age were all independent predictors of avoidance. When 

different predictors were used in another model, perceived likelihood of accident 

involvement, feelings of being at risk when driving and difficulties in specific driving situations 

emerged as important factors that predict avoidance of potentially risky driving situations. 

Finally, qualitative findings in relation to whether participants in the diary group perceived any 

differences in their driving after they kept diary revealed that drivers perceived changes in 

specific driving-related skills and abilities (“I feel that I have improved entering roundabout 

junctions”), and those concerning reaction times (“I’m facing the fact that I’m getting older 

and that time is the enemy”), and attention (“I think I’m more aware that I’m an older driver 

and as such I must give all my attention to my driving”;). They also reported changes in their 

hazard-perception (“I am more aware of the hazards”), and general awareness (“Before 

...when I had a near miss I’d be glad nobody was hurt and forget it. Now, when there is an 

incident, I analyse it to see who had made the error in judgment….”; “I have paid more 

attention to the mechanisms of driving and driving behaviours…”). 






Conclusions 

Due to fact that disparity in the driving performance increases with age, the investigation of 

the role of health conditions in driving performance and the identification and development of 

reliable medical assessments and on-road tests becomes even more difficult. However, the 

investigation of role of the drivers themselves may be promising, as it is focused on the 

individual needs and limitations. The ‘intervention’ method, the DD, used in the present study 

was theory-driven, designed to manipulate cognitive constructs within the Theoretical Models 

of Health Behaviours. The aim was to make it a useful tool for increasing the awareness of 

the drivers, as well as the sense of personal susceptibility. Increasing self-awareness by 

monitoring driving behaviours through the DD, appears to lead to the engagement in selflimiting 

driving behaviours, and this in turn, may reduce risk through reducing exposure on 

‘risky’ situations. 

It appears that many older people are sensitive to their visual and other deficits. The majority 

of the drivers in the present study reported that deteriorated health would contribute to their 

decision to quit driving. Moreover, the avoidance of potential risky situations appeared to 

differentiate between drivers of different age. Thus, helping older drivers realise how their 

health conditions and their functional limitations may impair driving, may influence their 

decision-making. 

Social-related purposes was the most frequently reported reason for driving. In the present 

study, the diary provided the drivers with the opportunity to think over individual driving 

journeys. Drivers monitored and reported not only on the difficulties and stress they 

experienced, but also on the importance and need for driving. Helping individual drivers 

recognise whether there is a real need for driving, may also influence their decision-making 

about driving. 

It has been found that, drivers with dementia overestimate their capabilities and may not 

restrict their driving, thus, may not ‘compensate’ for their failing abilities, as they are not 

aware of their limitations. Thus, the use of the driving diary as a way of monitoring one’s 

behaviours should be expanded in order to include individuals who may have reduced 

abilities of self-monitoring. In relation to this, the role of social support networks, should be 

investigated further. 






Furthermore, some older drivers may be more reluctant to reduce their driving under high– 

risk situations, for example those who live alone and have no alternative transportation. In 

fact, reports from older drivers’ focus groups consistently indicate that when there is no 

choice but to drive to get to doctor appointments, or to complete everyday errands, they will 

do so. Thus, although recognition of one’s limitations is one of the basic steps in order to 

enhance safety, it is deemed to fail if it is not coupled with the use of means that provide 

sufficient transportation resources to those older populations that need them the most. 

On the other hand, reducing driving when in fact one is still fit to drive, may lead to 

deterioration of driving skills. In the present study, women generally reported more stress 

and less confidence in their driving, and more avoidance of various driving situations. This 

may be related to the finding from other research that shows an increase in the population of 

female older drivers, who mostly rely on their partners, until they take up driving when the 

need arises, for example in the event that their partner is not fit to drive any more. 

Restricted mobility among older people has been found to be related with the onset or 

acceleration of adverse health outcomes, such as depression, even when accounting for 

socio-demographic and health-related factors. Therefore, enhancing the self-awareness and 

preserving the self-esteem of these individuals, may enhance the well-being of older 

populations. 

In conclusion, the role of driving diaries should be expanded to include individuals with a 

wider range of abilities and limitations. In addition, further ways to increase the selfawareness 

should be explored. These endeavours should be tailored to the individual’s 

needs and should be accompanied by alternative transportations that preserve the 

independent functioning and retain the dignity and self-esteem of the senior citizens.

Eleni Karagiannidou - RoSPA

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