All ETDs from UAB

Advisory Committee Chair

Russell Griffin

Advisory Committee Members

Paul Maclennan

Gerald McGwin

Cynthia Owsley

Hemant K Tiwari

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


Older drivers represent one of the fastest growing age groups of drivers in the United States. Crash risk among older adults, who have the highest prevalence of vision impairment, has been shown to be related to worse visual function. Diabetes mellitus is a chronic health condition affecting more than 23.1 million Americans, and one in three have pre-diabetes. Persons with diabetes are at increased risk of conditions which cause vision loss. Research indicates those with diabetes have higher rates of MVCs. Despite the increased MVC risk among each of these groups, work has yet to evaluate if diabetes modifies the effect of the association between visual function and at-fault MVCs among older drivers. Research is limited which assesses if pharmacologic classifications for diabetes therapy are associated with at-fault MVC rates. Lastly, literature indicates the scenarios and driver behavior for MVCs of older drivers differs com-pared to younger drivers; however, no research has assessed MVC aspects by diabetes status and by visual function impairment status. The purpose of this dissertation is to assess if diabetes modifies the associations of at-fault MVC rates and visual function, to evaluate if at-fault MVC rates are related to medication classifications used in treating diabetes, and to compare MVC characteristics by diabetes status and impairment status for several visual functions. The study sample was comprised of 1995 drivers aged 70 and older who enrolled and were followed for three years. At baseline, visual acuity, contrast sensitivity, visual processing speed, spatial ability, and visual field sensitivity were measured. Participants provided information on medications and self-reported diabetes. At-fault MVCs were obtained from reports from the Alabama Law Enforcement Agency. Findings include that although persons with diabetes have at-fault MVC rates 67% higher than other older adults and persons with diabetes have worse visual function for all measures, visual function was not associated with at-fault MVC rates among those with diabetes. Persons taking sulfonylureas had MVC rates 80% higher than non-users. No MVC characteristics or driver behaviors examined differed between persons with and without diabetes nor were differences observed for those with worse visual function for all functions measured.

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Public Health Commons



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