Handgrip strength in older adults and driving aptitude

a cross-sectional study conducted in traffic clinics with 421 older adults in Curitiba-Paraná from January 2015 to December 2018. A sociodemographic and clinical questionnaire, handgrip strength test, and queries from the National Registry of Qualified Drivers form were applied.

Results:

Reduced handgrip strength was not a predictor of inaptitude for vehicular driving (p=0.649). The predictors of inaptitude were: low education (p=0.011), incomplete elementary education (p=0.027), and cognition (p=0.020).

Conclusion:

reduced handgrip strength was not shown to predict for loss of driving skills in older adults. Low education level and reduced cognition level are conditions that were shown to be predictors for loss of vehicular driving license.

Descriptors:
Elderly; Automobile Driving; Automobile Driver Examination; Hand Strength; Cross-sectional Studies

Variables	n (%)
Age (years)
60 a 69	278 (66.0)
70 a 70	116 (27.6)
80 or more	27 (6.4)
Male gender	294 (69.8)
Marital status married/with partner	296 (70.3)
Education
Incomplete primary education	89(21.2)
Elementary School Complete/High School Complete/Incomplete	172(40.8)
Higher education complete/incomplete	160(38.0)
Monthly income (minimum wage^* * National minimum wage in effect at the time of data collection R$ 954,00; )
Up to 1	60(14.2)
1,1 a 3	137 (32.5)
3,1 or more	224 (53.3)
Disease Record	295(70.1)
Medication Use	280(66.5)
Reported falls in the last year	39(9.3)
No dizziness/fainting/vertigo	409(97.1)
Do not report alcohol consumption	329(78.1)
No tobacco use reported	379 (90.0)
Do not use assistive technologies	416(98.8)
No hospitalizations in the last year	378(89.8)
MMSE score with poor result ^ MMSE - Mini-Mental State Examination.	131 (31.1)
Reduced handgrip strength	84(20.0)

Variables	Detran’s evaluation results
	Fit / Fit with restriction		Unfit		p value
	n	%	n	%
Age					0.622^‡
60 to 69 years	260	93.5	18	6.5
70 to 70 years	109	94	7	6.0
80 years or more	24	88.9	3	11.1
Gender					0.086 ^†
Male	270	91.8	24	8.2
Female	123	96.9	4	3.1
Marital status					0.672 ^†
Married/with partner	275	92.9	21	7.1
Single/Divorced/Widowed	118	94.4	7	5.6
Education					0.002^‡
Incomplete primary education	99	86.8	15	13.2
Elementary school complete/High school complete/incomplete	136	92.5	11	7.5
Higher education complete/incomplete	158	98.8	2	1.3
Monthly income					0.067^‡
Up to one minimum wage	52	86.7	8	13.3
1.1 to 3 minimum wages	128	93.4	9	6.6
3.1 or more minimum wages	213	95.1	11	4.9
Disease Record					0.524^†
Yes	277	93.9	18	6.1
No	116	92.1	10	7.9
Medication Use					0.149^†
Yes	265	94.6	15	5.4
No	128	90.8	13	9.2
Falls					0.314^†
Yes	35	89.7	4	10.3
No	358	93.7	24	6.3
Dizziness/fainting/vertigo					0.567^†
Yes	11	91.7	1	8.3
No	382	93.4	27	6.6
Alcohol Consumption					0.352^†
Yes	84	91.3	8	8.7
No	309	93.9	20	6.1
Tobacco consumption					1^†
Yes	40	95.2	2	4.8
No	353	93.1	26	6.9
Use of assistive technologies					1^†
Yes	5	100.0	0	0.0
No	388	93.3	28	6.7
Hospitalization in the last year					0.053^†
None	356	94.2	22	5.8
1 or 2 hospitalizations	37	86.0	6	14.0
MMSE^* * DETRAN - Paraná’s Traffic Department; MMSE - Mini Mental State Examination; †Fisher's Exact Test (p ≤ 0,05) for the variables MMSE and Hospitalization in the last year; ‡Chi-square test (p ≤ 0,05) for variable education. score					0.002^†
Good	278	70.7	12	42.9
Bad	115	29.3	16	57.1
Handgrip strength					0.468
Preserved	316	93.8	21	6.2
Reduced	77	91.6	7	8.3

Variable	Rating	p ^* * Logistic Regression Model and Wald test, p<0,05. HGS - Handgrip strength; MMSE - Mini-Mental State Examination; CI - Confidence Interval; ref - reference; inc - incomplete; compl - complete; OR - ODDS RATIO	OR	IC95%
Model 1
MMSE	Good
	Bad	0.010	2.90	1.29 - 6.53
Last year's hospitalizations	None (ref)
	1 or 2	0.051	2.76	1.00 - 7.63
Education	Higher Ed. inc/compl (ref)
	Elementary School complete/High School inc/complete	0.016	6.60	1.42 - 30.6
	Up to Elementary School incomplete	0.002	10.4	2.31 - 47.2
Model 2
Handgrip strength	Preserved (ref)
	Reduced	0.670	1.24	0.46 - 3.30
MMSE	Good
	Bad	0.009	2.95	1.31 - 6.66
Last year's hospitalizations	None (ref)
Education	1 or 2	0.081	2.58	0.89 - 7.48
Escolaridade	Higher Ed. inc/compl (ref)
	Elementary School complete/High School inc/complete	0.016	6.62	1.43 - 30.7
	Up to Elementary School incomplete	0.002	10.5	2.32 - 47.4

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Tânia Maria Lourenço E-mail: taniamarlou@bol.com.br