Background: Attention and executive function may play an important role in ensuring safe driving as they involve paying attention to complex information and making an instantaneous judgment during driving. We hypothesized that poor performance in attention and executive function may increase the risk of near-miss incidents among older drivers. Objective: The aim of this study was to examine associations of current experience of near-miss traffic incidents with attention and executive function among older Japanese drivers. Methods: The study included 3,421 general older drivers (mean age: 71.7 ± 4.9 years; 56.3% men) with a valid driver’s license who were currently driving at least once per week and who had participated in a community-based cohort study between February 2015 and August 2016. The participants were asked about their experiences of near-miss traffic incidents in 10 situations that had almost happened during driving in the previous year. Results: Of the 3,421 older drivers, 1,840 (53.8%) had experienced near-miss incidents during driving in the previous year at least once. Male sex (OR 1.46, 95% CI 1.27–1.69) and high driving frequency (OR 1.11, 95% CI 1.07–1.15) were significantly associated with the current experience of near-miss traffic incidents when the overall data were analyzed. In young-old drivers aged 65–74 years, poor performance in attention as assessed by the Trail Making Test-part A (OR 1.45, 95% CI 1.05–2.00) was significantly associated with near-miss traffic incidents. Conclusion: Male sex, high driving frequency, and poor performance in attention (in young-old drivers) were associated with near-miss traffic incidents. Improvement in attention may play a role in decreasing the risk of traffic accidents among older drivers.

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