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Many people are living longer, and that means more older drivers are behind the wheel. It is a trend that continues to raise safety concerns on the road. This week is dedicated to Older Driver Safety Awareness.
Older drivers -- the facts
Older drivers have fewer motor vehicle crashes than younger drivers, mostly because they drive less. Per mile, though, crashes increase as people reach their 60s and beyond, at the levels seen in younger drivers. This suggests that age, or age-associated impairments, may be important risk factors. Consider these statistics:
The good news is that the trends show a decline in this risk over the past 20 years, possibly related to better safety standards as well as older drivers being more physically fit than in the past.
Conditions impacting driving safety
It is important to remember that aging itself is not the main problem affecting driving safety, but some medical conditions, that are treatable, may come with age that can impact driving ability for some people.
Dementia is among the top medical conditions associated with increased risk of car accidents. Beyond year three of the disease, the crash risk increases to that of a teenage male. Men with dementia are at higher risk. Patients with very mild to mild dementia need close monitoring and regular driving competency assessments, every 6 months. Some patients with mild dementia may continue to drive safely for up to a year. Once a physician diagnoses dementia, the question is not “if” a person should stop driving, but rather “when.”
Measuring driving ability
While the American Medical Association offers guidelines for physicians on the best ways to assess and monitor the older driver, guidelines and office-based measures do not predict crash risk with a high degree of accuracy! They may offer “red flags,” but problems identified through such office screening tests cannot alone be used to make a final recommendation on the need to retire from driving.
Cognitively impaired older drivers are often unaware of their driving and other functional limitations, so it is important for the physician to recognize a driver with early dementia and provide appropriate guidance on driving restrictions when necessary. You or another family member or friend should accompany a loved one to his or her appointments because patients may not accurately report their driving abilities and experiences.
Physicians also have access to other specialized assessments and performance-based testing that can be used to help in decision making. A formal road test may be recommended, but that testing is expensive, and may not be an affordable option for all families.
Here are other resources:
Plan for the future
In my experience working with patients and families, gradually reducing driving when necessary is less emotionally traumatic for the driver and is usually more successful than abruptly ending one’s driving privileges. Before recommending driving cessation, it is best to have completed medical evaluations related to driving so that you feel confident that it is time. This step will present a loss of autonomy – and will also be accompanied by emotional and practical implications for the driver. These are all things that will need to be addressed.
Brian R. Ott, M.D., is a neurologist at Rhode Island Hospital, where he is also director of the Alzheimer’s Disease and Memory Disorders Center. He is a world renowned researcher and expert on older drivers and drivers with dementia. Currently he is developing a video camera based intervention to help older drivers with mild cognitive impairment or early dementia. For more information about this program, call Justine Bernier at 444-6922, email firstname.lastname@example.org.