-Dr. Kathy Johnson, PhD, CMC
In a recent study done by the American Medical Association (AMA), it was found that motor vehicle injuries are the leading cause of injury-related deaths in adults over 65 years old. On averaege per mile driven, the fatality rate for drivers 85 years and older is nine times higher than for drivers 25 to 69 years old. AMA has now released a new Physicians Guide to Assessing and Counseling Older Drivers.
“For many, a driver’s license symbolizes independence and the decision to retire from driving can have both practical and emotional implications on a patient’s life,” said AMA President-elect Cecil B. Wilson, M.D.
“Physicians play an important role in the safe mobility of their older patients, and we encourage them to make driver safety a routine part of office visits for their senior patients.”
The AMA’s guide helps physicians talk to their older patients about driving safety and help them to better understand the public health issues involved. The guide covers topics that include screening, assessing functional abilities, handling evaluations and referrals, conditions and medications that may impact driving, addressing safer driving and counseling those who are no longer able to drive.
The Physician’s Guide to Assessing and Counseling Older Drivers was developed by the AMA in cooperation with the National Highway Traffic Safety Administration (NHTSA).
Why Are Older Drivers at Risk?
There are two reasons why older drivers have a higher risk of traffic fatalities: Drivers age 75 years and older are involved in significantly more motor vehicle crashes per driven mile, and older drivers are considerably more fragile and more likely to suffer a fatal injury in the event of a crash then their younger counterparts.
The excess crash rate of older drivers results from impairments in the following functions that are important for driving:
Vision – Vision is the primary sense utilized in driving. Adequate visual acuity and field of vision are important for safe driving, but tend to decline with age as a result of physiologic changes and an increase in diseases such as cataracts, glaucoma, macular degeneration, and stroke. Glare, impaired contrast sensitivity, and an increase in time to adjust to changes in lightness and darkness are other problems commonly experienced by older drivers.
Cognition – Driving is a complex activity that requires a variety of high-level cognitive skills, including memory, visual processing, attention, and executive skills. Certain medical conditions (such as dementia) and medications that are common in the older population have a large impact on cognition.
Motor function – Motor abilities such as muscle strength, endurance, and flexibility are necessary for operating vehicle controls and turning to view traffic. Even prior to driving, motor abilities are needed to enter the car safely and fasten the seatbelt. Changes related to age and musculoskeletal diseases (such as arthritis) can decrease an individual’s ability to drive safety and comfortably.
Declines in these functions make older drivers vulnerable to crashes in complex situations that require good visual perception, attention, and rapid response. As a result, older drivers are more likely to experience crashes at intersections, especially when a left-hand turn is involved.