In Japan, Driving Skill Training for Older Drivers Enhances Safety

Journal of the American Geriatrics Society Research Summary

More older adults in the US are driving than ever before, according to the Centers for Disease Control and Prevention (CDC). In fact, 56 percent more older adults were on the road in 2016 than in 1999. But as age increases, so do the risks for having a crash while driving. In 2016 (the last year for which statistics are available), motor vehicle crashes killed about 7,700 people over the age of 65 in this country, and 290,000 more were injured.

According to the CDC< fatal automobile crash rates spike between ages 70 to 74, and are highest among drivers 85 and older. These older drivers’ deaths are caused as much by their increased frailty and medical complications as by their increased risk of crashes. Age-related vision problems, the ability to think and make decisions, and age-related physical changes such as arthritis pain may also affect the ability of older adults to safely operate a motor vehicle.

As in the U.S., Japan’s population of older drivers has also grown. A national traffic safety report noted that over five million people in Japan aged 75 years or older — one in three people — had a driver’s license. The rate of fatal crashes for those aged 75 or older gradually increased from 7.4 percent in 2006 to 13.5 percent in 2016. Continue reading

When Do Age-Related Problems with Memory and Decision-Making Begin to Affect Older Adults’ Ability to Drive?

Journal of the American Geriatrics Society Research Summary

For older adults, driving can mean living a more independent, satisfying life. Therefore, it’s no surprise that about 86 percent of adults age 65 and older hold active driver’s licenses, and many of us expect to drive for longer as we age.

Car crashes can be devastating or even deadly for anyone, including older adults and other road users. However, the fatal crash rate based on the distance someone travels in a vehicle begins to rise at age 65. At the same time, when older adults stop driving due to health issues or other concerns, they may experience isolation and depression. They also may be more likely to enter long-term care facilities earlier than they otherwise would.

Researchers have a history of studying driver safety in older adults after they’ve been diagnosed with dementia, a decline in memory and other mental abilities that make daily living difficult. However, we have limited knowledge about the effects on older drivers whose problems with mental abilities are less severe than those associated with dementia.

Recently, a team of researchers designed a study to learn more about cognitive health and older drivers’ crash risks. The study was published in the Journal of the American Geriatrics Society. In this study, the researchers focused on links between levels of cognitive function and crash risk among older drivers without dementia over a 14-year study period. They also assessed the link between changes in cognitive function over time and later risks of crashes. Continue reading

Older Drivers Who Experience Falls May be at a Higher Risk for Car Crashes

JAGS graphicJournal of the American Geriatrics Society Research Summary

As we age, our ability to drive may help us live independently, shop for ourselves, and maintain social connections. Although car crash rates are low among older adults and are declining, older adults do still have higher rates of fatal crashes. Falls, which are a common and preventable cause of injury among older adults, may lower our ability to drive safely.

Experts believe that falls are related to driving in four ways:

  • They can cause physical injury that limits mobility (our ability to move) and interferes with driving performance.
  • Falling can increase the fear of falling, which leads to a reduction in physical activity. Reduced physical activity can weaken our physical strength, which also could reduce fitness for driving.
  • Falls can affect an older adult’s mental well-being, making them more fearful and leading to changes in driving behaviors.
  • Falls and difficulty driving may be caused by common factors, such as vision problems.

A research team created a study to see whether falls were related to driving risks and behaviors among older adults. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Taking the Keys Away: A Geriatrician’s Perspective

okhraviHamid R. Okhravi, MD
Associate Professor of Medicine/Geriatrics
Director, Driving Evaluation Clinic
Director, Memory Consultation Clinic
Glennan Center for Geriatrics and Gerontology
Eastern Virginia Medical School

As geriatricians, we often need to have difficult conversations with our patients, their families, and/or their caregivers. One of the most difficult of these is when we have to tell a patient that he or she is no longer capable of driving safely.

Not so long ago, I had this discussion with a patient of mine, Mr. M, a 79-year old with mild dementia. His daughter brought him to our Memory Clinic when she became worried about his driving skills.

According to Mr. M, he’s a good driver. But his daughter told me that Mr. M had caused two minor accidents within the last year. She also said that he occasionally got lost when driving outside his familiar routes.

I gave him tests to gauge his ability to think and make decisions, and he did poorly on all three of them.

When I discussed his test results with Mr. M and his daughter, I explained that his impaired performance didn’t necessarily prove that he’s an unsafe driver. However, his scores did show that his driving skills needed further evaluation. I suggested that medical disorders, such as cognitive impairment, could worsen his skills and increase the risk of driving errors that can lead to vehicle crashes.

Naturally, Mr. M was unhappy to hear what I had to say. He told me that he’s always been a safe driver, and he refused to stop driving. He told me that not being able to drive would change his life for the worse, and that it would be terrible not to be able to shop for groceries or attend the two weekly social activities he enjoys with his friends.

Despite his concerns, with his daughter’s encouragement, he agreed to have his driving evaluated. Continue reading

On Becoming an Older Driver

altshul headshotSara Altshul
AGS Staff Writer

I didn’t run right out and get my driver’s license on my 16th birthday, like so many of my high school pals did. In my rural hometown, a car was more necessity than luxury. Town was three miles away, school even further.

But my overprotective mom was reluctant to let me learn how to drive on her new manual-shift Saab. Instead, she chauffeured me wherever I wanted to go, and if I wanted to get somewhere when she wasn’t around, I walked or got a ride.

I finally got my license at 18, a few months before landing the coolest summer job of all time – as a Good Humor truck driver. Soon, I bought myself a $500 Simca, a tiny four-door French beauty whose battery was tied on with a shoelace. I had it for years before it literally fell apart.

Since then, I’ve driven hundreds of thousands of miles. Two cars I owned during my 40’s topped out at nearly 200,000 miles each. For the three years I lived there, I even zipped through the Italian countryside, up hills and through narrow, cobblestoned streets, in my second-hand, four-on-the-floor Mitsubishi. Coming to a stop on Tuscan hills in first gear took plenty of practice. Just ask my husband.

Thankfully, I’ve never had a crash and despite a speeding ticket or two over the years, my driving record is pristine.

I’m 66 now. My faculties are sharp and intact. But when I’m driving, I recognize that I have to be more conscious, more focused, and more alert than my younger self ever was. I exert a deliberate effort when I’m behind the wheel: I don’t pass as frequently, I don’t go as fast, and I don’t take chances like I may have done in the past. I am acutely aware of keeping myself, and my passengers, safe on the road. Continue reading