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