Assessing older driver safety

Physicians can play a major role in helping older patients continue to drive safely -- and telling them when it's time to stop driving.

Editorial. July 14, 2003.

One afternoon last month an 81-year-old North Carolina man got into his Toyota Camry with his wife and began to drive. Their trip ended when he made a left turn in front of an oncoming tow truck. The resulting wreck left him dead and his wife fatally injured, said the account in the Winston-Salem Journal.

Sadly, this type of car crash is all too common. Vision, cognition and motor function difficulties brought on by aging and disease make some older drivers a danger to themselves and others. People 65 years and older constitute 13% of the U.S. population but account for 18% of all traffic deaths. The fatality rate for drivers 85 and older is nine times that of drivers 25 to 69.

These statistics point to the critical role physicians can play in helping their patients maintain driving safety. By being aware of medical conditions and medications that interfere with driving, doctors can counsel patients accordingly.

For patients with impairments, physicians sometimes can keep them behind the wheel by treating the underlying disease. Other times, the patient needs a referral to a specialist -- such as an occupational or physical therapist -- who can provide the training an older person needs to keep or to regain driving skills.

In some cases, patients' skills are so poor they should retire from driving. Determining when older drivers are so impaired that they should be advised to hang up their car keys can be hard for their physicians, family members and friends. Breaking the news to the elderly person can be just as agonizing, given the loss of personal freedom and pride it represents.