ASK DR. BAUGHAN                                             January 28, 2000

DRIVING AND AGING

Anyone who has ever obtained a driver’s license can remember the pride and excitement of the day they first passed their driver’s test.  It was a major milestone in self-esteem and independence.  To lose a license due to driving under the influence or repeated traffic violations is a very strong sanction because we are so dependent on cars for our social lives and work.  To give up the privilege of driving because of the effects of aging on the ability to drive safely is a difficult issue that will affect 50 million people by the year 2020.  Currently, older drivers account for 13% of traffic fatalities and 18% of pedestrian fatalities.  How can a person tell if they or a love one is approaching that difficult time when for their own sake or for the general safety of others, they need to consider limiting or stopping their driving?

Diagnosing certain diseases such as strokes, dementia, or Parkinson’s disease may prompt considerations of driving safety.  The gradual effects on vision, hearing, reflexes, and concentration are harder to pick clear points in time to say, “Enough is enough.”  Warning signs of diminishing skills that are fairly obvious include running stop signs or red lights without realizing it, stopping for green lights, nearly missing collisions without being aware, getting lost in familiar areas, changing lanes without signaling or looking, driving on the wrong side of the road, stopping in the middle of intersections, or confusing the gas and brake pedal.  Many people may be aware when it becomes more difficult to see at night and begin limiting their driving to daytime hours only.  A driver may maintain their independence longer if they limit themselves to familiar roads and avoid high traffic situations. 

What physical or medical evaluations are pertinent?  Periodically review medications with your primary provider.  Which ones may affect concentration?  Are they all still needed?  Do not stop medicines without consulting with your physician, though, or you might make the situation worse.  Other than a history of driving problems as mentioned above, it turns out that a history of falls in the past 12 months is one of the more significant markers for driving ability.  Simple physical assessments that can be done include the “Get up and go test” (Can the person get up from a chair by themselves and walk 15 feet in 20 seconds?), the Functional Reach test (Can a person stand slightly more than arm’s length from the wall, then reach and touch the wall without losing their balance), functional range of motion of the neck to be able to turn and look to the left where the car’s “blind spot” would be, grip strength, and arm and shoulder motion (Can the person reach for and fasten the seat belt without difficulty?).

Alcohol is still the biggest risk for driving safety.  An older person who drinks is especially at high risk for causing accidents.  To maintain the ability to drive as long as possible, eliminate any effects of alcohol or unnecessary sedating medicines, maintain mobility of arms and neck as much as possible, ensure that eyes are checked regularly and glasses are worn.  Consider refresher driving courses or evaluations through the Department of Motor Vehicles, driving schools, rehabilitation centers, the AARP, or the American Automobile Association.  And always, buckle up.