AMA Issues Older Driver Safety Guide to Help Slow
Leading Cause of Injury Deaths in Seniors
Per mile driven, fatality rate for drivers 85+ is
nine times higher than for drivers 25 to 69
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March 17, 2010 - To help protect the lives of
senior citizens and make our roads safer, the American Medical
Association (AMA) has released a new Physician's Guide to Assessing
and Counseling Older Drivers. Motor vehicle injuries are a leading
cause of injury-related deaths in adults over 65. Per mile driven, the
fatality rate for drivers 85 years and older is nine times higher than
for drivers 25 to 69 years old.
For many, a driver's license symbolizes
independence and the decision to retire from driving can have both
practical and emotional implications on a patients 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 AMAs guide can help physicians address the
driving safety of their older patients and better understand the public
health issues involved. Topics covered in the guide 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.
A section with worksheets and resources for older
patients and caregivers is also included.
Older drivers have a higher risk of traffic
fatalities for two reasons: Drivers age 75 and older are involved in
significantly more motor vehicle crashes per mile driven, and older
drivers are considerably more fragile and more likely to suffer a fatal
injury in the event of a crash than their younger counterparts.
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).
The guide in pdf format is currently available
online -
Click Here.
To order a hard copy or CD ROM, please send your
name and preference
Click Here.
Physicians can order a free hard copy to be
available in four-six weeks Click Here
Later this year, a Continuing Medical Education
course for physicians will be offered on the AMAs Web site.
Why Are Older Drivers at Risk?
Here is AMAs Answer
Older drivers have a higher risk of
traffic fatalities for two reasons. First, drivers age 75 and older are
involved in significantly more motor vehicle crashes per mile driven
than middle-aged drivers. Second, older drivers are considerably more
fragile than their younger counterparts, and are therefore more likely
to suffer a fatal injury in the event of a crash.
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 funtion - Motor abilities such as muscle
strength, endurance, flexibility, and proprioception 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.
The AMA has adopted several policies with regard to
driving by older people. Links to these are below.
●
H-15.992 Motor Vehicle Accidents
In this policy, the AMA recognizes motor vehicle-related trauma as a
major public health problem.
●
H-15.972 Licensing People to Drive
This policy encourages research and development of screening methods and
articulates the physician's role in advising patients on driving safety.
