Assessing fitness to drive in the elderly and those with medical conditions: guidelines should specify methods and evidence

Salmi, Louis Rachid; Leproust, S.; Helmer, Catherine; Lagarde, Emmanuel

doi:10.1136/injuryprev-2013-040972

Cited by 10 publications

(11 citation statements)

References 18 publications

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“…Nevertheless, many of the current policies are not consistent with research findings. Given this lack of evidence-based knowledge in current driver licencing policies and guidelines -as demonstrated both in our paper and other recent scholarship (Salmi et al, 2014) -linking modern research evidence with driver licencing practices has remained a major challenge.…”

Section: Discussionmentioning

confidence: 83%

“…Assessments of older people's ability to drive are not evidence-based and fail to meet the criteria for a relevant screening programme (Salmi et al 2014). Overall, research so far has failed to demonstrate that age-based screening procedures decrease the number of crashes.…”

Section: Methodological Aspectsmentioning

confidence: 99%

“…In a recent paper, Salmi et al (2014) point out the very purpose of any screening programme: the early detection of a disease with potentially severe consequences is expected to improve prognosis by facilitating timely treatment. If driver's fitness assessments are assessed against the general criteria for assessing the relevance of a screening programme, they fail, because the potential benefits do not outweigh the disadvantages (Salmi et al 2014).…”

Section: Methodological Aspectsmentioning

confidence: 99%

“…If driver's fitness assessments are assessed against the general criteria for assessing the relevance of a screening programme, they fail, because the potential benefits do not outweigh the disadvantages (Salmi et al 2014). …”

Section: Methodological Aspectsmentioning

confidence: 99%

“…Lately, however, more evidence-based policies have been called for (Desapriya et al 2012;O'Neill, 2012b;Salmi et al 2014;Siren and Meng, 2012), and the trend of measuring impact as relative to the societal investment may be reaching this policy area. Especially during economic hardship, it is indeed in the interest of society to assess whether the costs associated with age-related controls are associated with a distinct road safety benefit.…”

Section: Introductionmentioning

confidence: 99%

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Driving licences and medical screening in old age: Review of literature and European licensing policies

Siren

Haustein

2015

Journal of Transport & Health

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Chronological age, per se, seems to be, in the case of mature drivers, only a weak predictor of safe driving performance. However, screening policies based on chronological age are widely used.Nevertheless, lately, more evidence-based policies have been called for. In this paper we first, investigate the evidence for and against having an age-based driver screening policy in place; second, we map and compare the current driving licensing policies in European Union (EU) member states in order to examine the variation; and third, we draw conclusions based on the literature and the policy mapping and provide policy recommendations. We find no evidence from the literature demonstrating that the benefits from age-based driver screening would outweigh the disadvantages, and we find the European policies, to a large extent, coercive and not evidence based. Based on research evidence, the policies are likely to limit the mobility and potentially worsen the safety of older persons.

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Section: Discussionmentioning

confidence: 83%

Section: Methodological Aspectsmentioning

confidence: 99%

Section: Methodological Aspectsmentioning

confidence: 99%

Section: Methodological Aspectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Driving licences and medical screening in old age: Review of literature and European licensing policies

Siren

Haustein

2015

Journal of Transport & Health

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Beyond Accessibility: Transport Systems as a Societal Structure Supporting Inclusion in Late-Life

Siren

2021

International Perspectives on Aging

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Mobility is associated with well-being, and an age-inclusive transport system is a prerequisite for satisfactory mobility throughout the life course. Yet a transport system – including the physical characteristics of environments, planning processes, design, and policies – involves more than allowing people and goods to move from one location to another. Rather, it is an arena of everyday life, related not only to direct service accessibility but also to wider social inclusion. If the structures surrounding late life transport mobility can match the changing needs of older adults in a changing society, they have the potential for supporting good ageing and social inclusion. Accessibility problems can be targeted through single-domain interventions, such as online shopping, telemedicine and care at home. However, targeting the loss of social inclusion caused by lack of transportation requires a broader understanding of transport as a social structure. This chapter reviews the scholarship on the links between transport mobility, well-being and social inclusion or exclusion. To demonstrate the mismatch between individual aspirations and surrounding structures, it revisits the concept of “structural lag” from the transport perspective. It also gives an overview of knowledge gaps related to transport and social inclusion or exclusion in late life.

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A moving human body causes fatal blunt trauma: an unusual traffic accident

2018

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In urban traffic accidents, mainly pedestrians and cyclists are at risk of being injured and killed. Lethal injuries are usually caused by the immediate impact of a car or a tram. This paper presents a fatal accident without any direct contact with a motor vehicle. A 63-year-old woman sitting on a chair in a pavement cafe was killed by the impact of a 60-year-old male cyclist, who was flung in her direction after colliding with a car. Autopsy yielded intracutaneous haemorrhages on the impact sites of the female victim (left cheek, left shoulder and left upper arm). The woman sustained a ring fracture of the skull base encircling the foramen magnum with subtotal severance of the brain stem and massive chest trauma. All the injuries were caused by the blunt impact of the moving human body. The head was forcibly bent towards the contralateral shoulder resulting in a depression fracture of the skull. Reconstruction of the accident at the scene was challenging, as the fatally injured victim remained sitting on the chair and did not show any striking external signs of traumatisation. According to the assessment of the technical expert, the collision velocity of the moving body amounted to 6-8 m/s.

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Assessing fitness to drive in the elderly and those with medical conditions: guidelines should specify methods and evidence

Cited by 10 publications

References 18 publications

Driving licences and medical screening in old age: Review of literature and European licensing policies

Driving licences and medical screening in old age: Review of literature and European licensing policies

Beyond Accessibility: Transport Systems as a Societal Structure Supporting Inclusion in Late-Life

A moving human body causes fatal blunt trauma: an unusual traffic accident

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