Driving, transportation, and mobility in the older adult

Abstract

Older adults drive more miles than prior generations and have mobility and transportation needs that are central to independence and well-being. While older adult crash rates have decreased due to safety improvements, those aged 80 years and older have higher morbidity and mortality from crashes due to physical vulnerabilities. Normal ageing is associated with cognitive, motor, and sensory changes that prompt healthy older adults to modify their driving. Older adults use a wide range of potentially driver-impairing medications that increase accident risk. Glaucoma, visual field changes from strokes, and other impairments assessed in the Useful Field of View test can significantly increase crash risk. Moderate and advanced dementia results in unsafe driving due to the impact on ‘process skills’, resulting in the prevailing opinion that they should not drive. However, there is no appropriate screening instrument to assess driving safety among older adults.