Introduction

To maintain their independence and social participation, more elderly people continue to drive. However their driving competency may be affected by the visual, physical, and cognitive changes associated with aging. This may make them more vulnerable to personal injury or fatality risk in the event of an accident. Data from Netherlands showed that the fatality rate is 5 times more for those > than 75 years, whereas the injury rate is doubled.

However using rigid age boundaries do not take into consideration the fact that the rate of ageing differs from one individual to another. There can be a large difference in driving skills between people of the same age, as well as in their physical and mental abilities.

The greatest increase in risk occurs when cognition is affected, associated with a 2 to 8 fold increase in the risk of at fault crash (Diller, Cook et al, 1998). A wide variety of medical conditions can affect mental abilities important for safe driving. (McCracken et al. 2001). However it had been shown that people with dementia continue to drive for about 4 years after the onset of symptoms. (Hopkins, 2004).

Factors that can affect road safety include:

1. Functional limitations
2. Physical vulnerability
3. Low annual mileage
4. Awareness or insight of one’s limitation
5. Driving experience
6. Compensation behavior
7. Medical illness (linked to Medical aspects of fitness to drive: A guide for medical practitioners. Website: www.nzta.govt.nz)

Complications

• High fatality rates
• Low injury rate

Preventions

1. Measures to reduce injury severity
   • Improve active vehicle safety
   • Improved passive vehicle safety
2. Measures to reduce crash involvement
   • Provision of education and training for older drivers
   • Infrastructural adaptations
   • Driver assistance systems
3. Measures of timely driving cessation
   • Licensing procedures
   • Doctor consultation

Rehabilitations

1. Driving assessment – simulated and on the road.
2. Improved awareness of driving deficits

Support group

1. Road Transport Department
2. Malaysian Occupational Therapist Society
3. Malaysia Society of Neurosciences
4. Malaysian Psychiatric Association
5. Malaysian Medical Association

Reference

1. Older drivers, Safety net (2009); Project co- financed by the European Commission, Directorate-General Transport and Energy.

2. Kay LG, Bundy AC, Clemson L. Awareness of driving ability in senior drivers with neurological conditions. Am J Occup Ther. 2009; Mar- Apr; 63(2): 146-150

3. Diller E, Cook L, et al. Evaluating drivers licensed with medical conditions in Utah 1992-1996. NHTSA Technical Report HS 809023, 1998. Washington.

4. Hopkins R, Kilik L, Day D, et al. Driving and Dementia in Ontario: A quantitative Assessment of the problem. Canadian J of Psy, 2004,; 49:434-438.

5. McCracken P Caprio Triscott J, et al. Driving with Dementia. The Canadian Review of AD and other dementias. 2001; 14-20.