Easier-to-use fitness-to-drive guide on way from CMA.
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OBJECTIVES: This article provides estimates of the percentage of seniors who are licensed to operate a motor vehicle. It describes the health characteristics of these license holders and reviews research relating to older drivers. DATA SOURCES: The data are from the cross-sectional file of Statistics Canada's 1996/97 National Population Health Survey. The sample size of respondents aged 65 or older was 13,363, weighted to represent 3.4 million individuals. Supplementary data are from the 1991 Survey of Ageing and Independence, also conducted by Statistics Canada, and from Transport Canada. ANALYTICAL TECHNIQUES: The percentages of seniors with a license were calculated by age and sex. Percentages by presence of chronic conditions, disabilities and medication use were age-standardized to control for the increasing prevalence of illness at older ages. MAIN RESULTS: The percentage of seniors who had a driver's license declined with advancing age. The negative association between disability and license holding was pronounced. The percentage of seniors with a driver's license was also relatively low among those with heart disease, arthritis, stroke or cataracts, and among those who reported taking selected medications in the last month.
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Among older adults who drive, the rate of those involved in fatal crashes rises after age 70. Problem driving in older adults involves visual, cognitive, and motor skills, which may decline with aging and chronic disease. Physicians and other health care providers may not be prepared to evaluate and advise the older patient on the emotion-loaded topic of driving ability. Although it is difficult to identify prospectively a high-risk driver, a targeted history and physical exam are useful clinical tools. Two models are proposed to guide the health care provider and patient through the process of limiting or ending the impaired older driver's time behind the wheel.
The dynamic impact tests at Southwest Research Institute for the first time exposed human volunteers to production-like driver air cushion system depolyments at impact levels equivalent to a 30 mph barrier crash (48 kph). No significant injury was produced. At no time was it necessary for the secondary restraint systems to be utilized and the entire program schedule was carried out as planned. All tests were conducted under the most safe and controlled conditions possible, and typify only what the air cushions might accomplish in direct, head-on impacts up to 30 mph (48 kph). In comparing the test results, the anthropomorphic dummies' response to impact was conservative compared to the human volunteers. These and other human volunteer tests were run to help understand what might be expected in real world driving conditions. To further understand the value of this new safety system, 1000 1973 Chevrolets were built and places in a high mileage fleet across the couhtry. They now have accumulated 41 millions miles of experience and have had 15 accidents of sufficient severity that the air cushion depolyed. This fleet was followed with 1974 vehicles with air cushions sold to the general public as an option. These cars, combined with the test fleet, have accumulated approximately 60 million miles and have a total of 25 depolyments with 34 occupants in the front seat. There has been one fatality in accidents involving these vehicles, a seven week old baby boy. The child was not restrained in any protective carrier. All other injuries have been classified AIS-1 except for three AIS-2. Facial injuries have been very minimal and there have been no known hearing impairments as a result of these accident situations. To date, the results have been encouraging but caution must be taken in their interpretation. The population of drivers is not to be considered normal. The 60 million miles may appear to be a large number, but only represents 25 minutes of driving time of the total U.S. car population in 1 year.
Medical aspects of driving safety are discussed. Legal problems in first care of victims of accidents and evaluation of fitness to driving are analyzed. The paper is addressed to specialists in public health management.
An interdisciplinary approach to licensing partially-sighted individuals to drive is presented. The model includes the participation of optometry, special education, and the department of motor vehicles.