Staying behind the wheel

Enhanced safety and quality of life are goals of a Canada-wide study on older drivers

by Val Shore

Tests currently used by doctors to assess a senior’s ability to keep driving need to be improved, a long-term study of older drivers is revealing.

“The currently available guidelines for physicians are not doing a very good job of identifying people at risk,” says Dr. Holly Tuokko, a psychologist with the University of Victoria’s Centre on Aging. “We need a better set of tools.”

Tuokko is part of Candrive, a Canada-wide research study aimed at improving the safety and quality of life for older drivers. The study is following the progress of 928 drivers aged 70 and older in seven Canadian cities—including 125 in Victoria—as well as about 300 participants in Australia and New Zealand.

Candrive is asking questions such as: How do seniors get assessed for their driving ability? And what are their attitudes toward driving as they age and health issues emerge?

Current physician assessments of seniors rely on what’s called a “mini-mental state” examination, which asks questions such as: What day is it? Can you remember these three words? Can you draw this diagram?

But there are other reasons why an older person may have difficulty on the road. They may not be able to move their bodies with sufficient flexibility or not know where their foot is in space, so they hit the gas instead of the brake.

"These kinds of issues are not typically on the radar for general physicians who are trained to identify a medical problem but have little or no training on whether that problem can affect driving," says Tuokko.

As a result, some seniors who should be going for driver evaluation tests are being missed, while others are being sent for tests unnecessarily.

Candrive is developing an easy-to-use clinical screening tool that will allow family practitioners to assess medical fitness to drive in older adults.

The team is also gathering data on violations and crashes, and tracking the 928 Canadian drivers over time with annual assessments and an in-car digital tracking device.

The device plugs in underneath the dashboard and records when and where they're driving. There’s also a GPS unit on the dash so that the study team can draw maps based on data such as route, stops and speed.

The results can be revealing, says Tuokko. "What people say they're doing and what they actually do don't always line up. Given that most doctors depend on patients to self-report their symptoms, these discrepancies are a little surprising."

Tuokko's own focus within Candrive is on the attitudes of seniors about their driving, and how those change over time. Do they restrict their driving under certain conditions? And what process do they use to stop driving?

The ultimate goal is to encourage drivers to self-reflect and self-regulate, rather than leaving it until someone takes their license away, says Tuokko. "It's much better for them mentally and physically if they make that decision on their own."

Mostly, Tuokko hopes the work will lead to increased safety for seniors who drive, and an awareness that older drivers are not necessarily bad ones. "Age is equated with poor driving but I don’t believe that’s appropriate," says Tuokko. "The focus should be on safety, not driver age."

View as PDF.