Home About Us Reports Research Paper 2002 Using Age as a Fitness-to-Drive Criterion for Older Adults Page 2

About Us

Reports

Research Paper

Using "Age" as a Fitness-to-Drive Criterion for Older Adults

The aging of the Canadian population is transforming the demographics of the driving population. With the aging of the baby boom generation, it is anticipated that the number of seniors living in Canada will increase exponentially, reaching 23% of the population by 2041. An increasing proportion of the older population has been driving throughout their adult lives and are expecting to continue to do so. Drivers over the age of 80 years are the fastest growing segment of the driving population.

Although studies of crash rates indicate that persons age 65 and older are relatively safe drivers, other research indicates that it is the oldest drivers (over 80 years) who pose a greater risk to themselves and the public. However, it is unclear from the existing literature whether the abilities of older drivers are compromised because of age itself, or because of the age-associated risk of having one or more medical conditions that can affect driving. This, coupled with the changing demographics of Canadian society, highlights the need for a review of the current laws regulating fitness to drive in the context of age.

We focused our review on the driver of the passenger vehicle as most drivers fall into this class and it is here where jurisdictions differ most in the use of age, and older ages in particular, to trigger some form of driver re-evaluation. In all provinces, testing of fitness to drive includes at least two components: tests relating to ability to drive; and medical tests (such as vision, psychological, physical abilities). It is primarily the latter type of testing in which age is either specifically used as a trigger for testing or is, by implication, a factor in determining fitness to drive. In addition to reviewing the laws and the extent to which they may be discriminatory on the basis of age (Parts 2 and 4), we reviewed the medical and social science literature to examine the extent to which age-related medical conditions affect driving (Part 3). In addition, through focus groups and individual interviews (Parts 5 and 6), we obtained the views of seniors, health care providers, driving researchers, and representatives from licensing authorities concerning the adequacy of the present age-based procedures for identifying problem drivers and the types of changes to the present procedure that may prove beneficial.

The review of the provincial and territorial statutory provisions disclosed considerable variation in how age is used in the licensing process with some provinces imposing testing for personal vehicle licensing up to ten years before others. It appears that one of the major reasons for using age to trigger re-evaluations is that older drivers may be at increased risk for medical conditions that may compromise their ability to operate a motor vehicle safely. In fact, reviews of the medical and social science literature show little data to support the assumption that the effects of age alone (i.e., in the absence of medical conditions) adversely impacts on driving performance. It is easy to erroneously conclude that there is widespread, gradual age-related deterioration in driving skills when only a few debilitated older adults pose a risk to other motorists. To the extent that the age-related testing laws are based on arbitrary distinctions of age alone, they may be legally discriminatory, and are at the least perceived as unfair. Seniors and health care professionals interviewed as part of this research questioned the use of age, per se, as a triggering mechanism. The fact that medical evaluations seemed only to be triggered by age rather than medical conditions (at all ages) was worrisome to both seniors and health care professionals.

In considering the unfairness of the laws requiring evaluations at an arbitrary age, it was recommended that alternate methods of triggering be considered: periodic medical evaluations (at younger ages as well); greater specificity in medical requirements (clearer delineation of the role of the health care professional); changes to existing reporting requirements; re-examination following multiple or specific types of accidents. It was concluded that it is unlikely that any one of these approaches will be sufficient to address the complexity of the issue and that a multifaceted approach targeting persons at increased risk for driving difficulties may yield the best result.

A number of issues relevant to this discussion and the use of age criteria in driver licensing were identified for consideration. Central to this discussion was the need for broad education and focused research to support future policy. It will also be necessary to vigilantly examine for unintended, as well as intended consequences of changes made to licensing policy. The role of alternative mode of transportation to meet the needs of de-licensed drivers was identified as important for consideration as was the cost of implementing criteria other than, or in addition to, age.