The health of the older driver

The Body

Vision - Cataracts, glaucoma, and macular degeneration can affect how well you see.

The older driver and/or concerned family members need to

  • get test results directly from the vision care professional
  • ask the professional if your vision affects your ability to drive safely

After a person reaches the age of 50, cataracts and other vision problems can quickly impair the ability to drive safely. Cataracts and some other eye conditions can be corrected to restore good vision. Annual vision examinations are very useful to identify vision problems so the problems can be corrected.

It is easy to see that good vision is important to safe driving. That is why an older driver who wears eyeglasses or contact lenses must always wear the lenses while driving.


Hearing
- An annual hearing exam is also very important for older drivers. Report any change in hearing to a doctor immediately. A hearing loss can come from a problem that is easy to correct, like wax or an object in the ear canal.


Range of Motion - For complete safety, it is not enough to use the rearview mirror when a driver turns or changes traffic lanes. A driver must be able to look through rear and side windows into the blind spots on both sides of the vehicle. It is dangerous if a driver cannot turn their head and shoulders enough to look to the sides.


Reaction Time - It is normal for reaction time to slow down as a person gets older. To reduce the possibilities of a crash, an older driver can learn to keep more space between their vehicle and other highway users. Even if the driver allows for more space it will not be enough if the reaction time of the older driver has become very slow.


Medicines

Medicines that are necessary for the health of an older person can also cause driving problems. Some drug combination can affect vision, judgment and response time, and can even appear to be dementia.

An older driver or a family member can take these steps to help an older person to continue driving safely:

Collect a list of the over-the-counter (OTC) medicines the older driver normally uses

  • check medicine cabinets, kitchen cabinets and drawers for any medicines the older driver normally uses
  • collect information about all the prescription medicines that the older driver uses and write a list, including
    • the exact name of the medicine and the name of the doctor who prescribed the medicine
    • the expiration dates, dosages and the times the person is to take each medicine

Take the list to a pharmacist

  • share the information with the pharmacist and ask which OTC medicines can interact with other OTC medicines or prescription drugs
  • ask for a printout of information for each prescription drug and information about the OTC medicines. The printout and the pharmacist can supply important information about driving after the driver uses the drug

Check for

  • more than one prescription from more than one doctor for the same drug
  • more than one prescription written at the same time by one doctor for one drug
  • label directions or doctor instructions that are not clear
  • automatic refills that do not require the authorization of the doctor
  • drug expiration dates that have passed
  • caps that are easy for the older driver to remove, but that are also easy to fasten tightly again (if the older driver cannot remove the cap easily, they can decide to go without doses of the medicine)
  • the behaviors of the older driver after new medicines are prescribed (for at least the first six weeks of a new medicine, look for reactions or behaviors that are not normal)


Conditions That Are Like Dementia and Other Medical Conditions

Alzheimer's disease and other dementia conditions are well known and the subject of much publicity. However, there are some medicines and other medical conditions that can cause actions and behavior that appear to be dementia. For example, anemia or mental depression can cause reactions and behaviors like those of a person who has a type of dementia.

It is important to understand which conditions can appear to be, but are not, dementia. If the true problem can be corrected, it can add years of safe driving for the older driver. The following can have some of the same qualities as dementia:

  • D — Drugs - the effects and side effects of single drugs or combinations of drugs
  • E — Emotional distress and depression
  • M — Metabolic diseases and diseases of the endocrine system
  • E — Eye or ear problems or environmental problems like allergies
  • N — Nutritional or neurological conditions (for example a mini-stroke)
  • T — Tumors or trauma (for example a fall where the head is injured)
  • I — Infections - some infections can cause confusion
  • A — Alcoholism, anemia, or atherosclerosis

A stroke, arthritis and other diseases that affect nerves, joints, bone or muscle, can also make vehicle control difficult. These conditions can put an older driver at risk.


Additional Information and Resources

The U.S. National Highway Traffic Safety Administration (NHTSA) has additional information about the health and safety of older drivers and older pedestrians:

Web Sites for People with Alzheimer's Disease and their Families

Alzheimer's Association
Alzheimer's Disease Education and Referral (ADEAR) Center
NYS Dept. of Health Information on Health Care Facilities
NYS Dept. of Health Information on Alzheimer's Disease and Other Dementias 
Help with Alzheimer's Disease and Other Dementias at NYS Dept. of Health