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The main goal of the Clinician’s Guide
remains helping healthcare practitioners
prevent motor vehicle crashes and injury to
older adults. Motor vehicle injuries persist
as the leading cause of injury-related deaths
among 65- to 74-year-olds and are the
second leading cause (after falls) among 75-
to 84-year-olds. While traffic safety programs
have had partial success in reducing crash
rates for all drivers, the fatality rate for drivers
over age 65 has consistently remained high.
Increased comorbidities and frailty associated
with aging make it far more difficult to survive
a crash, and the expected massive increase
in the number of older adults on the road
is certain to lead to increased injuries and
deaths unless we can successfully intervene
to prevent harm
The Clinician’s Guide to Assessing and Counseling Older Drivers, 4th Edition is published by the American Geriatrics Society (AGS) as a service to healthcare providers involved in the care of older adults. This 4th edition is an update of the 3rd edition to the current state of the literature, with a continued focus on the interprofessional nature of the team caring for an older adult driver. This edition is the result of a cooperative agreement between AGS and the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA).
The Clinician’s Guide is available in two formats, a digital text accessed through your browser and a downloadable PDF.
Older drivers may have age-related and medical conditions that affect their driving performance.
More than 90% of car crashes are caused by human error. In older adults, age-related changes of decreased vision, cognitive decline, slowed reaction time, and decreased grip strength increase the risk of common driving errors, including straying from driving lanes, failing to observe speed limits, and overlooking traffic signs.
The risk of dying in a car crash is 2.5 times higher for drivers aged 75 to 79 years and 5 times higher for those aged 80 years or older compared with younger drivers.
Older drivers are putting more miles on the road during their “golden years” than generations prior. Many older adults have safe driving habits, but unique age-related changes increase the risk for crash-related morbidity and mortality. Generalists are poised to assess and guide older adults' driving fitness. Although there is no uniformly accepted tool for driving fitness, assessment of 5 key domains (cognition, vision, physical function, medical comorbidities, and medications) using valid tools can help clinicians stratify older drivers into low, intermediate, and high risk for unsafe driving. Clinicians can then make recommendations about fitness to drive and appropriate referrals for rehabilitation or alternative transportation resources to optimize mobility, independence, and quality of life for older adults.
