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Archive for Sunday, August 31, 2003

80-year-old wonders how to know when to give up driving

August 31, 2003

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I, like everyone else I know, was horrified by the story of the elderly man in California who ran his car through a busy farmers market unable to stop. I'm 80, and I think my driving skills are still quite good. I don't drive at night except in emergencies.

The tragic story, however, has really been haunting me. How do I know when I need to seriously consider giving up the keys (and a major part of my independence)?

Thousands of people around the country are asking that same question. Partly in response to the California tragedy, the American Medical Assn. just published new guides for physicians to help determine the ability of older citizens to drive safely.

One part of the packet that the AMA is distributing to its doctors is the "Am I a safe driver?" quiz. Patients are told that if they check any of the 20 boxes, their safety and that of others might be at risk. They are advised to talk to their doctor about ways to improve their safety as drivers. Here is the list:

  • I get lost while driving.
  • My friends and family members say they are worried about my driving.
  • Other cars seem to appear out of nowhere.
  • I have trouble seeing signs in time to respond to them.
  • Other drivers drive too fast.
  • Other drivers often honk at me.
  • Driving stresses me out.
  • I've had more "near misses" lately.
  • Busy intersections bother me.
  • Left-hand turns make me nervous.
  • The glare from oncoming headlights bothers me.
  • My medication sometimes makes me dizzy or drowsy.
  • I have trouble turning the steering wheel.
  • I have trouble pushing down on the gas pedal or brakes.
  • I have trouble looking over my shoulder when I back up.
  • I have been stopped by the police for my driving recently.
  • People will no longer accept rides from me.
  • I don't like to drive at night.
  • I have more trouble parking lately.

According to the AMA, the following impaired functions are important for driving.

Vision: Acuity and field of vision are important and tend to decline with age. Diseases such as glaucoma and macular degeneration also impair vision.

Cognition: Driving is a complex activity that requires a variety of high-level cognitive skills, including memory, visual processing, attention and executive skills. Certain medical conditions (such as dementia) and medications that are common in the older population have a large impact on cognition.

Motor function: Muscle strength, endurance, flexibility and proprioception (the body's ability to react appropriately to external forces) are necessary for operating vehicle controls and turning to view traffic.

Declines in these functions make older drivers vulnerable to crashes in complex situations. It's a subject certainly worth talking to your doctor about -- even if it's hard for you to bring up. Good luck.

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