Hanging up your car keys ...
It is inevitable that you will have to stop driving at some point. While there are strategies that can mitigate some of the age-related changes that make driving more difficult as you age, there will come a time when driving isn't safe for you. The statistics make sobering reading: fatal crash rates increase noticeably starting at about age 70, and are highest among drivers age 85 and older, largely due to increased susceptibility to injury and medical complications among older drivers. However, giving up driving can affect us in ways we might not imagine, as is highlighted by one of the studies featured in this month's Newsbriefs. The findings indicate that older adults experience faster declines in cognitive function and physical health after they stop driving, and also have to contend with a considerable reduction in the size of their social network.
Age-related changes do impact our ability to drive safely. For example, our eyes may become oversensitive to headlight glare at night, and medical conditions such as arthritis can make the physical aspects of driving more challenging--you may find it harder to fully depress the brake pedal swiftly during an emergency stop, and may have trouble looking over your shoulder before changing lanes. Also, certain medications (including antihypertensives, antidepressants, and painkillers) can make you less alert, and affect your coordination.
Working around these limits may help you keep driving for longer. If you need glasses to see clearly, make sure the prescription is current, and if you take medications, talk to your doctor or pharmacist about adjustments that could aid safe driving. Use less busy routes, and schedule journeys during daylight hours. Since accidents are more likely when turning left, make three right turns instead of a left. Modify your car by adding larger wide-angle side and rear-view mirrors to minimize blind spots, or upgrade to a newer car with more safety features.
Cognitive changes also can affect driving, and are particularly difficult to tackle with older adults who may not be aware of their diminished driving skills. If you or a loved one get lost while driving to a familiar place like a grocery store, often confuse the brake and gas pedals, or frequently hit curbs while driving, you need to hang up your car keys for your own safety and the safety of other road users. But your wellbeing needn't suffer. When I've had this conversation with patients, something I do is discuss just how much it costs to run a car. If you add up the cost of insurance, vehicle registration, maintenance, and gasoline you may be surprised at how much money you could have at your disposal for other forms of transport that will ensure you aren't socially isolated. Your local senior center may offer a transportation service to get you there and back, while many county transportation departments operate a "dial-a-ride" bus service that provides curb-to-curb transit for seniors and people with disabilities. The Independent Transportation Network of America website (www.itnamerica.org) also has information on a transport network that can help keep you mobile after you give up driving.
By Rosanne M. Leipzig, MD, PhD Editor-in-Chief