Considerations for Assessment of Medical Competence to Drive in Older Patients

Allen R. Dobbs, PhD, DriveABLE Assessment Centres Inc.; Professor Emeritus, University of Alberta, Edmonton, AB.
Jean A. Caprio Triscott, MD, CCFP, FAAFP, Geriatrics, Program Director, Care of the Elderly Program; Associate Professor, Department of Family Medicine, Department of Medicine, University of Alberta, Edmonton, AB.
Peter N. McCracken, MD, FRCPC, Professor of Medicine, University of Alberta, Edmonton, AB.

The high and increasing crash rates of older drivers is of growing concern, and the role of physicians is coming under greater scrutiny. This is because age per se is unlikely to be the cause of many older driver crashes. The more likely causes are medical conditions, and physicians are well placed to identify patients with medical conditions that may impair the ability to drive safely. Although guidelines are available, these have limitations which reduce their utility in daily practice. This review discusses these limitations and suggests different approaches that are appropriate for evaluating fitness-to-drive for medical conditions having acute episodes vs. chronic outcomes.
Key words: fitness-to-drive, driving assessment, older drivers, physician responsibilities and driving.