AMA Guide to Assessing and Counseling Older Drivers

Motor vehicle injuries are a leading cause of injury-related deaths in the older population (persons 65 years and older). Per mile driven, the fatality rate for drivers 85 years and older is 9 times higher than the rate for drivers 25 to 69 years old.

Physicians play an important role in the safe mobility of their older patients. The AMA encourages physicians to make driver safety a routine part of their geriatric medical services and the guide is freely available as PDF documents here:

AMA Physician's Guide to Assessing and Counseling Older Drivers

For example, dementia is just one of the risks that older drivers face:



Evaluation of driving risk in dementia (click to enlarge the image).

For patients with dementia, the following characteristics are useful for identifying
patients at increased risk for unsafe driving:

- Clinical Dementia Rating scale (Level A)
- caregiver’s rating of a patient’s driving ability as marginal or unsafe (Level B)
- history of crashes or traffic citations (Level C)
- reduced driving mileage or self-reported situational avoidance (Level C)
- Mini-Mental State Examination scores of 24 or less (Level C)
- aggressive or impulsive personality characteristics (Level C)

References:

AMA Physician's Guide to Assessing and Counseling Older Drivers

Evaluation of driving risk in dementia - practice parameter update

Q&A from CCJM: When should I discuss driving with my older patients? http://buff.ly/1xeoBTw

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