Dr. Murray Feingold: When is it time for seniors to stop driving?

Dr. Murray Feingold

When is it time to tell Grandpa he should hang up the car keys because he is a danger to himself and others?

This is not always an easy decision to make. Taking away an individual's ability to drive also takes away their independence.

Many older individuals have mild impairments, making it difficult to be certain if their driving represents a danger. Physical and intellectual declines are responsible for limiting an older person's ability to drive.

Because poor vision is an important factor, there are vision tests they must pass. However, one study showed that these tests are not always sensitive enough in sorting out seniors with poor vision. For example, a person with cataracts may still pass the eye exam.

Seniors with arthritis of the neck may be limited in fully moving their necks, and thus are unable to see approaching vehicles as they attempt to switch lanes.

There may also be intellectual or cognitive impairment in older drivers. A recent article quoted a study in which 20 percent of drivers older than 80 failed a cognitive screening test to detect dementia.

These people were more likely to drive off the road, drive more slowly, apply less brake pressure and make slower left turns. They also have more difficulty with lane changing, merging into traffic and signaling to park.

Another issue is the decreased ability to intellectually process what they should do next while driving. They may be slower in making immediate decisions or knowing how to get from their present location to their destination.

Older people take a variety of medications that may have side effects that impair their ability to drive.

However, there are also studies that show the situation isn't all that bleak. A Rand Corporation study reported that drivers older than 65 were two-thirds less likely to be involved in a crash than drivers between the ages of 18 to 25.

It has been theorized that many older drivers are aware of their deteriorating skills and compensate for these lost skills by being more careful and avoiding risky situations.

There also are fewer alcohol-related accidents and less talking and texting on cell phones in this age group.

Although there are driver rehabilitation specialists who perform detailed evaluations to assess a person's ability to continue to drive, better guidelines are needed to help make this very important decision.

Massachusetts-based Dr. Murray Feingold is the physician in chief of The Feingold Center for Children, medical editor of WBZ-TV and WBZ radio, and president of the Genesis Fund. The Genesis Fund is a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.