Very old drivers: findings from a population cohort of people aged 84 and over

Background Increases in longevity will involve a significant increase among the number of drivers in the very old, who are at greater risk of being in volved in road accidents. Data are thus needed from studies of older popula tions to characterize those still driving, the reasons for giving up and to help formulate appropriate policies for dealing with the problems faced an d created by an increase in older drivers. Methods A driving questionnaire was administered to surviving members of a cohort comprising a representative sample of individuals aged greater than or equal to 84, the Cambridge City over 75 Cohort. Out of 546 survivors 404 completed the driving questionnaire at the 9-year follow-up. In addition, subjects were assessed, at baseline and at each follow-up, for cognitive pe rformance using the Mini-Mental State Examination (MMSE) and for physical i mpairment using the Instrumental of Activities in Daily Living (IADL) scale . Results Of the sample, 37% had driven in the past, and 8.4% were still driv ing, majority regularly. The drivers tended to be younger (mean age 86.6 ye ars), men (71%) and to be married (67.7%). Although physical disability and cognitive impairment are common in this age group, current drivers had few physical limitations on their daily activities and were not impaired on MM SE. None of the current drivers had visual impairment and 22.6% had hearing loss. Of those who had given up driving, 48.5% had given up at the age of greater than or equal to 80. The commonest reasons for giving up driving we re health problems (28.6%), and loss of confidence (17.9%). One-third repor ted giving up driving on advice. Conclusion A process of self-selection takes place among older drivers. Peo ple over the age of 84 who are still driving have generally high levels of physical fitness and mental functioning, although some have some sensory lo ss. Given the likely increase in the number of older drivers over the next decades, safety will be improved most by strategies aimed at the entire dri ving population with older drivers in mind, rather than relying on costly s creening programmes to identify the relatively small numbers of impaired ol der people who continue to drive.