60…50…40… Are you truly fit to drive?

Baby boomers are big on fitness. They want to be fit to work, fit to play. But what about fit to drive?

Most boomers, when they think of older problem drivers, visualize the stereotypical elderly person behind the wheel, the one who is poking along well under the speed limit, riding the brakes, head barely visible above the dashboard. Time for that person to hang up the keys, they think, thankful that’s an issue that won’t affect them for years to come.

But they might want to rethink that assumption. What many don’t realize is that the problems that may eventually end their driving days are beginning to occur now, at age 60 or 50 or even younger.

A recent survey by the American Automobile Association (AAA), which has partnered with the National Older Driver Research and Training Center at the University of Florida in Gainsville to launch a “Smart Features for Mature Drivers” safe-driving public-awareness campaign, found that 43 per cent of drivers over age 55 suffered from at least one of nine driving-related difficulties commonly caused by aging.

Even at age 40, mental acuity can begin to diminish, making snap decisions and multi-tasking more difficult. According to the Ontario Ministry of Transportation (MTO), drivers often make eight to 12 decisions every kilometre, sometimes with less than half a second to make the call. This means that even small age-related changes can make a big difference.

Vision problems also are occurring at younger ages. “We’re finding with the ozone-layer depletion that people are ending up with cataracts at a much younger age,” says Dr. Lil Linton, a New Brunswick optometrist and chair of the national public-education committee for the Canadian Association of Optometrists (CAO). “We’ve had patients who’ve had cataract surgery in their 40s.” And surgery is usually not done until a person’s vision is less than 20/40, the acuity required for driving.

Other vision problems come into play as people move through their 50s and 60s, glaucoma – which affects peripheral vision – and macular degeneration among the most common, although problems can also occur as a result of health conditions such as diabetes.

Hearing is another area where problems begin to crop up early on. MTO statistics state that by age 65, a third of the population has some hearing loss, and this gradually increases with age, affecting ability to hear horns, sirens and brakes.

By age 60, mobility is often becoming an issue, as muscle strength and range of motion may have decreased by as much as 25 per cent, often making it more difficult to check the blind spot, look for traffic and pedestrians at intersections, merge with oncoming traffic, yield the right of way, back up and park. By the time a person hits 70, arthritic joints may make movement painful. All this impacts the ability to respond quickly.

Medical conditions that may begin to develop around this time, such as Parkinson’s or stroke, can have substantial effects on reaction time, concentration and co-ordination, as can the medications prescribed for these conditions.

An important key to preventing problems on the road is to be aware of the issues and compensate for them.

People, regardless of age, often don’t have a realistic appraisal of their driving abilities, says Dr. Shawn Marshall, a specialist in physical medicine and rehabilitation at University of Ottawa and a principal investigator with the team on older person driving with CanDRIVE, an interdisciplinary research program dedicated to improving safety of older drivers.

“If I’m presenting at a conference and I ask ‘are you a better than average driver?,’ 95 per cent of the people will say ‘yes,’ that they’re better than average, which is impossible,” says Marshall. “Driving is a complex skill and I can guarantee that there’s a huge variability in driving ability.”

He advocates driver refresher courses, particularly those with an in-car/on-road component, as opposed to only classroom sessions.

According to Linton, the same principle of awareness and compensation applies to vision and driving. “We find that quite often people aren’t even aware they’re having a problem because it’s such a gradual change. They say ‘I see just fine,’ and then we tell them they don’t meet the road requirements.”

The best protection is to have regular eye exams, she says. In fact, the CAO would like to see regular vision screening in conjunction with drivers’ licence renewals, ideally starting at age 40, perhaps legislated nationally. “In most cases, now, screening is done when people have their initial driving test and they’re never screened again until they’re probably 80.”

Dr. Irene Turpie, a specialist in geriatric medicine and medical director of the Health for Older Adults program at the St. Joseph’s Centre for Ambulatory Health Care in Hamilton, says the best approach is simply “to age well.”

“Aging well is the secret to everything,” she says. “You look after your eyes because that’s one of the problems that stops you driving. You do the preventive things, like stop smoking because we know there is a correlation between smoking and macular degeneration. You look after your blood pressure because that helps keep you from having a stroke. You exercise, to keep healthy.”

But an additional piece of advice Turpie offers is to “select a healthy community to live in as you get older.” For example, she says, choose communities where it’s possible to get around without having to drive, she says. “So the public transportation system needs to be improved. That would be helpful.”

In terms of choosing where to live, Marshall agrees. It’s part of what he calls planning for “driving retirement.”

“Every single baby boomer out there will be planning for financial retirement,” he says. “But none of them are preparing for the day when they won’t drive any longer. It’s interesting. If you look at statistics, most people have to give up driving 10 years before they pass away.”

And often communities targeting retirees are built in more remote areas where a car is a necessity. “They’re car dependent because they’re outside of public transportation systems.”

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PROBLEMS START EARLY

  • At age 40: Multitasking is more challenging, night vision worsens and recovery from glare is reduced. Cataracts start earlier than they used to.

  • At age 50: Nine in 10 people require bifocals, and reaction time slows.

  • At age 60: Muscle strength and range of motion decrease by as much as 25 per cent.

  • At age 70: Arthritic joints may make movement painful and restrict mobility, and conditions such as stroke, Parkinson’s disease, hypertension and diabetes may affect perception and behaviour.

    – Source: AAA