Driving impairment in the aged

Older drivers may have age-related and medical conditions that affect their driving performance.

More than 90% of car crashes are caused by human error. 

Age and impaired driving- Age-related changes of decreased vision, cognitive decline, slowed reaction time, and decreased grip strength increase the risk of common driving errors, including straying from driving lanes, failing to observe speed limits, and overlooking traffic signs 

The risk of dying from a car crash is 2.5 times higher for drivers aged 75 to 79 years and 5 times higher for those aged 80 years or older compared with younger drivers.

 Acute medical conditions that can impair driving include seizures, fainting, low blood pressure, low blood glucose, and irregular heartbeat, which may cause dizziness or trouble breathing.

Chronic medical conditions that can impair driving include dementia, neurologic conditions that affect muscle strength and coordination such as Parkinson disease or a prior stroke, and untreated sleep apnea, which increases the risk of falling asleep while driving.

Medications that cause sleepiness or affect the ability to think clearly, such as benzodiazepines, opioids, anticholinergic drugs, and certain anticonvulsant and antipsychotic drugs, increase the risk of car crashes. 

Distractions- cell phones or texting while driving should be discouraged, sedating medications should be avoided.

Treatment of potentially reversible risk factors, such as cataract surgery for impaired vision or continuous positive airway pressure (CPAP) therapy for sleep apnea, are recommended.

Performance-based road tests can help evaluate how well older drivers navigate traffic situations and determine if their driving privileges should be revoked.

Technology that can alert drivers if they are drifting from their lane, if a vehicle is in their blind spot, if pedestrians are in their path, or if they must take action to avoid a crash. 

Automatic parallel parking and emergency braking and provide alerts about worsening weather conditions or obstructed traffic signs, which may also decrease driving errors. 

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