Staying healthy in your car: Coping with
illness and age
About one of every seven drivers is older than 65; that’s a
total of 23 million senior citizens behind the wheel. Illnesses and
age can affect motor vehicle safety. An Alabama study showed that heart
disease, previous strokes, arthritis, and the use of various medications
indicate increased the risk of crashes. But taking a few precautions
can help prevent accidents and injuries.
Every state requires an eye test for licensure; most require a visual
acuity of 20/40 or better in at least one eye and a lateral visual field
width of 140–160 degrees. It’s a reasonable standard, but
it may not go far enough. If you’re over 50, a checkup will protect
you from visual loss due to glaucoma, and it may reveal cataracts or
other problems that can be corrected. If you have problems with your
hearing in daily life, get your ears checked to see if you need help
hearing traffic noises and horns.
Arthritis pain can make it difficult to perform common driving maneuvers
(turning your neck, gripping the wheel, or pressing the pedals). Medication
can ease joint pain, and exercise can increase mobility and strength.
Physical therapy and occupational therapy can be particularly helpful
if they are targeted to improving the functions needed for driving.
Most people with heart disease can drive safely without any restrictions.
If your heart disease is important enough to require medication, it’s
important enough for you to discuss driving with your doctor. In any
case, don’t drive if you don’t feel well.
The minor memory lapses that occur with normal aging should not pose
any problem with driving. In contrast, the forgetfulness, impaired judgment,
and loss of directional skills that may be signs of dementia are very
troublesome. One study found that nearly a quarter of senior citizens
with cognitive impairment continue to drive — and that most doctors
don’t intervene. It’s never easy to give up driving but the
American Academy of Neurology’s guidelines say that persons with
Alzheimer’s disease should not drive, even in early, milder cases.
The same is true for other conditions that cause significant cognitive
Even normal, healthy aging is bound to take a toll on a person’s
reflexes, reaction time, muscular strength and flexibility, and sensory
ability. A few states already require road tests before drivers 75 and
older can renew their licenses, and more are sure to follow, but you
can arrange your own test. Some medical institutions offer 2- to 4-hour
evaluations run by certified occupational therapists. They will check
your observational skills and reflexes as well as your ability to control
your speed, change lanes, and negotiate intersections, where left turns
are a particular challenge for older drivers.
Knowing when it's time to give up your keys is a difficult and sensitive
area without a single guideline that applies to everyone. For most people,
it’s a gradual transition, beginning with not driving during bad
weather, as well as avoiding traffic and night driving. Accidents and police
citations are red flags. A string of accidents means it’s time to
stop; even a single fender-bender may be a warning. Memory loss is another
possible indicator. Forgetting where you put your keys is no problem, but
if you forget where you are going or why you left home, it’s time
to forget your keys permanently. Getting lost in familiar territory, whether
in your car or on foot, is another sure sign of trouble.
November 2005 Update
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