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Abstract
We aimed to assess how often and for what reasons general practitioners (GPs) consider older drivers medically unfit to drive. All GPs certified to carry out fitness-to-drive assessments in Geneva (medical assessors, n = 69), as well as a random sample of 500 GPs practising in Vaud, Neuchatel and Jura, were asked to complete a questionnaire about the mean number of assessments per week, the number of negative decisions in the previous year and the main reason for the most recent negative decision. Completed questionnaires were returned by 268 respondents (45 medical assessors and 223 other GPs, participation rate: 47%). The mean proportion of drivers with a negative decision was 2.2% (standard deviation [SD] 3.3). The proportion was slightly lower among medical assessors (1.1%, SD 1.3) compared to other GPs (2.3%, SD 3.3, p <0.001). The main reasons for being considered medically unfit to drive were cognitive (64%) and visual acuity impairments (18%). GPs in this survey reported considering approximately 2% of older drivers as medically unfit to drive, mainly because of cognitive and visual acuity impairments. Further research should identify how GPs decide if older drivers are fit or unfit, and assess the effectiveness of medical screening in reducing car crashes involving older drivers.
Highlights
The number of older drivers has increased substantially in the last decades and this trend is expected to continue due to population ageing and the improved health of older drivers [1,2,3,4]
Completed questionnaires were returned by 268 respondents (45 medical assessors and 223 other general practitioners (GPs), participation rate: 47%)
The proportion was slightly lower among medical assessors (1.1%, standard deviation (SD) 1.3) compared to other GPs (2.3%, SD 3.3, p
Summary
The number of older drivers has increased substantially in the last decades and this trend is expected to continue due to population ageing and the improved health of older drivers [1,2,3,4]. Some medical conditions such as visual and hearing impairments often lead older drivers to abandon driving [11]. Despite these forms of self-regulation, the demographic shift could have implications for road traffic offices and fitness-to-drive decisions [2,3,4,5]. According to some studies, a range of health conditions (e.g. neurological diseases, visual impairment, psychoactive medication use) which often occur in the elderly could impair driving performance [12, 13]. According to a Swedish study, the increase in the number of older drivers’ car crashes in Sweden from 1983 to 1999 was smaller than the increase in the number of older drivers [14]. The negative health and safety outcomes resulting from this screening may outweigh any safety gains
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