Transport, driving and ageing

Abstract

SummaryTransport is the invisible glue that holds our lives together, an under-recognized contributor to economic, social and personal well-being. In public health terms, the medical profession had previously allowed itself to focus almost exclusively on the downsides of transport. However, the research basis for transport, driving and ageing is steadily evolving and has important academic and practical considerations for gerontologists and geriatricians. For gerontologists, teasing out the critical role of transport in the health and well-being of older people is an imperative, as well as the key challenges inherent in transitioning from driving to not driving. The safe crash record of a group with significant multi-morbidity allows us to focus on the remarkable strategic and adaptive skills of older people. From a policy perspective, strictures on older drivers are an exemplar of institutionalized ageism. For geriatricians, a key challenge is to develop strategies for including transportation in our clinical assessments, formulating effective strategies for assessment of medical fitness to drive, incorporating enabling techniques, giving due consideration to ethical and legal aspects, and developing and promoting multi-modality and alternative transportation options.

Driving as a Travel Option for Older Adults: Findings From the Irish Longitudinal Study on Aging

“…One of the most striking trends in the fields of transport, health and aging has been a shift from a previous misplaced emphasis on the safety of older drivers to a realization that a lack of transport access and equity is likely to be a significant threat to well-being and health in later life (O’Neill, 2015). We now know that older drivers are not only a safe group of drivers, but also that their crash rates and fatalities continue to decline (Cicchino and McCartt, 2014) even despite the higher levels of fragility that increases the risk of fatality compared to younger people for a crash of a given severity.…”

Tackling Societal Challenges Related to Ageing and Transport Transition: An Introduction to Philosophical Principles of Causation Adapted to the Biopsychosocial Model

“…The health impact of forced driving cessation seems to be of higher concern [7,46]. There is therefore a natural shift in the domain towards also addressing the problem of social isolation and independence rather than traffic safety alone [12]. This shift is inevitable given cars are already equipped with automatic braking systems, parking systems, and new technology increasing passengers’ security.…”

“…The physician’s role in assessing fitness to drive has therefore shifted from a pure traffic safety perspective [5,6] to a broader perspective that includes other priorities related to driving cessation [7], out-of-home mobility [8,9], mood disorders [10], and quality of life [11]. Physicians and medical practitioners are the privileged partners patients rely on to facilitate their transport transition and prevent social isolation and depression [12]. This biopsychosocial approach of driving cessation requires transdisciplinary skills and a better understanding of causality across disciplines.…”

Inclusion of medical fitness to drive in medical postgraduate training curricula

“…The importance of mobility and transport as a vector of health and well-being is an increasingly recognised element of medical practice. Not only are there many interventions which support and enhance continued driving with relevant medical conditions (1) but also routine advice on such conditions is associated with a 45% reduction in crashes (2). There is concern that doctors are unaware of guidelines on supporting medical fitness to drive (MFTD) (3) (4) (5) (6).…”