By Stacy M. Brown | The Washington Informer | Word In Black
This post was originally published on The Washington Informer
(WIB) – Millions of older Americans take to the roads daily, driving to doctor’s appointments, grocery stores and social events. However, according to researchers, the healthcare system lacks effective mechanisms to assess their fitness to drive.
While driving is a cornerstone of independence and connectivity, nearly one in six older drivers experiences mild cognitive impairment.
In Washington, D.C., Vision Zero data from 2016 to 2019 revealed that crashes involving drivers 65 and older accounted for nearly 9% of all incidents, resulting in 1,152 injuries and seven fatalities. Despite driving less frequently than other age groups, researchers said older drivers present unique challenges due to age-related declines in vision, reaction time, and cognitive abilities.
In 2020, the United States had 48 million licensed drivers over 65. Of these, an estimated 17% experienced mild cognitive impairment — a condition that increases the risk of motor vehicle crashes. That same year, crashes involving drivers over 65 resulted in 7,480 deaths and nearly 150,000 injuries. The statistics reveal an urgent need for reliable evaluations to determine which seniors should remain behind the wheel.
“I’m in an Uber and I got an elderly driver,” social media user Ezee, wrote on X (formerly known as Twitter). “Nothing wrong with some elderly drivers getting their hustle on, but the ones I get seem to almost always get into a car accident because they can’t see good or drive good.”
A recent study by researchers at Brigham and Women’s Hospital lays bare the gap in the healthcare system’s ability to address this issue. The researchers argue that with approximately 8.2 million people over 65 years old experiencing mild cognitive impairment, a comprehensive healthcare approach is essential to evaluating and addressing driving safety among older adults.
Researchers noted that family physicians often face a difficult dilemma when assessing an older patient’s ability to drive. They said that existing cognitive tests are usually inadequate, and the stakes are high. Removing a license prematurely can lead to depression and social isolation while failing to identify unsafe drivers endangers everyone on the road.
The study authors concluded that specialized driving evaluation programs offer a promising solution, particularly on-road evaluations conducted by occupational therapists or other trained professionals.
However, such programs come with a high cost — ranging from $500 to $800 in Massachusetts. Without Medicare coverage, many seniors cannot afford this potentially life-saving service.
Further, researchers noted that the absence of Medicare coverage forces individuals to bear the cost privately, and the lack of coverage also creates broader public health concerns. In 2016, Medicare’s expenses for traumatic brain injuries exceeded $19 billion, with motor vehicle crashes contributing significantly to these costs. Preventing accidents through proper driving assessments could save lives and reduce healthcare spending.
Advocacy groups such as AARP and the Alzheimer’s Association reportedly recommend that at-risk drivers undergo comprehensive evaluations, all of which helps to identify unsafe drivers and provide recommendations for restrictions or compensatory strategies for those with mild impairments. Medicare already covers fall risk assessments by occupational therapists, recognizing the value of preventive care. The authors added that extending similar coverage to driving assessments could yield comparable benefits.
Critics point to a lack of standardization across driving assessment programs. Still, researchers said there is general agreement on the behaviors that signal unsafe driving, such as failing to notice traffic signals or veering into oncoming traffic. Advances in technology, including GPS-logged driving data and simulation tools, may also offer more cost-effective and standardized solutions in the future.
Changing Medicare policy would require congressional action and funding, but the cost of inaction — in human lives and healthcare expenses — far exceeds the investment. Kirk Daffner, a corresponding study author, said driving requires the coordination of complex cognitive and physical functions and that programs evaluating at-risk individuals are essential to improving road safety.
Researchers studied eight driving assessment programs in Massachusetts, finding that approximately 15% of older adults with mild cognitive impairment failed driving evaluations. Extrapolated nationally, this represents over 1.2 million potentially unsafe drivers. While these programs can prevent accidents, their high costs remain a barrier for many.
Meanwhile, officials said the number of senior drivers continues to grow. Census data shows a 38.6% increase in Americans aged 65 and older between 2010 and 2020. By 2022, 14.5% of licensed drivers were over 70 years old, according to U.S. Department of Transportation data. States like West Virginia, New Hampshire and Vermont had the highest percentages of drivers aged 70 and older, while the District of Columbia, Utah and Alaska had the lowest.
According to the study, comprehensive driving evaluations could serve as a preventive measure similar to fall risk assessments. Medicare coverage for these services would enhance safety and protect seniors’ independence by providing tailored recommendations rather than outright license revocation.
“It is imperative to support programs in our healthcare system that can evaluate driving safety of at-risk individuals in a manner analogous to Medicare’s coverage of a fall risk assessment,” Daffner stated.
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