Restricted driver’s licences reduce traffic crashes and traffic violations for older drivers

Asbridge M, Desapriya E, Oglivie R, et al.  The impact of restricted driver’s licenses on crash risk for older drivers: A systematic review  Transportation Research: Part A. 2017; 97: 137-145.

Review question

Do restricted driver licences have an impact on the number of crashes, traffic violations and continued independent mobility for drivers over the age of 55?

Background

As the proportion of seniors continues to grow in the Western world, the implications of the aging population with driver’s licences also increase. Although driving cessation is often considered a personal issue, the rate of car-related incidents, particularly traffic fatalities, increase among the aging population. Currently, there are tests and regulations in place to promote the safety of drivers over the age of 65, such as a graduated driver’s licence program as well as cognitive, visual and motor tests to ensure adequate driving ability.

Based on evidence, the ability to drive greatly increases the quality of life for older adults. For example, older adults are more likely to participate in social engagements and family activities if they are able to drive a car. Allowing older adults to keep their driver’s licences enables independent mobility; however, there are safety concerns for senior drivers, such as a greater likelihood of crashes and traffic violations, which present policy challenges.

The number of studies highlighting the effectiveness of driving interventions for older adults is limited. Thus, this systematic review aims to collect the existing information related to restricted driver’s licensing to identify the effectiveness of current policies in promoting independent mobility while ensuring safety.

How the review was done

A detailed search of a number of electronic databases for studies published from 1980 to 2015 was conducted. Studies that focused on older adults with a mean age of 55 and highlighting the topics of driver restrictions, traffic crashes, traffic violations and independent mobility, were included in the review.

A total of 3,331 studies were identified in searches, and seven were included in the review after assessments for eligibility.

This review was funded by AUTO21 Network of Centres of Excellence, Canada’s automotive research program.

What the researchers found

The studies considered in this review reveal that generally, older drivers are safe drivers because they drive fewer miles and in safer driving conditions. However, medical and functional decline does contribute to a higher risk of traffic crashes and violations.

Restricted driver’s licences based on health functionality do lower traffic-crash probability for older adults. Nonetheless, the difference between medically at-risk drivers and healthy older drivers provides evidence against the need for a standardized age of driver’s licence restriction.

It is important to continue the support of restricted driver’s licences through a systemic and pragmatic approach. This may include upgrades to transportation infrastructure and a plan for smooth transitions for older adults into non-driver status. For example, the Physician Guidelines for determining Medical Fitness to Drive should be reviewed to consider including older adults with multiple chronic conditions.

Conclusion

This review found that restricted driver’s licences reduced traffic crashes and traffic violations while increasing independent mobility among adults over the age of 55. Promoting the safety of older adults who drive during a time of declining health may include driving restrictions, such as only driving during the day, and medical testing to ensure adequate driving function. Limitations of this study are a lack of relevant randomized controlled trials, as well as a lack of a meta-analysis. Further research is recommended to investigate the specific driver restrictions that are most effective, drivers’ compliance with the restrictions, as well as potential improvements to the driver’s fitness assessment tool.