The evidence for safety benefits associated with in-person licence renewal for older adults (age 75+) is inconclusive

Koppel S, Bugeja L, Stephens A, Cartwright A, Osborne R, Williams G et al. The safety benefits of older drivers attending an in-person licence renewal Journal of Transport & Health. 2020 June 1;17:100845.

Review question

What is the impact of in-person licence renewals for older drivers (age 75+) on safety?

Which screening tools should be included?

Background

Older drivers (age 75+) have the most vehicle crash-related deaths and serious injuries per distance travelled. This can be due to greater injury susceptibility, age-related functional impairments, medical conditions, and medication use.

Policies are being implemented which require older drivers to demonstrate their fitness-to-drive by presenting themselves to a licensing authority in person, rather than completing the process online.

In-person licence renewal policies aim to identify and evaluate potentially unsafe or unfit drivers. However, it can also result in safe older drivers losing their licences prematurely.

How the review was done

A detailed search of a number of electronic databases was conducted for studies published up to March 2019. Studies that focused on older drivers (age 75+), screening tools for licence renewal processes, fitness to drive, and crash risk were included in the review.

A total of 8,899 studies were identified in searches and 5 were included in the review after assessments for eligibility.

This review was funded by VicRoads (Melbourne, Australia).

What the researchers found

Some studies found an association between vision screening and reduced fatal crashes in drivers aged 85+. However, the evidence on the safety benefits of all the screening associated with in-person licence renewal remains inconclusive.

Unsafe or unfit drivers may be less likely to attend an in-person licence renewal and opt for non-renewal instead. It is suggested that going to the department of motor vehicles has a greater impact for identifying at-risk drivers than the screening that are conducted at these centres.

Safe and fit older drivers who stop driving too early can experience psychosocial and health consequences. Additionally, they might resort to other transportation methods such as walking that may pose risk given their health conditions.

Conclusion

No suitable screening tools for a population-based in-person licence renewal process for older drivers were identified. There is inconclusive evidence on the safety benefits of in-person licence renewal.

The authors suggest that a population-based controlled study in multiple jurisdictions is needed to investigate the safety benefits of each of the components of in-person licence renewals for older drivers.