older people’s health issues
The Older Driver
Reasons for Impaired Driving
Driving involves the precise execution of simultaneous tasks (such as braking and steering). These tasks require several attributes, including the following: A clear mind Good judgment, planning, and decision-making abilities Attention and mental focus Quick reaction time Coordination Adequate strength Good range of motion in the upper body (upper trunk, shoulders, and neck) Sensation in legs and feet Good vision and hearing Deficits in any of these attributes can greatly affect driving performance. Such deficits can result from several causes. Virtually all these attributes are impaired to some degree as people age and become worse with the presence of medical illnesses. Aging itself usually results in a gradual and subtle decline in strength, coordination, reaction time, ability to concentrate, vision, and hearing. Older people may have less stamina and become fatigued more quickly, especially in situations that require concentration. Older people are less able to focus on more than one task at a time. However, most changes attributed to aging are modest and are often not the main reason for driving safety issues. Disorders that are more common among older people can be especially troublesome for older drivers. For example, the blood sugar level of drivers with Diabetes Mellitus (DM) may rise too high or drop too low. Such changes can interfere with clear thinking, attention, mental focus, vision, and sensation in the feet. Older drivers with Dementia (including Overview of Stroke or so-called ministrokes ( Seizure Disorders can abruptly cause people to become unaware of their surroundings or even lose consciousness. A recent Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) may increase the risk of fainting or light-headedness. Arthritis causes joint Joint Pain: Single Joint and Glaucoma and , most notably Obstructive sleep apnea , can cause drowsiness that leads to a crash. Many older people take drugs that can have undesirable side effects. Side effects can include sleepiness, dizziness, confusion, and other symptoms that interfere with driving. Both prescription and nonprescription (over-the-counter) drugs can have these side effects. When starting a new drug that could affect visual, physical, or mental function, people should not drive for several days to be sure no side effects occur. Drugs that may interfere with driving include the following: Antiseizure drugs Antiemetic drugs (used to manage nausea) Antihistamines Antipsychotics Benzodiazepines, or other antianxiety drugs Drugs used to treat glaucoma Drugs used to treat Parkinson disease Muscle relaxants Opioids Sleep aids Some sedating antidepressants (See also the U.S. Food and Drug Administration'sSome Medicines and Driving Don't Mix.) Many recreational drugs, including Alcohol Use and Stress, particularly when driving in unfamiliar areas or in heavy traffic, may contribute to driving difficulty. Fatigue and distraction also decrease driving ability. Using a cell phone or texting while driving increase crash risk. Although all drivers should avoid these distractions, older adults are especially vulnerable because of age-related changes or a decline in attention and multitasking abilities. Advanced crash prevention technologies, such as lane departure warnings and blind-spot indicators (see MyCarDoesWhat.org fortoday's car safety features), are now available in many cars. Falls in Older Adults have been associated with an increased risk of motor vehicle crashes because avoiding falls and avoiding crashes both require coordination of cognition with visual and motor systems, all of which may be decreased in older drivers. Thus, interventions that reduce fall risk, such as physical activity, balance training, and reducing the use of sedating drugs, may have a role in improving both ambulation and driving safety. For some older adults, the only deficit in driving ability is simply a lack of recent driving experience. It is common for one person in a relationship to do more of the driving than the other. When the main driver in a relationship dies, the other person may be unprepared to resume driving safely. Older people in a relationship should share driving activities because infrequent drivers are at high risk of stopping driving altogether (also known as driving retirement). 