What they said ... `... despite a more than halving of the state's road toll in the past eight years, there just hasn't been any reduction whatsoever in the number of older drivers killed on our roads' Mr John Lees, the executive director of the Transport Accident Commission
`The real decision is back on the individual to make an informed decision about whether they continue to drive and, if so, under what circumstances' Professor Ken Ogden, the RACV's public policy manager
Over recent years there have been a number of proposals that elderly motorists must either surrender their licences on reaching a certain age or regularly undergo licence re-testing and/or medical fitness-to-drive tests. It has also been suggested that for elderly drivers licence re-testing should occur more frequently than the current ten-year licence renewal period.
Such proposals have come from state coroners and traffic licence authorities.
Though these proposals have been supported by some elderly drivers they have met with opposition from others and from the Royal Automobile Club of Victoria (RACV).
Attention has also recently been focused on the fitness of elderly drivers by a series of television advertisements produced by the Transport Accident Commission (TAC).
Background
Monash University's Accident Research Centre released study findings in September, 1997, which indicate that in Victoria the elderly were one of the groups particularly at risk of being involved in a single vehicle crash. Other studies have indicated that the aged are also particularly likely to die as a result of road trauma.
Findings such as these, and similar findings that have been released at least since 1996, have led to calls from Victoria Police and others that measures be taken to improve the safety of elderly drivers.
The most extreme of these suggestions would encourage the elderly to cease driving. Other proposals have tended to focus on education both for elderly drivers and those who support them - family and medical practitioners.
Currently, in Victoria, a licence can be suspended after a report by a medical practitioner indicating that a person is unfit to drive. Vic Roads then requires a test before the licence can be re-issued.
It is also possible for members of the public to inform Vic Roads of any driver they consider to be unsafe. Vic Roads can then order a medical or driving re-assessment.
Such re-assessments can result in a licence being rescinded or re-issued with special conditions.
Also of interest are a number of American studies.
The US Roads Road Management & Engineering Journal reports a 1994 study which indicated that drivers over 60 had poorer comprehension of traffic signs. The report is titled Elderly Drivers and the comprehension of Traffic Signs.
There is also a news report of a virtual reality road test conducted by researchers from the University of Maryland in an attempt to determine why elderly drivers have accidents. The news report is titled Virtual road test may show why elderly drivers crash. It was written by Jane Allen and produced by Associated Press and Nando.net.
Finally there is an abstract or summary of a report published in the Cleveland Clinic Journal of Medicine. The report is titled The elderly driver: What physicians need to know.
It concludes that elderly drivers overall do not have significantly more accidents than younger drivers and that most who should give up driving do so on their own.
It also makes the interesting common sense observation that most elderly people who have difficulty with the daily activities of living probably also have difficulty driving and so should have an evaluation. It also warns US physicians that they may be held liable if they do not advise at risk patients to be evaluated.
Arguments in favour of special restrictions being placed on elderly drivers
The primary argument offered in favour of restrictions being placed on elderly drivers is that drivers over the age of 60 and in particular drivers over the age of 70 are involved in a disproportionate number of accidents on the road.
Those who argue that special restrictions should be placed on elderly drivers claim that drivers aged over 65 are the highest risk group behind the wheel.
It is claimed that despite making up only 13 per cent of Victoria's population, drivers aged over 65 accounted for almost 21 per cent of the states driver fatalities. It has also been noted that this is more than double the proportion of road deaths that this group accounted for in 1989.
It has also been claimed that while deaths among drivers aged 17 to 64 fell by 28 per cent last year, the number of drivers aged 65 and over killed jumped 48 per cent.
Looking at the longer range picture, critics note that deaths of all drivers on our roads have fallen 53 per cent since 1989. Closer analysis of this figure apparently shows that deaths among the 18-21 age group have come down 37 per cent, but there has been no reduction among those aged over 65.
According to this line of argument, elderly drivers are a particularly at risk group and this trend may be worsening.
Mr John Lees, the executive director of the Transport Accident Commission, has claimed, `... despite a more than halving of the state's road toll in the past eight years, there just hasn't been any reduction whatsoever in the number of older drivers killed on our roads.'
It has further been claimed that the problem is likely to worsen as our population ages and the number of elderly drivers on the road increases.
Mr Lees has stated, `The real risk is that ... unless something changes the situation will get far worse as the number of older drivers on the road is set to increase more than six-fold in the next 15 years.'
Those who argue that the elderly are a particularly at risk group tend to stress the effects that physical deterioration can have on driving ability.
Mr Lees has claimed, `As we age our reflexes inevitably slow, eyesight deteriorates, hearing becomes less acute and we tend to have more difficulty in processing or coping with complex information and scenarios. All these factors make driving more difficult and more dangerous`
Those who argue either for the loss of licence beyond a certain age or frequent re-testing of elderly drivers claim that such measures are necessary as many elderly drivers are unlikely to be able to determine their own fitness and so do not see themselves as a hazard.
Research has apparently indicated that most older drivers were amazed when told they were the highest-risk group.
Mr Lees has noted that the elderly are not the only group in society who do not always realise when they have lost the level of fitness necessary to perform a particular activity.
Mr Lees claims, `Sport is littered with examples where the ageing champion, despite all evidence, wanted to go on for one more season.'
Mr Lees stresses, however, that a failure to recognise one's unfitness to drive can result in death.
`When the analogy is applied to driving, the consequences are inevitably far more severe than a tarnished reputation,' Mr Lees claims.
Mr Lees. Supporting regular medical fitness tests for the age has stated, `Part of the answer to reducing levels of road trauma among older drivers may be found in increased consultation with ... doctors, pharmacists and eye specialists.'
Other suggestions have included requiring elderly drivers to have regular licence renewal tests.
In 1997, support for this proposal came from Victoria's Police assistant commissioner, Mr Graham Sinclair. Mr Sinclair has suggested that after a certain age, possible 60, 65 or 75, this re-testing should occur.
The Australian Retired Person's Association has indicated that it would not oppose compulsory regular tests for drivers over a certain age, possible starting at 75 or perhaps lower.
Finally, it has been claimed that the elderly pose a threat not only to themselves but to their passengers and to other road users.
Thus the emphasis of the recent series of advertisements produced by the TAC has been on the dangers faced by passengers, including young passengers, travelling with elderly drivers.
Those who emphasise this element of the issue tend to suggest that if it comes down to a question of the mobility and dignity of elderly drivers as opposed to their lives and the lives of others, including children, then the risk to life is more significant.
Arguments against special restrictions being placed on elderly drivers
There are a number of arguments raised against restrictions being imposed on older drivers.
Firstly, it is claimed, to place blanket restrictions on elderly drivers would discriminate against the group as a whole.
According to this line of argument, it is only a minority of older drivers who are a hazard on the road, therefore, it is claimed, not all drivers over a certain age should have limitations imposed upon them.
This point has been made by Mr Brian Shakes, the executive manager of the Australian Retired Persons Association.
Mr Shakes has claimed, `There are lots of 60-year-old drivers that are as fit as a fiddle, and to lump them in with one or two persons who may have some health problems is grossly unfair and it carries on this prejudice about people over 60.'
Professor Ken Ogden, the RACV's public policy manager, has claimed that despite the physical impairments that may effect them as a group, the elderly are not over-represented in the road toll.
Professor Ogden has noted, `In Victorian statistics from 1992 to 1996, people over 55 have accounted for 21.9 per cent of all deaths in the state. At the same time they were 22 per cent of the population.'
Professor Ogden goes on to claim that there are other groups among drivers that are disproportionately represented in the road toll.
` ... drivers under 25 ... account for 30.8 per cent of all deaths but only 15 per cent of the population ...' Professor Ogden states.
It is also claimed that the ability to get around conveniently is very important for the aged.
According to this line of argument, some elderly people may, for example, feel unsafe on public transport.
Mr Eric Florence, 70, has claimed that public transport is a poor option for many elderly people, especially in the outer suburbs where it is infrequent. Mr Florence also said the new ticketing system is confusing.
In addition, it has also been noted that elderly people living in the country may not have access to an efficient public transport system.
Many elderly people also live alone with reduced support networks and so, again, being able to drive themselves about is necessary to them.
Therefore it is claimed, being able to drive is particularly important to many older people.
These points have been summed up by Professor Ken Ogden, the RACV's public policy manager.
Professor Ogden has said, `... mobility is such a terribly important part of lifestyle for people, but particularly elderly people, that to ... come down with a very insensitive and draconian "get the old people off the road" sort of reaction is ... quite unacceptable.'
The RACV argues that measures such as re-testing the elderly on their driving ability are not simply discriminatory, but are also ineffective as a means of reducing the road toll. It also argues that re-testing is not cost efficient.
Professor Ogden claims, `In South Australia, compulsory re-tests were tried and it was found that, for the money it cost, it was not as effective as other methods in reducing the older driver road toll.'
The RACV believes there are means apart from re-testing and restrictions to allow the elderly to drive safely.
The RACV runs an education program that allows drivers to look at their mobility.
The program is titled Years Ahead and encourages older drivers to take responsibility for their driving safety. It gives driving tips, emphasises the importance of being fit to drive and gives information about alternative forms of transport.
The club also urges doctors to advise patients on the effects of prescription drugs on driving and the effect that some medical conditions can have on one's ability to drive.
The RACV believes that the elderly should be able to decide for themselves when, if at all, they need to stop driving.
Professor Ogden claims, `The real decision is back on the individual to make an informed decision about whether they continue to drive and, if so, under what circumstances.'
The RACV also points out that impairments or disabilities that can reduce one's ability to drive are not simply confined to the elderly. Professor Ogden has pointed out, `Thirty-year-olds can have a disabling medical condition, too.'
Overall, the RACV argues, what is needed are means of making roads safer for everyone, not just the elderly.
Professor Ogden maintains, `We should start by building improvements into roads that help keep pedestrians and drivers safe. Elderly pedestrians are particularly at risk ... Vehicle makers can also design cars that offer better crash protection and keep in mind the needs of older drivers.'
There are those who support the elderly being able to continue driving, yet, unlike the RACV, do not object to periodic testing over a certain age.
Mr Max Hind, 76, from Hawthorn, Victoria, has said, `Over 75 I think would be a good idea.'
Many of those who hold this view, however, believe that testing only the elderly would be discriminatory and that many other drivers would benefit from such testing.
This view has also been put by Mr Hind. `I tell you what,' Mr Hind commented, `there should be a lot of young people that should be tested too.'
Further implications
It is difficult to predict what changes, if any, will occur in the regulations effecting elderly drivers.
The issue is a politically sensitive one and it seems unlikely that any Government would want to alienate elderly votes. This is especially the case given that as our population ages the elderly voting block is going to become larger and thus more influential.
Most of the changes that have been formally proposed are fairly conservative. There has been a recent series of TAC advertisements targeting the elderly as a road risk. There is the possibility that health professionals, including doctors and opticians, will be given particular training to increase their awareness of the effect of certain medications and age-related conditions on driving ability. It is hoped that these health practitioners will become more active in warning their elderly patients of the dangers they face and how best to minimise them.
There is also the possibility that elderly drivers will be required to undergo re-testing before the re-issuing of their licences and that this may occur more frequently than the ten year period which currently applies for all licence renewal. However, given that this is a relatively expensive procedure and that its effectiveness has been queried, it seems likely that it would only be introduced if other more conservative measures failed.
Sources The Age
14/2/96 page 3 news item by Tim Colebatch, `Older drivers a hazard'
3/8/96 page 3 news item by Gabrielle Costa, `Coroner urges limits on older drivers'
11/2/97 page 4 news item by Sushila Das, `Call for safety focus on elderly drivers'
12/2/97 page 6 news item by Gabrielle Costa, `Age and cars - a hazardous combination?'
15/3/97 page 3 news item by Sandra McKay, `RACV rejects call to take elderly drivers off the road'
22/4/97 page 3 news item by Belinda Parsons, `Older drivers may face testing'
22/4/97 page 3 news item by Andrea Carson, `Vic Roads bowls aged motorists a curly one'
19/3/98 page 17 comment by John lees, `If you're over 65, think before you drive'
20/3/98 page 15 analysis by Steve Dow, `Over 65, so are they still OK to drive?'
20/3/98 page 16 comments, `When is it time to stop?'
29/3/98 page 20 comment by Pino Saccaro, `Respecting the consent of age'
The Herald Sun
22/4/97 page 7 news item by Peter Mickelburough and Matthew Pinkney, `Police want tests for older drivers'
23/4/97 page 19 comment by Ken Ogden, `Don't rap old drivers'
13/3/98 page 15 news item by Geoff Wilkinson, `Young and elderly most likely to die'
16/3/98 page 18 editorial, `Fitness, not age'
17/3/98 page 2 news item by Peter Mickelburough, `Our deadliest drivers'
18/3/98 page 19 comment by Ken Ogden, `Don't shame older drivers off the road'
22/3/98 page 32 news item by Anthony Black, `It's still drive time for Alan at age 93'
6/4/98 page 15 news item by Bruce Brammall, `Elder takes safe road'
23/4/98 page 19 news item by Peter Ryan, `A hot burst of age rage'
Internet
There are a number of Internet sites dealing with elderly drivers
Abstracts or summaries of a number of relevant studies conducted by Monash University's Accident Research Centre can be found through the Centre's homepage.
Two particularly useful summaries are
Fatal single vehicle crashes study: Summary report (published in September, 1997) and found at http://www.general.monash.edu.au/MUARC/rptsum/es122.htm and
Safety of Older Drivers: Strategy for future research and action initiatives (published in July, 1997) and found at http://www.general.monash.edu.au/muarc/rptsum/es118.htm
The Accident Research Centre's homepage can be found at http://www.general.monash.edu.au/muarc/
Also of interest is a report produced by the Road Accident Prevention Research Unit, Department of Public Health, University of Western Australia.
The report is titled Road Safety and the Health Sector. It includes a detailed discussion of the difficulties of trying to accurately estimate a person's fitness to drive. The report can be found at http://www.general.uwa.edu.au/u/phhomep/roadwatch/cp53.htm
Also of interest are a number of American studies.
The US Roads Road Management & Engineering Journal reports a 1994 study which indicated that drivers over 60 had poorer comprehension of traffic signs. The report is titled Elderly Drivers and the comprehension of Traffic Signs. It can be found at http://www.usroads.com/journals/rej/9705/re970503.htm
There is also a news report of a virtual reality road test conducted by researchers from the University of Maryland in an attempt to determine why elderly drivers have accidents. The news report is titled Virtual road test may show why elderly drivers crash. It was written by Jane Allen and produced Associated Press and Nando.net.
It can be found at http://www.business-server.com/newsroom/ntn/info/092297/info12_14496_noframes.htm
Finally there is an abstract or summary of a report published in the Cleveland Clinic Journal of Medicine. The report is titled The elderly driver: What physicians need to know.
It concludes that elderly drivers overall do not have significantly more accidents than younger drivers and that most who should give up driving do so on their own.
It also makes the interesting common sense observation that most elderly people who have difficulty with the daily activities of living probably also have difficulty driving and so should have an evaluation. It also warns US physicians that they may be held liable if they do not advise at risk patients to be evaluated.
The abstract can be found at http://www.ccf.org/ed/ccjm/sep7abs1.htm
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