Driving and Other Means of Mobility for Older People

Mobility is necessary for independent living. Lack of mobility is linked to many adverse effects for older people. Effective mobility allows spontaneous travel to a wide range of destinations and activities. As people get older, the number of journeys they make and the length of those journeys reduce. Where people have a car available, the large majority of journeys are made by car. By the age of 75, male drivers are on average driving less than 3000 miles per year, and female drivers less than 1400 miles. Older drivers try to avoid stressful driving conditions such as darkness, congested areas, unfamiliar areas, high speed roads and bad weather. In Europe, older people make about 25-30 percent of their journeys on foot and 10-15 percent by bus. In North America, older people make very little use of buses and walking. Walking and bus travel are much more effective mobility options in large urban areas. Older drivers are at greater risk of injury to themselves, because of the greater fragility of older people, but there is no evidence that they are a greater risk to other road users. Older people are at greater risk travelling as pedestrians than as car occupants. Older drivers may give up driving for several reasons; most common are health or vision, safety, concern over driving competence and cost. There is widespread appreciation that the best way to maintain the mobility and independence of older people is to enable them to continue to drive as long as it is safe to do so. Highway design can make driving easier and safer for older people, which would also help younger drivers. The patterns of land use needed for environmental sustainability create the situations which help the independent mobility of older people. It is possible that technical improvements to road vehicles could make them easier for older people to drive. There is an increasing number of programs to make older drivers aware of their limitations and to help them continue to drive safely. There is no evidence that age-based screening programs for whole populations of older drivers are effective in reducing accidents. There is some evidence that screening programs frighten older drivers, particularly women, into stopping driving before they need to do so. Emphasis should be given to assessing drivers who might be at risk because of medical conditions such as incipient dementia. Realistic mobility alternatives to the car would allow older drivers to use the alternatives for journeys that would be stressful to drive, and eventually to maintain their independent mobility without driving.