Elderly drivers were in the news on the weekend when Canadian geriatrician David Lussier said they were just as dangerous as young “hoons”.

The problem, he says, is older drivers have greater trouble multi-tasking. They’re also more likely to be medicated and suffer conditions affecting their ability to drive well, like deteriorating eyesight or early-stage dementia, than younger drivers.

The Age devoted its editorial to the issue on Tuesday, canvassing “suggestions that elderly drivers should be required to renew their licences in person, submit to regular tests of their driving competence and have mandatory vision testing”.

This is an occasional but perennial issue; I discussed it a couple of years ago, and it’s worth revisiting. I noted then that:

  • Older drivers are under-represented in crashes; that’s not because they’re superior drivers but because on average they drive less than younger cohorts;
  • But they’re over-represented in casualties; that’s because their greater frailty means they’re more likely to be killed or seriously injured in the event of a crash.

The upshot is that, when allowance is made for the fact they drive less, the fatality rate per kilometre for drivers aged 70 years and older is comparable to that of drivers in the high-risk 17-25 group. What I don’t know is whether or not elderly drivers pose a greater risk of casualty to the rest of the population than other age groups of drivers.

This is a fraught issue given the increasing numbers of elderly drivers (i.e. drivers aged over 85) increased 94% in NSW in the five years up to June 2011.

NSW has mandatory age-related driver testing, but it is the only state that’s taken this path. From the age of 85, NSW drivers must either sit a bi-annual driving test or opt for a restricted licence that limits their driving (e.g. only during daylight hours, or within a restricted radius of their home).

It might seem a sensible approach, but casualty rates for elderly drivers in Victoria are claimed to be no higher than in other states even though Victoria has neither compulsory age-related driver testing nor compulsory medical checks.

The Age makes a suggestion that’s worth considering further:

“Why limit regular testing to the elderly? Why not encourage all drivers to submit to regular driving competency tests? That would surely elevate awareness levels, and challenge those with misplaced confidence.”

The biggest challenge for policy though is likely to be the growing numbers of elderly who give up driving because of ill health or deteriorating faculties. As I’ve noted before, reduced mobility will lead to a significantly lower quality of life for many people.

Managing the basics of life, such as shopping and doctors’ appointments without a car is hard when decisions like where to live were premised on good health and access to a car. People who suffer age-related problems like incontinence value the privacy of a car and might be reluctant to use public transport.

Rates of depression are higher for older people who can no longer drive. Many have lost partners and live alone, so they value opportunities for social contact. They’re also more at risk of casualty as pedestrians than they are as drivers.

The “non-driving elderly” is an issue that’s already here. An expansion of home services will be a big part of the solution, but maintaining a reasonable level of mobility outside the home will be much harder.

This is where it’s important to put ideology aside. Trains and buses will help some, but for many they involve too much walking, too much time away from home, inadequate facilities, and too many compromises on privacy.

The most realistic solutions in the next few decades are likely to be based around cars and small vans (e.g. para transit) that operate door-to-door. For example, there’s scope for innovation around the way taxis are deployed. There’s also an enormous fleet of private cars and drivers that could be mobilised, too, given the right regulatory incentives (e.g. Uber).

Peter Fray

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