Staying Active

Safer Roadways Possible, But Would Reduce Older Motorists’ Independence

Listen to Dr. Sims' discussion:

Alabama's testing procedure for driver safety is "probably not adequate" to screen for declining skills among older motorists, says Richard Sims, M.D., UAB Center for Aging expert. But getting more at-risk drivers off the road would have a severe impact on their personal independence in a state largely lacking alternative public transportation.

"At this point," says Sims, a geriatrician at UAB and the VA Medical Center, "research is focusing on several tests that are probably another level above the standard visual acuity and peripheral vision tests that one gets at the Department of Motor Vehicles. Several of my colleagues at UAB, in particular Karlene Ball, Ph.D., and Cynthia Owsley, Ph.D., have been investigating for some years what types of tests might be more effective.

"They have developed a test called 'useful field of view,' which is defined by the diameter of the circle where you can take in information visually at one glance. We know that if your useful field of view is shrunk below a certain point, then your risk of having a crash in the subsequent two or three years is considerably higher. This useful field of view is measured as the speed of visual processing time, and is found to be not only a predictor of car crashes, but also of the ability of an older adult to manage certain activities within the home."

But taking away an older person's driving privileges has large ramifications for his or her life, Sims points out:

"It's a big issue because taking away the keys from an older adult is a major impediment to independence-particularly here in the state of Alabama, because we don't have alternative transportation. And this is something that other states have, to varying degrees. Many of the states in the northeast have buses and trains; that sort of modality that we don't have. So the implications for stopping an older Alabamian from driving are greater than would be the case in some other places. Most older adults feel very threatened by having their keys taken away, and of course that's very understandable.

"As you can imagine, there's a lot of variety between the states as far as reporting requirements for physicians. For example, before I came to Alabama I was in Pennsylvania, which requires a physician to report any impairment that might place an older driver-or any driver, for that matter- at risk for a car crash. The state of Alabama does not mandate that physicians must report, although we do have a mechanism by which unsafe drivers can be reported to the Department of Public Safety in Montgomery."

As for the future of public transportation in Alabama, Sims says:

"I think there's some awareness on the part of our political leaders that this is something that needs to be fixed. So in that regard, at least, we're making some progress."

A downloadable audio file of Dr. Sims' article is also available.