Chapter 20 Older Drivers with Acute or Chronic Medical Conditions (Includes Noncommercial Motor Vehicles, Excludes Commercial Drivers)

The primary guideline for assessing and counseling older drivers is set forth by the American Medical Association (AMA)¹ in conjunction with the National Highway Traffic Safety Administration (NHTSA). Older drivers are at greater risk for fatal crashes because of their fragility. Three important areas that tend to decline in function in older drivers are (1) vision, (2) cognition, and (3) motor function.²

More than 100 medical conditions or situations identified by the AMA may affect the older driver. The largest proportion of concerns are diseases of circulation (25%), the nervous systems (15%), the eye (13%), or the musculoskeletal system (13%), or are medication related (13%).

Red flags (listed below) indicate a medical condition in need of further evaluation or management. These concerns may be observed from patient behavior, witnessed during acute events, or noted in a patient’s medical history.¹ The complete list of medical concerns with detailed explanations can be found at the AMA web site (http://www.ama-assn.org/ama/pub/category/1079.html).

Additional physician driver evaluation recommendations and signs of unsafe driving from the Association for Driver Rehabilitation Specialists (ADRS), the American Geriatric Society (AGS), and the Alzheimer’s Association (AA) are also included below.

RED FLAGS AND CONTRAINDICATIONS FOR DRIVING

E00-E90 ENDOCRINE, NUTRITIONAL, AND METABOLIC DISEASES

F00-F99 MENTAL AND BEHAVIORAL DISORDERS

G00-G99 DISEASES OF THE NERVOUS SYSTEM

H00-H59 DISEASES OF THE EYE

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