Thursday, 30 July 2015

Rural driving for older populations – are current licensing procedures inequitable?

Drivers with early dementia in rural areas may pose less risk on the road than urban counterparts according to a report by health, law and ageing experts at Monash University. 

Researchers from Monash University’s School of Public Health and Preventive Medicine (SPHPM) and Ballarat Health Services are calling for further research and analysis of function-based driver testing models for older drivers and those with diagnosed dementia.

 Professor Joseph Ibrahim and colleagues explore how the driver licensing system as it currently stands may directly or indirectly perpetuate discrimination against older people with dementia.

They also highlight the adverse health and social outcomes driving cessation has on older drivers, proposing that rural drivers in the early stages of dementia be allowed to drive with a greater level of cognitive impairment than those in urban centres.

”There is a window of time during which drivers with a diagnosis of dementia can drive as safely as other drivers of the same age.

“Premature driving cessation for people with dementia living in rural areas is likely to increase difficulties in accessing healthcare, services and material resources,” Professor Ibrahim said.

The existing research on older drivers and age-based testing models suggest function-based testing may be more appropriate as older drivers may be influenced by a low mileage bias that may account for the higher crash and mortality rates.

Existing data shows that 22-46 per cent of patients with mild-to-moderate dementia continue to drive.  The general consensus among clinicians is that it is usually safe to drive for about three years following diagnosis.

The collaborative report critically analyses current guidelines and interventions used to inform decisions made by clinicians, calling for validated tools to determine the level of risk posed by drivers in the early stages of dementia both to themselves and others.

The report draws a roadmap for policy-makers, licensing authorities and researchers and raises the idea of whether a more individualised approach, that takes geographical location into consideration, is needed.

An extract of the Inequity in health: older rural driving and dementia is available here.

For more information and insights on driving with dementia, watch the video developed by Professor Ibrahim from School of Public Health and Preventive Medicine’s Department of Forensic Medicine in collaboration with Victoria and Tasmania Dementia Training Study Centre Australian Centre for Evidence Based Aged Care La Trobe University.

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