How old is ‘too old’ to drive?

Key points:

• If you live in New South Wales, Queensland, Western Australia, South Australia or Tasmania and are 65 – 85 years old, you may be required to undergo reassessment or reaffirm your medical well-being

• While road fatalities have generally decreased over the last decade, the number of fatalities for older road users has increased

• Data provided by the Bureau of Infrastructure Transport and Regional Economics indicated that the average length of hospital stay following a road crash is seven days for those over 75 years of age, while it is four days for those aged 25 – 54

‘Walkability’ is a term used in urban planning to describe whether people can commute across a city on foot and perform day-to-day tasks without the use of a car, such as grocery shopping and visiting loved ones.

However, when compared to the rest of the world, Australian cities fail to accommodate people who do not own a car or possess the ability to drive. A study published in 2022 reported that approximately 37 – 44 percent of the population in Sydney, Melbourne and Adelaide live in neighbourhoods with above-average walkability, compared with 97 percent of people in São Paulo, 96 percent in Hong Kong, 92 percent in Chennai and 87 percent in Mexico City.

Researchers have since revealed that impaired cognitive function foreshadows the decision for many seniors to stop driving — more so than age or molecular signs of Alzheimer’s disease.

Among research participants, even the slightest cognitive changes were a sign that retirement from driving was imminent. Further, according to the authors of the study published in the medical journal Neurology, women were more likely to stop driving than men.

Ganesh Babulal, PhD, of Washington University School of Medicine, explained that Alzheimer’s disease develops over a long time and people may have a 10- to 15-year period where they have no symptoms, despite the disease developing in the brain.

“We were looking to see whether older adults with signs of early Alzheimer’s would be more likely to stop driving than people without these signs,” he said.

The study involved 283 participants with an average age of 72 who drove at least once a week. They had cognitive tests at the start of the study and then every year for an average of 5.6 years. They also had brain scans and cerebrospinal fluid collected at the start of the study and then every two to three years.

During the study, 24 people stopped driving, 15 people died and 46 people developed cognitive impairment.

Among the people who stopped driving, nine people had a neurologic condition, four had significant vision changes, eight had general health issues and three moved to an assisted living facility.

The researchers found that female participants, people who developed cognitive impairment and people who performed worse on the cognitive tests were more likely to stop driving than male participants, those with no cognitive problems and those who performed better on the cognitive tests.

Once researchers adjusted for other factors that could affect stopping driving, they found that female participants were four times more likely than male participants to stop driving. Prior studies have examined the gender difference and posited that men may view their ability to drive as a part of their identity.

A limitation of the study was that researchers did not have information on other medical conditions, any decline in vision or hearing or the use of medications, such as antipsychotics and sedatives, all of which can affect driving.

In Australia, a person’s age or gender does not determine whether one can drive — regardless of state or territory.

Older people in Australia may be required to undergo medical assessment or be required by law to report any health conditions that may affect their driving ability.

Some of the most common conditions that can hinder a person’s ability to drive disproportionately affect older people, including:

• stroke;
• Parkinson’s disease;
• sleep disorders;
• cataracts;
• glaucoma;
• dementia and diabetes.

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