Between January 1987 and December 1988, information was collected to investigate the car use and driving performance of a group of 50 stroke drivers and 50 able-bodied drivers matched on sex, age, driving experience and current annual mileage. In addition to differences between stroke and able-bodied groups, the differences between drivers in the age groups under 59 years, 60-69 years and 70-79 years were considered. The principal conclusion was that those who returned to driving after a stroke were as safe as their able-bodied controls, as assessed by a Driving Test. However, in both groups there was evidence of a decline in basic driving skills from 60 years onwards. This was thought to be due to changes in cognitive functioning associated with ageing. Of particular concern was the finding that stroke drivers over 70 years old demonstrated additional deficits residual to the stroke. There was a marked decrease in awareness of road situations and car control, particularly in those with right-sided brain damage. However in the group studied this had not led to greater accident involvement. The investigation of car use demonstrated that older drivers, particularly following a stroke, restricted their car use to avoid potentially dangerous situations. These drivers had a lower annual mileage and were less likely to drive unaccompanied, at night, on the motorway or abroad. Although many drivers spontaneously used compensatory measures as a response to recognised limitations, many were unaware of the normal age-related changes which might affect vision, observation and reaction time. It is suggested that information on age-related changes for all drivers and retraining on driving techniques, particularly for those who have had a stroke, would enable those over 60 years to continue driving safely for as long as possible. (A)
Abstract