In 1993, we sought proof of a relationship, among older drivers, between unsafe driving and medical or intellectual deterioration. We identified 37 drivers 65+ with temporary license suspensions, 23 had caused crashes, and 14 were guilty of moving traffic violations. Case subjects and matched controls underwent a medical and cognitive evaluation. Three suspended drivers had overt or suspected dementia, but no controls. Furthermore, the crash-involved drivers, compared to controls, had more cognitive impairments, although there were virtually no medical differences. Five years later, we renewed the examination, primarily to examine the possible progression of the cognitive impairment. Mortality was higher in the case group (8/37) than among controls (2/37), and affected mainly crash-involved drivers (6/23). Two case subjects with suspected dementia had progressed, while another was detected at follow-up. The mental status and general health of previously crash-involved case subjects had declined more than that of controls. Case subjects, particularly crash-involved drivers, had stopped driving to a greater extent than controls. Thus, the cognitive impairments found initially are progressive, and often linked to a deterioration of general health. Automatically returning temporarily suspended licenses to older drivers with unsafe behaviour is therefore not an adequate traffic safety measure. For the covering abstract see ITRD E113725 (C 22328 CD-ROM).
Samenvatting