Age, meds, and driving

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The great secret that all old people share is that you really haven't changed in seventy or eighty years. Your body changes, but you don't change at all. And that, of course, causes great confusion.” —Doris Lessing

It’s a touchy subject, let no one be in doubt: getting older, taking more meds for various ailments, and how those two in combination affect one’s performance behind the wheel. And for the record, this issue directly involved me for a time: due to a pinched nerve in my spine, I had to take pain meds for a stretch – meds that definitely affected my judgment behind the wheel. Fortunately, for me at least, a series of spinal injections solved my problem (so far) allowing me to go off the pain meds entirely – so now my driving faculties are back at full power.

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[In the interest of full disclosure, going off those pain meds proved to be one of the tougher and more unpleasant episodes of my life, let me tell you – but that story is for another day.]

I bring this up as a new study compiled by the AAA Foundation for Traffic Safety finds that a large percentage of older drivers – aged 55 and up – take one or medications per day, yet very few realize how those meds affect their driving performance.

The University of Alabama at Birmingham conducted a survey of 630 drivers aged 55 and older (with the average age 70.4) on behalf of AAA. Conducted between September and December 2007, the survey assessed the participants’ knowledge regarding both prescription and over the counter (OTC) medication use and how it might affect their ability to drive. Here’s what the survey uncovered:

• The overwhelming majority of those surveyed – about 92% – said driving was their preferred mode of transportation and 60% said they drove six or seven days per week, with men driving twice as much on average as women.

• About 95% of respondents reported having had one or more medical condition and respondents 75 and older reported the most medical conditions as well as taking the greatest number of potentially driver impairing medications.

• Approximately 78% of respondents currently used one or more medications, with 71.3% using one or more prescription medications, and 68.7% currently used one or more prescription medications that were potentially driver impairing (PDI).

• In addition, 19.1% of respondents currently used five or more medications, 12.1% currently used five or more prescription medications, and 10.2% currently used five or more prescription PDI medications.

• Overall, 27.6% of respondents indicated some awareness of PDI medications; however, awareness decreased with increasing age for both women and men. Few respondents (17.6%) had received a warning about PDI medications from a healthcare professional.

• Among respondents currently taking five or more PDI prescription medications, 21.9% indicated some awareness, and 18.8% reported receiving a warning about PDI. Among respondents 75 years and older, approximately 77% reported no-AEW, even though these subjects had the greatest number of medical conditions and were currently taking the greatest number of prescription PDI medications.

[To read the full AAA report, click here.]

This is the real kicker, I think – that few respondents (18%) received a warning about potentially driver impairing medications (e.g., ACE inhibitors, sedatives, and beta blockers) from a healthcare professional. Further, the study found that such warnings do not increase with increasing numbers of medications or with increasing numbers of medical conditions, noted AAA. In effect, the level of awareness of potentially driver impairing medications decreased with age, while in contrast the number of prescription medications people were taking increased.

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Let’s face another fact here as well: a significant portion of the U.S. population (including yours truly) is getting older, and although older drivers are involved in a small proportion of total motor vehicle collisions (MVCs), they have the highest number of MVCs per mile traveled according to AAA. With the number of drivers 65 years of age and older expected to double by 2030 (according to the Federal Interagency Forum on Aging Related Statistics 2008), reducing the risk of MVCs among these drivers will increase in importance. Therefore, the relationship between medication use and MVC risk is likely to grow increasingly important as the older population continues to grow, noted AAA.

And the truck driver population is aging faster than most. According to the Transportation Research Board, by 2004, the percentage of truck drivers over 65 had risen to 3.7%. If this trend continues, more than 5.5% of the truck driver population would be over the age of 65 years old by 2014, TRB noted – a “graying rate” that’s almost twice as fast as the overall workforce.

Healthwise, too, truckers face other problems: according to recent research, 55% of truck drivers overweight and more than 50% smoke, compared to a national overall average of 20.9% and 25%, respectively.

This issue of surrounding aging drivers is only continue to grow unless measures are taken to increase awareness about medications that can impact safe driving, noted Kathleen Marvaso, AAA’s vice president of public affairs. High-risk groups include those with multiple medical conditions and those taking multiple medications or potentially driver impairing medications. "[We] need to be aware of health and wellness issues which can affect their ability to drive safely," she said.

Indeed, it’s a trend that will bear watching.

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