Liisa Hakamies-Blomqvist

Driving tests with older patients : Effect of unfamiliar versus familiar vehicle

The aim of the study was to study the effect, for older license holders, of taking a driving test with an unfamiliar vehicle, as compared to their own cars. The study population consisted of licensed patients 65-85 years referred to the Traffic Medicine Centre (TrMC), Huddinge University Hospital, for an evaluation of their medical and cognitive fitness to drive. In the clinical practice of TrMC, driving tests have been used since 1997, with inspectors from the Swedish National Road Administration (SNRA) acting as evaluators. Initially, patients were allowed to use their own cars. From the beginning of the year 2000, however, dual brakes were made mandatory and most evaluations were then made with SNRA cars. When comparing the outcomes of driving tests from the period prior to 2000 (n=96) and after 2000 (n=69), it was found that the number of drivers who failed the test increased by 16%. Also, those who passed the test after more than one trial decreased by 20%. The potential of the neuropsychological assessment to correctly classify drivers in outcome groups was considerably reduced in the period after 2000. These results support the view that, for older drivers with cognitive deterioration, the need to adapt to an unfamiliar vehicle represents a supplementary cognitive load that may compromise their driving ability and the validity of the assessment. A measure aimed only at increasing the safety of examiners and examinees thus had an unintended side-effect that is detrimental to older clinical populations.

Attitudes of Primary Care Physicians Toward Older Drivers: A Finnish-Swedish Comparison

Finnish and Swedish general practitioners(GPs) activities, knowledge, and attitudes related to aging and driving were compared using a mail survey to evaluate the effects of the two countries different driver licensing policies. The hypothesis was that the existence of an obligatory medical screening system in Finland would make the Finnish GPs more active or knowledgeable concerning aging and driving than their Swedish colleagues with no experience of such a system. The survey was sent to a random sample of registered GPs who worked in primary health care centers in Sweden (n = 1,500) and in Finland (n = 1,527); 1,682 respondents completed the form and were included in final analysis. The results did not support the hypothesis: The Swedish GPs reported more activities than did their Finnish colleagues. The level of knowledge was similar in both countries, but the Finnish GPs had higher confidence in their diagnostic competence and more restrictive attitudes than did the Swedish GPs. The existence of an obligatory medical screening system hence did not make the Finnish GPs more active or knowledgeable concerning aging and driving compared to their Swedish colleagues. In contrast, it may contribute to the Finnish GPs unrealistic confidence in their own assessment skills and in the adequacy of the present screening system in Finland.