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Dr. Bonnie Dobbs, from the Faculty of Rehabilitation Medicine, is an expert in the science of medical conditions and driving cessation. She has recently participated in a symposium in Cambridge, Mass. on the consequences of giving up your license and works to educate physicians, family members and licensing boards on identifying deficiencies that lead to an increased risk of traffic crashes.

On a per-person basis, older drivers have low crash rates, partly because they spend less time on the road. However, their crash rate per number of kilometers driven is alarmingly high. The rates rise steadily after age 70 and for drivers 75 and older it rivals or exceeds that for drivers aged 16 to 24.

While age itself isn't an automatic reason for poor driving, older drivers are faced with more medical conditions such as stroke, cardiovascular disease or taking any drugs that have prominent central nervous system effects.

Some older drivers impose restrictions on their own driving--such as avoiding driving at night or on weekends or under bad weather conditions--but the high crash rate of seniors suggest that not enough people are doing so. Part of the problem is that older drivers have lost the insight to judge their own driving ability. Dobbs has found that drivers with dementia significantly overestimate their driving competence--yet at some point in the progression of their illness, all drivers with a dementia such as Alzheimer disease will have to stop driving.

Not only is it a problem for the person with the disease but for the caregiver as well. Dobbs has previously found that more than one-third of caregivers considered driving to be one of the most difficult aspects of caregiving. Despite this important loss there are few, if any, programs available that are specifically designed to assist individuals and their caregivers in coping with this negative event. Dobbs has changed that. She is in the middle of a two-year study funded by Alzheimer Canada that tests the effectiveness of intervention for not only the person with dementia but for the caregiver as well.

"Driving is so central to one's ability to go about their day," said Dobbs. "It's also imperative that we revoke the licenses for some of these people but we want to make it easier to take that away. So far we think almost everyone has found this process to be very helpful."