Medical review of fitness to drive in older drivers: the Maryland experience.
BACKGROUND
Over the next several decades, both the number and percentage of older drivers will increase dramatically. Older age is inherently associated with medical conditions, particularly those involving cognition and vision, that can affect medical fitness to drive. Over a 60-year period, the Maryland Motor Vehicle Administration (MVA) in conjunction with its medical advisory board (MAB) has matured a comprehensive system to identify at-risk older drivers and to assess their medical fitness to drive.


METHODS
This paper describes the medical review process in general, and in particular for older drivers, that has evolved in the state of Maryland. The resources, philosophy and research underpinnings of its MAB review process are examined.


RESULTS
Studies of functional screening measures in older drivers indicate that older drivers at risk of being at-fault for future crashes can be identified. The feasibility of using such screening measures for drivers referred to the MVA has been confirmed by practical use for a period of seven years.


CONCLUSIONS
It is possible to create a medical review process with a goal of "safe mobility for life" that supports preservation of the driving privilege among many older drivers.
Soderstrom
Carl A
CA
Medical Advisory Board, Maryland Motor Vehicle Administration, Glen Burnie, Maryland 21062, USA. csoderstrom@mdot.state.md.us
Joyce
John J
JJ
D000056:Accident Prevention / Q000592:standards / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008004:Licensure / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D008297:Male; D008396:Maryland; D016743:Mental Competency; D008609:Mental Status Schedule; D010809:Physical Fitness / Q000502:physiology* / Q000523:psychology*; D018570:Risk Assessment; D017751:Safety Management; D013647:Task Performance and Analysis