Research Papers

The impact of restricted licenses on crash risk for older drivers: A systematic review

Filename 3B-Ogilvie-FP.docx
Filesize 76 KB
Version 1
Date added June 30, 2016
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Category 2016 CARSP XXVI Halifax
Tags Research and Evaluation, Session 3B
Author/Auteur Mark Asbridge, Ediriweera Desapriya, Rachel Ogilvie, et. al.
Stream/Volet Research and Evaluation

Slidedeck Presentation not available

Abstract

Background/Context: As the Canadian population ages there is an urgent need to identify evidence-informed strategies which have the potential to enhance older adults’ safety and independent mobility. Previous research has demonstrated the positive impact of continued independent mobility on older adults’ health and community engagement. Restricted driver licensing policies have been mandated in several countries as an intervention to facilitate traffic safety and independent mobility for older drivers. Studies testing the effectiveness of individual policies have produced mixed findings; a systematic examination of the impact of restricted driver licensing policies on reducing morbidity and mortality among senior drivers is warranted.

Aims/Objectives: The objectives of this study were to examine if restricted driver licenses are more effective than unrestricted driver license in 1. reducing crashes, 2. reducing traffic violations, and 3. facilitating continued independent mobility for older drivers.

Methods/Target Group: The methodological approach of this study was systematic review. A comprehensive electronic database search was conducted to identify all literature related to restricted driver license policies. A total of 3331 abstracts and 39 full text articles were reviewed. Seven papers met the inclusion criteria and were included after rigorous quality and risk of bias assessment using the Newcastle-Ottawa Scale (NOS). All seven studies reported motor vehicle collisions as the primary outcome measure, which included more than 2.1 million participants with or without a driving restriction. Our comprehensive search resulted in a very heterogeneous set of included studies, which meant that meta-analysis was not appropriate. The synthesis is a narrative interpretation and discussion of the seven individual studies.

Results/Activities: Results showed that restricted driver licensing may be effective at reducing crash risk for older drivers with few health conditions, and those requiring few driving restrictions. The review also demonstrated that in the majority of studies medically-restricted drivers incur fewer traffic violations than non-restricted drivers or drivers with non-medical restrictions. Overall, the review of evidence on both crash risk and traffic violations yielded mixed, yet promising results.

Only one included study assessed the impact of restricted licenses on older adults’ independent mobility, with results indicating a positive impact. Overall, a major limitation of this body of research is a failure to consider if, and how restricted licenses facilitate older adults’ independent mobility.

Discussion/Deliverables: The results of this systematic review demonstrated that restricted driver licensing has the potential to improve traffic safety among the general population and positively impact independent mobility of older Canadians. Efforts should be focused to educate health care professionals about such options so they may advise their clients appropriately and avoid making premature driving cessation recommendations. Moving forward, more evidence is needed on the direct impact of restricted licensing on older adults’ independent mobility and more generally, quality of life.

Conclusions: Supporting older drivers to safely remain independent and engaged in the community has positive impacts on all strata of society. Restricted licensing is one approach that has the potential to promote road safety for all and contribute to improved quality of life for older adults.

Mark Asbridge, Ediriweera Desapriya, Rachel Ogilvie, et. al.