Assessing Driving in Older Adults: Perspectives of Vision Care Providers

Despite the relationship between vision, aging and driving, there is a dearth of research investigating the perspectives of vision care providers (VCPs) regarding their role in their older patients’ decisions about driving. This study investigated VCPs’ attitudes about, barriers to, actions taken regarding, and information used when assessing the driving capabilities of their older adult patients. Additionally, this study describes the referral patterns of VCPs when driving concerns are identified as well as additional assessment resources desired by VCPs. The authors surveyed a stratified random sample of 500 VCPs (response rate 80.1%, n=404), identified using membership lists of the Michigan Society of Eye Physicians and Surgeons and the Michigan Optometric Association, about their attitudes and behaviors surrounding driving evaluation. Linear regression analyses were performed to identify associations with responses. Over 80% of VCPs feel confident in their ability to determine whether vision is adequate for safe driving. VCPs cite liability risk – both for reporting (24%) and not reporting (44%) -- as a barrier to reporting unsafe drivers. Two-thirds report routinely inquiring about driving and 86% consider counseling patients about driving their responsibility. Approximately 60% are concerned that reporting patients negatively impacted the doctor-patient relationship and 43% think reporting is a breach of doctor-patient confidentiality. Significant differences were found between VCP characteristics, particularly, provider type, regarding attitudes and behaviors around driving evaluation. Based on responses of “often” or “always”, the vision tests that VCPs reported to be most frequently used in assessing driving capabilities included visual acuity (99%), peripheral vision (82%), and visual field (66%). VCPs less frequently considered other medical conditions (49%) and medications that might affect driving (33%). Inquiries by VCPs about night driving, reading signs, and glare were very common (≥87%), whereas questioning about other driving challenges (merging, making left turns, and backing up) and the patient’s recent driving record were infrequent (<10%). VCP characteristics that increased the likelihood of seeking driving information included female gender, younger age, and general practice (vs. specialization). Regarding referral, 36% of VCPs report sometimes/often/always relating concerns about patients’ driving to the primary care physician. Additional resources endorsed by VCPs as helpful/very helpful included driving assessment guidelines (81%), clinical screening instruments (70%), and a patient self-evaluation tool (60%). While VCPs view advising patients regarding safe driving as an important responsibility, addressing barriers, finding ways to increase communication between VCPs and other members of the healthcare team, and providing useful resources deserves further attention.

  • Record URL:
  • Supplemental Notes:
    • This document was sponsored by the U.S. Department of Transportation, University Transportation Centers Program. Cover title: Addressing Driving with Older Adults: Investigating the Perspectives of Vision Care Providers.
  • Corporate Authors:

    University of Michigan, Ann Arbor

    School of Public Health
    Ann Arbor, MI  United States  48105

    University of Michigan, Ann Arbor

    Michigan Center for Advancing Safe Transportation throughout the Lifespan
    2901 Baxter Road
    Ann Arbor, MI  United States  48109-2150

    Research and Innovative Technology Administration

    University Transportation Centers Program
    1200 New Jersey Avenue, SE
    Washington, DC  United States  20590
  • Authors:
    • Janz, Nancy K
    • Musch, David C
    • Leinberger, Rebecca L
    • Niziol, Leslie M
    • Gillespie, Brenda W
  • Publication Date: 2011-11-15


  • English

Media Info

  • Media Type: Digital/other
  • Features: Figures; References; Tables;
  • Pagination: 20p

Subject/Index Terms

Filing Info

  • Accession Number: 01703111
  • Record Type: Publication
  • Report/Paper Numbers: M-CASTL 2011-03
  • Created Date: Apr 26 2019 12:05PM