With more senior drivers on the road than in years past, the importance of assessing driver fitness has increased. In the latest issue of Mayo Clinic Proceedings, researchers look at this topic along with tools that clinicians can use to determine if patients are able to safely operate a vehicle. "Driving retirement is a normal part of aging, and should be carefully considered and discussed openly," says Ericka Tung, M.D., a Mayo Clinic internist and geriatrician, and lead study author. "Primary care providers are uniquely poised to counsel patients about driving safety because they understand their patients' health conditions, capacities, challenges and goals." While there isn't a single one-size-fits-all test that can be performed, providers can look at several areas of functioning to assess driving fitness. These areas include:

- Cognition, including changes in memory, attention or language.

- Vision, including visual fields and depth perception.

- Mobility and physical function, including functional range of motion, and coordination of the neck, upper body and lower body.

- Health conditions, including underlying conditions that could affect the ability to safely operate a vehicle

- Medications (A medication list should be reviewed to verify that there is no drug interaction that could impair driving alertness.)

Equally important in a patient's workup is the input of family members or care partners. The authors note that recorded observations of a loved one's driving performance, his or her ability in completing basic tasks of life, or a history of falls can be useful in determining when it's time to stop driving. Depending on clinical findings, driving rehabilitation or alternative transportation may be warranted.

Since driving provides a sense of independence and control for many seniors, it is important that any decision be communicated clearly and with compassion. When determining if it's time to stop driving, it is critical that a conversation with a patient's primary care provider occurs, so that patient can retire from driving at the appropriate time - rather than waiting for an accident. "Open dialogue is encouraged between patients, families and primary care teams to ensure safety on the road," says Tung.

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