Assessing Driving in Older Adults: Perspectives of Vision Care Providers

Janz, Nancy K; Musch, David C; Leinberger, Rebecca L; Niziol, Leslie M; Gillespie, Brenda W · 2011 · ROSA P / University of Michigan

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Summary

This study investigates the perspectives of vision care providers (VCPs), including ophthalmologists and optometrists, regarding their role in assessing the driving safety of older adult patients. With the population of drivers over age 65 projected to grow significantly, and vision being a primary factor in driving licensure and safety, understanding how VCPs evaluate and counsel patients is critical. The research aimed to identify VCPs’ attitudes, barriers, behaviors, referral patterns, and desired resources for driving assessment, addressing a gap in literature that had previously focused mainly on family physicians. The researchers surveyed a stratified random sample of 500 VCPs from Michigan professional organizations, achieving an 80.1% response rate (n=404). The survey, based on the Health Belief Model and pilot-tested, assessed attitudes, barriers, referral practices, and resource preferences using Likert scales. Multivariable linear regression analyses were conducted to identify associations between provider characteristics (e.g., type, gender, age) and their responses. Results indicated that while 86% of VCPs consider counseling patients about safe driving a responsibility and 81% feel confident in their ability to assess visual adequacy for driving, only 39% believe they should report unsafe drivers to government agencies. Major barriers included liability concerns (24% feared liability for reporting; 44% for not reporting) and fears of damaging the doctor-patient relationship (57%) or breaching confidentiality (43%). VCPs frequently used visual acuity (99%), peripheral vision (82%), and visual field (66%) tests but rarely assessed other medical conditions or medications. Significant differences emerged by provider type; for instance, MD-specialists were less confident in their assessment abilities and less likely to view counseling as a core responsibility compared to optometrists. Referral rates were low, with only 36% of VCPs reporting concerns to primary care physicians. Most VCPs endorsed driving assessment guidelines (81%) and clinical screening instruments (70%) as helpful resources. The study concludes that while VCPs view driving advice as important, significant barriers related to liability, confidentiality, and inter-provider communication hinder effective intervention. The findings highlight a need for standardized assessment tools, clearer guidelines, and improved communication strategies between VCPs, primary care physicians, and patients to facilitate safe transitions from driving to non-driving status.

Key finding

Vision care providers cited liability risk for both reporting and not reporting unsafe drivers as primary barriers, with 43% viewing reporting as a breach of confidentiality and 57% concerned about negative impacts on the doctor-patient relationship.

Methodology

survey

Sample size: 404

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

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• licensing policy
• sensory abilities
• older drivers
• mci dementia driving
• fitness to drive assessment
• older driver retraining

Information type

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• Methodological Resource: tool software