Management of Functionally Impaired Drivers

Leonard, Kathleen M.; Edwards, Jerri D.; Utley, Dawn · 2006 · ROSA P / University Transportation Center for Alabama

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Summary

This study addresses the growing highway safety concern regarding functionally impaired older drivers in Alabama. As the population ages, declines in sensory, motor, and cognitive skills—such as visual acuity, neck mobility, and processing speed—increasingly affect driving ability. The research was motivated by the need to balance public safety with the older drivers' desire for independence, noting that current Alabama regulations rely on self-monitoring or physician reporting, which are often ineffective due to drivers' lack of insight into their own impairments. The primary objective was to identify high-risk drivers and evaluate licensure renewal alternatives that could protect citizens while maintaining mobility. The researchers employed a multi-method approach involving surveys, performance testing, and comparative analysis. First, they surveyed 323 Alabama residents to assess attitudes toward driver screening and safety issues. Second, they administered the DRIVINGHEALTH® (DHI) inventory, a computerized battery assessing visual, cognitive, and physical functions, to drivers of various ages. This included a specific analysis of 900 older drivers (aged 64–97) whose performance was correlated with crash records obtained from the state. Third, the team conducted a literature review of licensure requirements in other states to identify best practices. Finally, they generated and weighted seven potential licensure alternatives for Alabama, evaluating them based on safety impact, personal cost, and state expense. The findings revealed strong public support for mandatory screening, with 72% of survey respondents agreeing that Alabama should require screening at license renewal, regardless of age. Performance data showed that older drivers performed significantly worse than younger drivers on all DHI subtests. Crucially, older drivers with a history of crashes performed significantly worse on specific subtests measuring processing speed (UFOV), divided visual search (Trails B), and leg strength/mobility, even after adjusting for miles driven. No significant correlation was found between self-perceived driving ability and actual performance, supporting the need for objective testing rather than self-regulation. Among the seven proposed alternatives, the highest-rated option was implementing a comprehensive driver battery (cognitive, physical, and visual) for drivers over a certain age or at accelerated renewals. Visual testing for targeted age groups was ranked second, while maintaining the status quo was ranked lowest. The study concludes that Alabama should implement a comprehensive screening tool for older drivers at re-licensure. The authors argue that mandatory, performance-based testing is necessary because older drivers often lack the insight to self-regulate their driving despite functional declines. By identifying at-risk individuals through tools like the DHI, the state can refer drivers for remediation or education rather than simply revoking licenses, thereby enhancing overall road safety while preserving the independence of older citizens. The research highlights that functional screening, when integrated with education and counseling, offers profound benefits for injury prevention and societal safety.

Key finding

Older drivers with a history of crashes performed significantly worse on the Unfocused Field of Vision and Trails B subtests of the DRIVINGHEALTH Inventory compared to those without crash involvement.

Methodology

dataset

Sample size: 900

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via bulk_ingest_rosap on 2026-05-23 (6 acquisition events logged).

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

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• licensing policy
• older driver retraining
• fitness to drive assessment
• older drivers
• mci dementia driving
• age related perceptual decline

Information type

What kind of knowledge this paper contributes, grouped by family — independent of topic (what it is about) and method (how it was studied).

• Applied Guidance: policy recommendations
• Empirical Findings: observational prevalence
• Methodological Resource: validation psychometrics