Driving has become an essential instrumental activity of daily living. As we age we need our cars to get to the doctor, the pharmacy, the grocery store, and to places of leisure and worship. Those who lose the ability to drive can experience isolation and depression. As rehabilitation professionals we have assessments to help determine whether an older person can drive safely, and we have interventions to enhance driving performance. We can also offer guidance on alternatives to the use of personal automobiles for those who can no longer drive safely. While the area of older driver safety and mobility is relatively new, there is a growing body of literature on the topic. This special issue of Topics in Geriatric Rehabilitation provides reports of recent research, overviews of tools for rehabilitation professionals, and new perspectives on viewing the issue of older driver safety and mobility.
From the University of Florida's National Older Drivers Research and Training Center, lead investigators Sherrilene Classen and Orit Shechtman and colleagues provide companion articles reporting on studies of the impact of roadway design on driving performance, one using simulated driving and the other actual on-the-road driving trials. We know how important the environment can be in facilitating other instrumental activities of daily living and basic activities of daily living. This research demonstrates how important the road environment can be for older drivers.
Assessment of driving performance is a critical issue, addressed in 5 articles in this issue. We want older drivers to drive as long as they can drive safely. Loren Staplin of TransAnalytics and Bella Dinh Zarr of AAA (formerly known as the American Automobile Association) report on self-assessment tools they have developed. John Eberhard, formerly with the National Highway Transit Administration, and colleagues provide an excellent compilation of information relating to safe mobility of older persons, including resources on assessment. Michael Justiss, also with the University of Florida's National Older Drivers Research and Training Center, reports on a behind-the-wheel driving assessment for older adults he developed within his doctoral dissertation. Cristina Posse and colleagues at the University of Florida report on the reliability of the American Medical Association's physician screening instrument for older drivers. Judith Friedland of the University of Toronto and colleagues provide a provocative article on the role of family doctors as "regulators" of driving privileges for older drivers.
What does an older driver program look like? Wendy Stav and colleagues describe the University of Florida's "Independence Drive." This program provides evaluations, driving interventions, and counseling on alternative approaches for older drivers. Christopher Mitchell of the Transportation Research Board provides an overview of the issues of being a pedestrian, with a comparison of approaches used in Europe and the United States.
In the final article, Kezia Awadzi and colleagues of the University of Florida's Public Health Program describe a public health model for viewing older driver safety.
William C. Mann, OTR, PhD
Issue Editor