Cognitive change, medical illness, and crash risk among older drivers: an epidemiological consideration

This paper reviews selected issues concerning the natural history of cognitive change among older persons and whether the potential effects of such change on the safe operation of a motor vehicle can detected prior to the occurrence of an adverse outcome, such as a crash. Data are reviewed from selected recent, large, population-referent epidemiological studies that have sought direct associations between medical conditions of their treatments and crash risk. Several important medical risk factors have been identified and, if confirmed, these factors must be considered along with the assessment of cognitive decline and dementia when evaluating safety issues in older drivers.