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HELPING OLDER ADULTS STAY SAFELY BEHIND THE WHEEL
Dr. Shawn Marshall wants to help guide important conversations about driving
- For many older adults, driving represents far more than transportation. It means independence, connection to family and friends, access to essential services, and the freedom to remain active in their communities.
Yet as we age, health conditions can affect the physical and cognitive abilities needed to drive safely. For clinicians, deciding when to raise concerns about a patient's fitness to drive is one of the most difficult conversations to have with older adults. Existing assessments often lead to an all-or-nothing decision, with few tools available to objectively measure an individual's level of risk.
“There are enormous benefits to keeping older adults in the driver’s seat for longer,” says Dr. Shawn Marshall, Investigator with the Bruyère Health Research Institute. “Revoking a license prematurely has huge consequences, so we want to make sure that we have a way to evaluate driving in a way that’s reflective of actual risk.”
Understanding a personal level of risk
- Most older adults are safe drivers. But when medical conditions create uncertainty, health care providers need better ways to understand an individual's risk without relying on age alone.
To address this challenge, Dr. Marshall and the Candrive research team developed the Candrive Risk Stratification Tool, the first standardized tool of its kind designed to help clinicians assess an older adult's risk of being involved in a collision. Built using health and driving data collected over seven years from 928 drivers aged 70 and older across Canada, the tool provides an objective benchmark that can be completed in just five minutes during a clinical visit.
Rather than asking whether someone should or should not drive, the tool helps identify different levels of risk, allowing conversations to be tailored to each person's circumstances.
“Crash risk is a meaningful outcome that patients understand,” says Dr. Marshall. “It’s a tangible consequence, and with an objective measure of risk, we can support clinicians in assessing the nuances of driving risk and ability with greater certainty.”
"There are enormous benefits to keeping older adults in the driver’s seat for longer."
Dr. Shawn Marshall
Investigator, Bruyère Health Research Institute
Supporting nuanced conversations about driving
- The research team sees this tool as a way to shape a positive conversation with older adults. While certain conditions are clear indicators it’s time to hang up the keys, many cases are more nuanced.
With this new approach, older adults can expect a more nuanced conversation and recommendation from clinicians. For some, that might mean adjusting driving habits, pursuing additional assessments, or participating in remedial driving lessons. For others, it provides reassurance that they can continue driving with confidence.
“We can shift the conversation from license revocation to focusing on supporting independence whenever it is safe to do so,” says Dr. Marshall. “The future of healthy aging isn't simply about helping people live longer, it’s about helping older adults remain active, connected, and independent as much as possible.”
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