Ever since we were in our teens, most of us have associated our driving skills with personal freedom. The ability to use your driving skills to get behind the wheel and head on down the highway has been celebrated in American story and song as the most basic expression of personal liberty. “See the USA in your Chevrolet,” as the TV ads used to say.

Given that fact, when a senior is threatened with the loss of the freedom to drive, it can be devastating. There are certainly times when taking away the keys is the only safe response to declining driving skills based on physical or mental impairment.

But new research reported recently on the HealthDay website suggests another culprit that might be taking older drivers off the road prematurely. This new data, which the article describes as “more rigorous” than previous research, reveals how several common categories of medications can impair a senior’s driving skills.

The research might indicate that some seniors can continue driving safely with proper control of prescriptions. At the very least, says the article, doctors need to do a better job alerting older patients to possible drug dangers. HealthDay reporter Amy Norton wrote the article. Let’s examine her report – then hear a somewhat different perspective from Rajiv.

Seniors on Common Meds Face Impaired Driving Skills

Norton brings us a new study which has found that some common medications “including antidepressants, sleep aids and painkillers” may be the culprits behind the decline of driving skills in certain seniors. Even some over-the-counter painkillers are implicated, data shows.

Most medication users are aware of the label warning “Do not operate heavy machinery,” but Norton explains that this new study has taken a more serious look at the dangers of driving while under the influence of a wider array of medications, “following older adults for up to 10 years and testing their driving skills with annual road tests.”

She adds that “it turned out that those using certain classes of medications were at greater risk of failing the road test at some point.”

Driving Skills Study Was Comprehensive, Thorough

Norton writes, “The study — published September 29 in JAMA Network Open — involved 198 adults who were 73, on average, at the outset. None had signs of cognitive impairment (problems with memory, judgment or other thinking skills).”

For up to ten years (five, on average), the participants were given yearly check-ups, including a road test with a professional driving instructor. The study reports that at some point during that period, 35 percent of drivers received a failing and marginal grade on their road tests.

Driving Skills: Some Meds Can Triple the Risk of Test Failure

Certain drugs were implicated in those failing and/or marginal grades, including antidepressants, sedative/hypnotics (also called sleep medications), or non-steroidal anti-inflammatory drugs (NSAIDs). Users of these drugs were three times more likely to get a less than stellar test grade.

But Dr. David Carr, the lead researcher on the study and a specialist in geriatric medicine at Washington University’s School of Medicine in St. Louis, is quick to note that the study didn’t necessarily prove that the drugs are fully to blame. “It can be hard,” he said, “to draw a direct line between a particular medication and diminished driving skills: Is it that drug, or the medical condition it’s treating or another medication an older adult is taking?”

Still, while researchers are hesitant to assign blame, the likelihood that certain drugs play a role in poor driving performance seems undebatable. Norton writes, “In this study, though, Carr and his colleagues were able to account for many factors, including participants’ medical conditions, memory and thinking skills, vision problems and whether they lived in more affluent or disadvantaged neighborhoods. And certain medication groups were still linked to poorer driving performance.”

Driving Skills Diminish with Drug Side Effects

The medications in question work because they act on the central nervous system, and this comes with potential side effects like drowsiness or dizziness, both of which definitely affect driving.

Carr doubts that most doctors are routinely paying attention to whether the drugs they are prescribing could have this practical knock-on effect in an older patient’s life. Doctor visit time is limited, and medication discussions tend to be quick and not thorough.

“The bottom line is, we need to pay attention to this and advise our patients,” he says.

Patients Need to be Proactive, Demand Answers

Carr urges patients to be proactive about asking questions in regards to potential side effects whenever you get a new prescription. If you’re already experiencing sluggishness or other similar symptoms, be sure to ask your doctor if it could be tied to your medication.

“We wouldn’t want anyone to just stop taking their medication on their own,” Carr warns. “Talk to your health care provider about any changes.”

Doctors and Drug Companies Need to be More Responsive

Jake Nelson, director of traffic safety advocacy and research at the nonprofit AAA, agrees with Carr (though AAA was not involved in the study) that patients should be cautious about their prescriptions, but not reckless or quick to stop taking them without doctor approval.

Nelson points out that most doctors are happy to talk alternatives, if they’re available, even adjusting the times of day that you take a particular drug. “Don’t feel like you’re being a burden by asking these questions,” Nelson says. “This is about putting your health and safety first.”

But Nelson also believes that it shouldn’t all land on patients’ shoulders to tackle this issue. He says that the pharmaceutical companies should take a stronger role in alerting medication users to the risk of driving impairment. The “fine print” doesn’t cut it.

(Norton notes that AAA has further resources on safe driving for seniors.)

Driving Skills Can Be Affected by OTC Drugs

As stated, the biggest medication culprits for poor driving performance appeared to be antidepressants, sleep aids, and NSAIDs, a drug class that includes ibuprofen. “The odds were greatest for those on an antidepressant or sleep medication – with 16 percent to 17 percent putting in a poor road performance per year overall,” Norton writes. “That compared with rates of 6 percent to 7 percent of their peers not using those medications.”

But Carr points out that the researchers did find a few surprises. For example, no link was found between driving performance and antihistamines or anticholinergic medications.

This is surprising, because as Norton writes: “Antihistamines are notorious for making users drowsy. Anticholinergic medications are used to treat a range of conditions, from overactive bladder to chronic obstructive pulmonary disease (COPD) to Parkinson’s symptoms. They can cause side effects like sedation and blurred vision.”

But Carr notes that the older drivers in the study could very well have been using the newer types of antihistamines, which are non-drowsy, and that there possibly weren’t enough participants taking anticholinergics to make a difference in the results.

Nevertheless, in the end, safety should be your highest concern, Carr says, no matter what medications you’re using. Talk to your doctor about any concerns you may have, no matter what they are.

Norton concludes, “Read labels on prescription and over-the-counter medications carefully, looking for cautions about potential side effects such as drowsiness and dizziness that could impair driving.” As the adage goes: better safe than sorry – especially behind the wheel.

Rajiv’s Take: If Driving Skills are Impaired, You Have Good Options

Rajiv has seen this issue play out in hundreds of families, so, as might be expected, he recommends taking a proactive approach.

“Sooner or later,” he says, you’re going to need to hang up the car keys and stop driving. Wouldn’t it be better to map out alternatives to driving while you’re still healthy? Why put yourself and others at risk by insisting on getting behind the wheel when it’s no longer the smart, safe thing to do? When it comes to personal mobility, planning ahead is powerful.”

These days, non-driving seniors have a wide range of options, including Über, Lift, Go Go Grandparent, Silver Ride, National Volunteer Transportation Center, and more. “And how about speaking to your family and see if they might be willing and able to help?” Rajiv asks.  “How about living closer to your kids, friends, or others you trust, if not with them, so the driving issue is almost the same as no issue at all?”

Before you dig in your heels when it comes to driving, consider your options. You may find you’ll save money and stress when you decide your driving days are done. 

Breaking News: Rajiv’s New Book is Here!

We have big news! The long-awaited book by Rajiv Nagaich, called Your Retirement: Dream or Disaster, has been released and is now available to the public.  As a friend of AgingOptions, we know you’ll want to get your copy and spread the word.

You’ve heard Rajiv say it repeatedly: 70 percent of retirement plans will fail. If you know someone whose retirement turned into a nightmare when they were forced into a nursing home, went broke paying for care, or became a burden to their families – and you want to make sure it doesn’t happen to you – then this book is must-read.

Through stories, examples, and personal insights, Rajiv takes us along on his journey of expanding awareness about a problem that few are willing to talk about, yet it’s one that results in millions of Americans sleepwalking their way into their worst nightmares about aging. Rajiv lays bare the shortcomings of traditional retirement planning advice, exposes the biases many professionals have about what is best for older adults, and much more.

Rajiv then offers a solution: LifePlanning, his groundbreaking approach to retirement planning. Rajiv explains the essential planning steps and, most importantly, how to develop the framework for these elements to work in concert toward your most deeply held retirement goals.

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(originally reported at www.healthday.com)