Marco Trabucchi, president of the Italian Association of Psychogentria
Gianluca Dotti
During this summer, the chronicles reported the theme of suitability for the driving in old age to the center of public attention. In more than one case, ultraottanenteni motorists have taken motorway in counterclin or committed other sensational errors, causing fatal accidents or with serious injuries, as happened on 27 July last on the A4 Turin-Milan, in the Novarese, On the border with Lombardy, when an 82 -year -old elderly had entered the opposite direction to a toll booth and clashing with a car from the opposite direction he died causing the death of 3 other travelers. Then, four days later, another over 80 entered On the A32 Turin Bardonecchia In the wrong sense, ending up colliding frontally with another car and causing the death of the passenger who traveled with him.
Net of the emotional impact, the question raises real and complex questions: How is it possible to guarantee the safety of all road users, without arbitrarily compressing the right to the mobility of the elderly? It makes no sense to deal with the theme with ideological or rigid approaches, he warns Marco Trabucchipsychiatrist, geriatrician and president of the Italian Association of Psychogeriaria. «It would be unjustified to exclude all the elderly from the guide on principle – observes – and whoever does it too simple is a cialtrone. Advanced age alone is not a clinically valid indicator. The real knot is to build better tools to scientifically evaluate the psychophysical conditions of each person, without giving in lassism or prejudice ».
According to Trabucchi, who in this period is dedicating a lot of energy to the theme, We need a profound revision of the driving license renewal criteria, indicatively for those who are more than 75 years old. The current medical examinations are not enough. «Today we are talking about checks that last a few minutes, I don’t want to say superficial but certainly they do not investigate essential aspects such as operational memory, reflexes and attention, in addition of course hearing and vision. A short neuropsychological screening, already experienced in other contexts, would allow to grasp hidden deficits that increase the risk of driving error ». Statistical evidence support the need for an intervention.
According to Istat and ACI data relating to 2023, Between seventy -year -olds and eighty years of age, 2,312 and 2,190 seriously injured in road accidents were recorded respectively. Even more significant is the data on the mortality rate: the 85-89 class has recorded the highest value ever, with 103.8 victims every million inhabitants, exceeding even twenty points even the twenties.
In the group of elderly, the problem is not related to imprudence, but to a progressive decline – often subtle – of the sensory and cognitive skills, to which is added the particularly critical point of the variability of the performance.
“The same person can guide well in the morning and lose lucidity in the afternoon, thanks to the heat, a discussion, a digestive difficulty or the interaction with a drug – explains Trabucchi –. Geriatric medicine teaches us that the stability of functions is not guaranteed. For this reason, serious checks are needed, but also flexible over time, but also the awareness that you cannot completely eliminate the risk and have total control».
ASAPS, the Friends of the Traffic Police Association, also reported a growth in the cases of driving in countermenation attributable to the elderly: 14% of the total cases, which rises to 32% for those with a fatal outcome. The situation has aggravated in recent weeks, with peaks over 60%, an anomaly that requires punctual checks, but which certainly has a summer heat in the summer heat.
But there is another factor to consider, often neglected: the systemic effect of the revocation of the license. In many areas of the country, especially the internal or rural ones, the car is the only means of accessing health services, shopping, going to religious functions, participate in social life.
«In contexts where public transport are ineffective – says Trabucchi – Remove the license means, in fact, to isolate the person. The difficulties multiply, and the risk of an accelerated decline increases significantly».
The theme also concerns the summer months. Just in summer, many elderly people remain alone in the city, while children and family members move away from holidays. «It is precisely in these moments – warns Trabucchi – that risks grow, also due to the effect of high temperatures. Dehydration, common in old age, can temporarily alter cognitive functions and compromise driving safety ».
Among the most discussed solutions, the introduction of progressive driving limitations: prohibiting access to motorways or circulation in night hours for those who exceed a certain age threshold or present light deficits. This approach is already in use in some European countries and aims to find a balance between autonomy and protection. The role of the family and the general practitioner becomes in this decisive framework. Family members, in particular, are often the first to notice behavioral or cognitive changes.
For Trabucchi, it is essential “Educating families to face the question without reticence, but with realism. There is no need for alarmism: together with road safety, it is a question of building an environment where the elderly can continue to live well, Even if it is necessary to stop guiding ».
