TCD Researcher Involved in First Irish Cochrane Review in Geriatric Medicine

Posted on: 15 April 2009

Findings of the first Irish Cochrane Review in geriatric medicine concerning driving and dementia which were recently published show the current screening of drivers over 70 years of age is inefficient.

Professor Desmond O’Neill, Consultant Physician at Aois agus Eolas ― the Centre for Ageing, Neurosciences and the Humanities at the Adelaide and Meath Hospital, Dublin Incorporating the National Children’s Hospital and Associate Professor of Gerontology at the Trinity College School of Medicine, worked on the review with lead author of the research, Dr Alan Martin, specialist registrar also at the hospital and concluded that assessments for those over 70 do not help make the roads safer.

The Cochrane Review methodology was applied to prior joint research on ageing and driving conducted by the Centre for Ageing, Neurosciences and the Humanities and Yale University . The review supported the findings that the cognitive test which most strongly predicted future crashes would, if used as a screening tool, potentially prevent six crashes per 1,000 people screened over 65 years of age, but at the price of stopping the driving of 121 people who would not have a crash.

The systematic nature of the Cochrane Reviews* adheres to a strict design in order to make them more comprehensive, therefore minimising the chance of bias, and ensuring their reliability.  Professor O’Neill commented that the Cochrane Reviews were a vital research tool in evidence-based healthcare, and that the medical community in Ireland were fortunate that the Health Research Board (HRB) had funded open access to the Cochrane Reviews for Ireland .

Commenting on the research Professor O’Neill said: “Repeated studies had shown that older drivers were not a greater risk on the road and, while there was some impairment of function as drivers get older it was compensated for by their experience and caution. There is a French saying which, when translated, says, ‘In getting old, you get more mad and more wise’, and people forget you get wiser. Older people tend to be sensible drivers. Their accident record is better than younger drivers every year.”

Professor O’Neill has also recommended to the Road Safety Authority, which is currently reviewing the fitness-to-drive guidelines, that it should move the resources that are wasted on the screening of older drivers to a more targeted process and look at putting in place an assessment system for people over 70 who are known to have a significant medical problem, which would be much more cost effective.


*About the Cochrane Reviews
Based on the best available information about healthcare interventions, Cochrane Reviews explore the evidence for and against the effectiveness and appropriateness of treatments (medications, surgery, education, etc) in specific circumstances. Designed to facilitate the choices that doctors, patients, policy makers and others face in health care, the complete reviews are published in The Cochrane Library four times a year. Each issue contains all existing reviews, plus an increasing range of new and updated reviews.