Some common medications impair driving in older adults: study

New research suggests that some drugs prescribed to older adults appear to be impairing their ability to drive.

US and South African researchers assessed 198 cognitively healthy people aged 65 and above with a valid driver’s licence to determine whether specific medication classes were associated with performance decline, as assessed by a standardised road test to evaluate additional associations of poor road test performance with comorbid medical conditions and demographic characteristics.

They found that drivers were more like to fail a road test as they aged if they were prescribed certain antidepressants, sedatives or hypnotics, nonsteroidal anti-inflammatory drugs (including aspirin and ibuprofen) or paracetamol.

Data was collected from participants in St Louis, Missouri, and neighbouring Illinois, where participants were enrolled in the Knight Alzheimer’s Disease Research Centre, between 28 August 2012 and 14 March 2023.

The outcome measure was performance on the Washington University Road Test, with the outcome defined by pass or marginal/fail. Multivariable Cox proportional hazards models were used to evaluate associations between potentially driver-impairing medication use and road test performance.

The study found that of the 198 included adults (mean [SD] baseline age, 72.6 [4.6] years; 87 female [43.9%]), 70 (35%) received a marginal/fail rating on the road test over a mean (SD) follow-up of 5.70 (2.45) years. Any use of antidepressants (adjusted hazard ratio [aHR], 2.68; 95% CI, 1.69–4.71), serotonin and norepinephrine reuptake inhibitors (aHR, 2.68; 95% CI, 1.54-4.64), sedatives or hypnotics (aHR, 2.70; 95% CI, 1.40-5.19), or nonsteroidal anti-inflammatory drugs (aHR, 2.72; 95% CI, 1.31-5.63) was associated with an increase in risk of receiving a marginal/fail rating on the road test compared with control individuals.

Conversely, participants taking lipid-lowering agents had a lower risk of receiving a marginal/fail rating compared to control individuals. There were no statistically significant associations found between anticholinergic or antihistamines and poor performance.

It should be noted, however, that while the study of older adult drivers found that antidepressants, SSRIs or SNRIs, sedatives or hypnotics, and NSAIDs or acetaminophens were associated with an increased risk of poor driving performance on a road test, researchers could not determine whether these medications directly caused the risk of decline in driving performance individually or collectively.

Researchers suggest that physicians and pharmacists be aware of potential driving risks in older drivers who are prescribed psychotropic drugs and pain medications and provide consultation accordingly.

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