By Beth Levine

There is a lot of concern about teen drivers with ADHD getting behind the wheel. And, while that apprehension is valid, not as much attention has been paid to older drivers with ADHD.

Well, guess what? In a study recently published in JAMA Network Open, researchers at Columbia University Mailman School of Public Health found that older drivers were roughly twice as likely to be in a crash or receive a traffic ticket than their neurotypical counterparts. They also are a bit more likely to use hard braking — the term for when someone needs to slam on their brakes to avoid a crash.

Study participants were active drivers aged 65 to 79 years in the Longitudinal Research on Aging Drivers (LongROAD) project. That’s a multi-state study to gather data about driving safety among older drivers.

The study tracked older drivers for approximately 44 months via data-recording devices in their cars and annual assessments. The study found about 3% of the adult drivers in the project had ADHD— “which actually is quite consistent with two other reports from Europe,” says senior study author Guohua Li, MD, DrPH, professor of epidemiology at the Mailman School of Public Health,

Li and other experts launched the LongROAD project after they found that older adults suffered from mental health issues, such as depression and suicidal ideation, after giving up driving. The project is supported by the AAA Foundation for Traffic Safety.

“We would like to prolong driving, because it helps keep the balance between independence, mobility and safety in general in the United States. In previous studies, we’ve seen that women stop driving about 12 years before death, and men stopped driving about eight years before death. A concern is that once we give up the privilege of driving, we lose to a large degree our freedom and independence and become dependent on others,” says Li.

Li and his team looked specifically at older drivers with ADHD because they hope to use the survey results to increase public awareness of ADHD “because while ADHD has been extensively studied in children and young adults, there’s very little research on ADHD in old age,” Li says.

Interventions to Keep Older Drivers with ADHD on the Road Longer

But people with ADHD should not despair. There are things you can do to keep yourself driving longer, says Annie Garner, PhD, an associate professor in the Department of Psychology at Saint Louis University in St. Louis, Mo.

First, the easy stuff:

• Take your ADHD medications to control ADHD symptoms, obviously. But more important, make sure you time them so they are working when you are driving. Many long-lasting ADHD meds take time to take effect in the morning and are no longer in effect in the afternoon. Talk to your prescribing doctor about the times of day you drive and when you feel your medication is no longer active. And talk about medication options to ensure that medications are working when you are on the road.
• Go over your other medications with your prescribing physician. Some may cause drowsiness; others may not.

“Studies have shown that older adults with ADHD have significantly more medications prescribed to them than the older adults without ADHD,” Garner says. “To me, that raises questions about what other medications they’re on, and whether some of those medications might contribute to an increased crash risk.”The CDC presents this fact sheet on prescription medications, over-the-counter medicines, dietary supplements and some herbal products that can that increase your risk of a fall or motor vehicle crash

• Get enough sleep. Sleep conditions like sleep apnea can affect attention, and sleep disturbances are more prevalent among individuals with ADHD. A common treatment for sleep apnea is the overnight use of a CPAP machine — which stands for continuous positive airway pressure.
• “If you are using a CPAP, check that you are using it appropriately so that you are alert and more attentive when driving,” cautions Garner.

• Consider cognitive behavioral therapy (CBT) to give you coping mechanisms when you are on the road.
• Reduce distractions. No singing along to the oldies, no radio or podcasts, ask your passengers to keep the yakking to a minimum, no texting and no phone calls — even if they’re hands-free. In fact, keep your phone in the glove compartment so you aren’t tempted to take a peek while driving.

High Tech Help

First, an important word of caution: Garner warns against relying solely on these apps and optional automobile features. In fact, a recent study published in the journal Transportation Research Part F: Traffic Psychology and Behaviour found that vehicle automation led teen drivers with ADHD to take longer glances off the road, increasing crash risks. Similar effects were found in a second study published in the journal Accident Analysis & Prevention in terms of hazard anticipation.

So use these aides, but use them wisely. You still have to do your due diligence, too. They are meant to support you only — not do all the work for you:

• Download apps that block calls and texts while the car is moving, such as Apple iOS 1, which offers a Do Not Disturb While Driving Mode.
• Automatic Emergency Braking built into some cars detects a potential car crash and automatically brakes for you.
• Forward-Collision Warning in some cars tells you if you are following the car ahead too closely.
• Lane Departure Warning in some cars signals with a beep if you drift into another lane with no warning.
• Lane-Keeping Assist in some cars actually provides assistance with steering and braking assistance if you start to drift.

Happy Travels!

Age doesn’t necessarily have to keep you off the road, even if you have ADHD. Follow these recommendations and you may be hitting the road for longer than you thought possible.