As a physician, Bhattacharya spends much of her time seeing senior patients at the Landon Center on Aging, which has led to her research interest in older driving safety. We spoke to Bhattacharya about her work on helping seniors drive more safely — and helping them make the transition to being non-drivers when that is no longer possible.

Can you tell us what drew you to researching driver safety for older people?

I have built a geriatrics practice where I have seen the value of providing support to patients and families surrounding the complex issue of driving safety. The anguish that loved ones feel as they see their parent drive is written on their faces when they come to me. I enjoy supporting patients through this, giving caregiver guidance and researching this complex topic.

How often does driver safety come up with your older patients?

Every week, I see patients and caregivers challenged by a driving concern. It may be a child not wanting their parents to drive or a patient perceiving driving limitations.  It is a topic that is often not addressed in a health provider’s visit and is one that I see is crucial for patient and public safety.

What are some of the cognitive issues that can affect older drivers?

Cognitively, dementia is the most common neurological disease that affects driving safety.  Cognitive impairment can result in deficits of judgment, attention, executive function and response to driving stimuli. Strokes may also affect the driving safety of individuals, depending on the resulting physical and cognitive impairments. And the use of medications such as benzodiazepines, opioids, sedatives, illicit drugs and barbiturates can also affect driving fitness.

And what physical issues can cause issues with older drivers?

Visual impairments are a common cause of driving limitations, including cataracts, glaucoma, macular degeneration and diabetic retinopathy.  Physical weaknesses and impairments can lead to an inability to get in and out of a car, a loss of pedal control and difficulty with blind spot detection.  And neuropathy from diabetes or strokes can impair the force your foot feels against a pedal, inaccurately giving feedback on acceleration and deceleration.

Why is losing the ability to drive safely so devastating to many seniors?

Driving is a marker of independence, especially in a rural state like Kansas. It is a symbol that stands for autonomy, self-worth, freedom and mobility. Losing the ability to drive is perceived as losing all of this, which is heartbreaking.

Can you talk about why you think an interprofessional approach is important when providing help for older drivers?

That approach is a key to providing support for older drivers and their families. Driving fitness encompasses multiple domains including physical therapy, occupational therapy, caregiver support which involves social work, as well as overall physical health. It takes an interprofessional team to work together and to communicate with each other to formulate a plan.

When an older person reaches a point where they can no longer drive safely, what transportation alternatives are available to them and their families or caregivers?

Common transportation alternatives include selling your car and using public transportation or services like Uber and Lyft; using Go Go Grandparent or senior transport where it’s available; and using social services as a resource.

Much of your work is in the field of geriatrics. What attracted you to this area of family medicine?

My older patients during my family medicine residency convinced me to pursue geriatrics. I’ve enjoyed the life lessons older adults teach me, the appreciation they have for health care professionals and the smiles I see in their eyes. I feel honored to be able to guide them with their medical needs, polypharmacy issues, memory loss and end-of-life concerns.

Tell us about your research work around commercial drivers and safety?

We conducted a five-year study funded by the U.S. Department of Transportation exploring clinical tools to improve the on-the-road performance of commercial drivers. We studied 31 commercial drivers, and, among the results, we found that the number of tickets a commercial driver received over a five-year period was related to the number of years of education they had.

Are there any other areas of research that are on the horizon for you?

We would like to explore the impact of electric vehicles on older drivers. How does the change in attention, screen time and pedal control impact their driving performance?  In addition, using our pilot data results, we would like to explore how we can help school bus drivers improve their on-the-road performance.