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Japan introduces tougher cognitive function test for elderly who want to drive

TOKYO — Japan has begun implementing a tougher cognitive function test for elderly who wish to renew their driver’s license, in a bid to determine those at risk for dementia and to curb the rise of serious traffic accidents.

An elderly woman pushes a walking aid as she walks on a street at Tokyo's Sugamo district, an area popular among the Japanese elderly. Reuters file photo

An elderly woman pushes a walking aid as she walks on a street at Tokyo's Sugamo district, an area popular among the Japanese elderly. Reuters file photo

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TOKYO — Japan has begun implementing a tougher cognitive function test for elderly who wish to renew their driver’s license, in a bid to determine those at risk for dementia and to curb the rise of serious traffic accidents.

Although it is expected that the new revision will encourage elderly suspected of dementia to forfeit their driver’s license, resulting in fewer serious accidents, municipalities must also devise ways to address the needs of elderly people who have relied on cars due to limited availability of transportation.

In recent years, there has been a spike in the number of accidents caused by elderly drivers — often with tragic results.

A man in his 80s driving a light truck plowed his vehicle into a group of elementary school students, killing a first grade student and injuring six others in Yokohama last October.

Prime Minister Shinzo Abe held a cabinet meeting to discuss how to handle the rise in such traffic accidents across the country, in which the elderly become both offenders and victims.

The revised law, which took effect March 12, has made a tougher dementia test mandatory for people aged 75 or older when they renew their driver’s license every three years.

The number of driver’s license holders in the ageing demographic subject to tougher mandatory tests has nearly doubled from around 2.58 million in 2006 to some 5.13 million in 2016, according to the National Police Agency. This population size is expected to soar as the postwar baby boomers join them around 2025.

Medical checkups will be mandatory if drivers aged 75 or older are suspected of dementia in the cognitive test when they renew their driver’s license. Those diagnosed with dementia will subsequently have their driver’s license revoked or suspended.

Compulsory testing every three years had already been required before the latest revision to the law, but even those who were suspected of suffering from dementia did not need to see a doctor unless they violated certain traffic regulations, such as driving backwards or through a red light.

So there was a risk of a person causing a serious accident, if their symptoms worsened over the three years.

Overall, fatal traffic accidents in Japan totalled about 3,400 cases last year, down from about 6,100 in 2005. But those caused by drivers aged 75 or older have remained flat at more than 400 each year over the same period.

Last year, a total of 459 fatal traffic accidents were caused by such aged drivers, accounting for around 10 percent of the total. Of the 459 cases, 31 broke designated traffic rules in the lead up to their accidents, which might have been prevented by mandatory dementia testing.

The law revision is expected to increase the number of drivers who have to see a doctor for a dementia check from 4,027 in 2015 to around 50,000 a year, of which 15,000 are expected to have their driver’s license revoked or suspended, up from 1,472 the same year, according to the National Police Agency.

The new revision is expected to further prevent traffic accidents, and the police agency is also urging doctors nationwide to cooperate in examining the elderly for signs of dementia.

Amid the rapidly ageing society, the number of drivers who voluntarily returned their license jumped from 19,025 in 2005 to 345,313 in 2016, according to the agency.

Tokyo and Osaka saw particularly high numbers of voluntary license forfeits, compared to relatively low figures in rural areas due to limited public transportation networks in those places.

In the Nishimera village, Miyazaki Prefecture in southwestern Japan, people aged 65 or older account for 40 percent of the total villagers, many of whom drive a car to go to fields or the hospital.

The municipality offers a taxi coupon worth ¥144,000 (S$1,810) as a one-time benefit to those who voluntarily return their driver’s license, aiming to “facilitate them in getting used to life without a car”, a municipality official said.

In much of Japan’s countryside, however, the revised law may deprive the elderly of daily transportation means.

Mr Hiroshi Shinoda, 75, who routinely drives in his town of Kuroshio, Kochi Prefecture in western Japan, said despite the inconvenience he understands the importance of the enhanced screening to prevent the elderly from causing serious traffic accidents.

“It’s inevitable that we have tougher medical tests to prevent severe damage,” but added that “a car is essential for daily life in a mountainous village where buses run only once a day. The elderly would not be able to function in their daily lives without substitute means such as taxi-sharing.”

The National Police Agency set up a committee in January to discuss the issue with relevant ministry officials, dementia researchers and traffic psychologists, among others.

The authority is considering taking further measures based on physical characteristics of the elderly, such as deteriorating judgement and eyesight and detailed analyses of accidents.

Mr Kiyoshi Komoda, an automotive critic, said, “We want healthy elderly to drive but screening for dementia is necessary to prevent accidents. The problem is the symptoms are up and down with dementia, probably making it more difficult in some cases for doctors to make a judgement.” KYODO

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