Highway Bureau, MOTCHighway Bureau, MOTC

1. Background of planning driving license management system for elderly drivers

In recent years, media often reported the cases of elderly drivers failing to drive safely. According to the statistics done by National Police Agency, MOI, the numbers of deaths caused by traffic accidents in A1 category are mostly elderly. It has become one of the popular concerns among the nationals for how to establish an effective driving license management system in terms of elderly drivers’ driving safety.

2. The purpose of implementing driving license management system for elderly drivers

In consideration of the changes on physical functions caused by aging, and these changes will affect the competence in safe driving, including the delay of reaction time, the slowing down of overall action, the declining perception-action presentation, cognition changes in concentration and identification, and visual changes. Based on the care of elderly drivers’ road safety, a proper testing mechanism shall be established in terms of physical and mental conditions to help elderly understand whether their physical conditions are suitable for driving a vehicle. It can also provide the family members a reference to advise those who are not suitable for driving to stop it. The driving license management system for elderly drivers is planned and promoted with the reference to the management systems in the advanced countries in order to maintain the road safety for the elderly and for other road users.

3. International systems- summary of management regulations for elderly drivers in other countries

1. Definition of age for special management: In Japan, it is an age of 70 years old; 65 years old in Singapore, 60 years old in Hong Kong, and 70 years old in the UK, which is the lowest in the western countries.
2. Control of validity on different driving licenses: It uses the approach of shortening the validity of the driving license; usually to 3 years or 2 years.
3. Special requirements when applying for license renewal: Health examination form signed by the doctor, receiving educational training, and implementing road test.
4. Other special management measures and approaches: Limiting the driving in the daytime or on the community road. In France, drivers with specific disease will be limited on the validity of driving license. In Germany, drivers will be restrained on driving if involving with driving accidents or will be required to submit a qualified health examination certificate.

4. Schedule for driving license management system for elderly drivers

Ministry of Transportation and Communications started to develop and evaluate the management system for elderly drivers since 2013. Other than asking the diplomatic missions of Taiwan under the authority of Ministry of Foreign Affairs to collect driving license management rules for elderly drivers, it also takes the reference to the approach of cognitive function testing used in Japan and entrusted Taiwanese Society of Psychiatry to research and develop the cognitive function testing system.

Highway Bureau held public hearings at Taipei, Taichung, Kaohsiung, and Hualien in December 2014 to communicate the planning and ideas of management system on the elderly drivers as well as to listen to the opinions from the public.

Opinions from the 4 sessions of public hearings were summarized in May 2015 and then medical experts and relevant departments were invited to develop concrete proposal. The conclusion was the system will be applied to automobile and motorcycle drivers and riders who are aged at 75 or above and the reviewing cycle is license renewal for every two years. The application of license renewal will have to pass health examination standard regulated in road traffic safety regulations as well as the cognitive function testing.

In order to promote internet participation mechanism, an internet platform was used to interact with the public in order to widely consult the opinions from the public before formulation of the policy as well as enhance the quality of policy communication. Public opinions were collected through the website of “Public Policy Internet Participation Platform- Public” under the supervision of National Development Council. After statistics, there were 86% of the public favoring the topic.

Motor Vehicles Offices (Stations) all over the country started to carry out pilot cognitive function testing on elderly drivers at age 75 or above in May 2016. By January 2017, there were 7,943 people completing the test and 5,803 people among them passed the test with a pass rate of 73.06%.

5. Driving license management system for elderly drivers

1. Object: Drivers who have been issued general automobile and motorcycle driving license:
   1. Drivers who are at 75 years old or above after the implementation date.
   2. Drivers who are 75 years old or above and involved with specific violations or license suspension after implementation date.
2. Time limit for license renewal and the validity on the driving license:
   1. For Drivers who are 75 years old after implementation date (that is drivers who were born after July 1st, 1942 (included)), the deadline for the initial license renewal is one month before 75 years old to the expiration of full three years; the validity on the driving license is until the driver is 78 years old (based on the date of birth). For drivers involved with specific violation or license suspension before renewal, they shall handle the renewal within three months after the notification date and the validity on the driving license will be until 78 years old (based on the date of birth).
   2. For Drivers who are 75 years old before implementation date (that is drivers who were born before June 30th, 1942 (included)) and involved with specific violation or license suspension after the implementation date, they shall handle the renewal within three months after the notification date and the validity on the driving license will be until 78 years old (based on the date of birth).
   3. After implementation date, the validity on the initial driving license elderly drivers at 75 years old or above apply for will be three years.
   4. For the renewed or applied driving license based on above three rules, drivers can apply for the reissuance of new license with a validity of three years to the highway supervision authority within one month before or after the expiration.
3. Reviewing method: Other than passing “health examination”, please submit the proof of passing “cognitive function testing” or enclose “certificate of not suffering from moderate dementia or above”.
   1. Health examination:
      Health examination should follow the provision on Article 64.1.1 of Regulations for Road Traffic Safety. If the physical or fitness change and is different from the condition of original driving license application , please deal with it according to regulations for automobile and motorcycle driving license for people with disability.
   2. Cognitive function testing:
      Along with the increase of age, the degeneration of physical function is an important focus. Considering the elderly are prone to dementia in our country in recent years, We take reference to the approach used in Japan and entrust Taiwanese Society of Psychiatry to develop the cognitive function testing. A simple cognitive function testing is planned to be carried out during license renewal to test Drivers’ correct cognitive ability towards time and space, short-term memory and thinking ability, judgment as well as the ability of working their hands and minds together; to initially test whether the drivers are prone to dementia. Drivers who fail to pass the cognitive function testing shall go to medical institutions for further examination. If the examination result is above moderate dementia and the drivers do not have safe driving ability, the driving license will not be renewed and reissued based on the safety consideration.
   3. The three procedures in the cognitive function testing can be used to understand drivers’ following abilities:
      1. Correct cognitive ability toward time and space- The applicant gives the answer of the day, date, month, and year of the testing date as well as the location. The suggested scores for passing standard uses 4 points/3 points as the cut-off score. There are five questions in total; to pass the test, correct answers for 4 questions or above are required.
      2. Short-term memory and thinking ability- Showing 10 images related to daily life and traffic environment to the applicant and then putting the images away. After two minutes, ask the applicant to name the images showed. The suggested scores for passing standard uses 3 points/2 points as the cut-off score. To pass the test, it requires to name three images shown or above.
      3. Testing judgment and the ability of working hands and minds together- Draw a big circular clock on the testing paper and complete the drawing of the clock with the numbers and location that shall appear on the clock as well as draw the correct of the short hand and long hand of the specified time on the clock. The suggested scores for passing standard uses 4 points/3 points as the cut-off score. There are seven items for assessment; that is, obtaining 4 points or above is passing the test.
   4. To pass the cognitive function testing, the applicant must pass all the three tests above.
   5. The venues that implement cognitive function testing are supervision offices, public hospitals, public health centers, and the private hospitals, clinics, and agencies that are contracted with supervision offices.
4. Handling mechanism for failing to apply for license renewal according to the regulations
   1. Drivers who are 75 years old after the implementation date and are reported driving with overdue license will be fined from NT$1,800 to NT$3,600 and be prohibited from driving according to “operating vehicles with an expired driving license” specified in Article 22.1.7 of Road Traffic Management and Penalty Act. However, no punishment will be carried out if the license renewal is completed according to the rules within three months after the notice date.
   2. For drivers over 75 years old after implementation date and involve with specific violations or license suspension, they will be informed to return back the driving license. If they fail to return the license, the supervision office will directly announce the license revocation.

6. Flow chart for elderly drivers’ license renewal

Supervision offices select files and send out notice

1. Drivers go to medical nstitution for health examination.
2. Drivers go to testing unit for cognitive function testing:
   1. Procedure 1: Test on correct cognitive ability towards time and space.
   2. Procedure 2: Test on short-term memory and thinking ability.
   3. Procedure 3: Test on judgment and ability of working hands and minds together.
3. Drivers go to hospital for dementia test.
4. Passing health examination and passing cognitive function testing or enclosing certificate of not suffering from moderate dementia or above.
5. Reissuing a driving license with a validity of three years.
6. License renewal will not be granted.