【Event Report】The Center Organized a Forum on “Is Elderly Driver Management Policy Feasible?Symposium on Traffic Injury Prevention and Balancing Mobility Rights of Older Adults” to Discuss Policy Strategies for Road Safety Among Older Adults.

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(From left to right: Deputy Director Chang Yao-Hui from the Motor Vehicles Division of the Directorate General of Highways, Secretary-General Chang Shu-Ching from the Federation for the Welfare of the Elderly, Director Lee Po-Chang from the Center for Health and Welfare Policy at Taipei Medical University, Director Wu Chih-Ying from the Department of Family Medicine at Wanfang Hospital, and Professor Pai Chih-Wei from the Institute of Injury Prevention and Control at Taipei Medical University)

On July 15, the Center for Health and Welfare Policy at Taipei Medical University hosted a policy forum titled “Elderly Driver Management: Feasibility, Traffic Injury Prevention, and the Right to Mobility for Older Adults.” The event explored key issues including the current elderly driver management system, injury and accident analyses, the impact of medications and illnesses on driving risks, and the traffic autonomy of older adults. The goal was to identify balanced strategies that safeguard both the mobility needs of the elderly and overall traffic safety, and to foster a safe, inclusive, and flexible transport environment for an aging society.

Lee Po-Chang, Director, Center for Health and Welfare Policy, TMU

In his opening remarks, Director Lee stated that as Taiwan enters a super-aged society, elderly driving has become an increasingly important issue. Age-related physiological and cognitive differences pose new challenges for traffic policies that must balance road safety with fairness. He expressed hope that this forum, through its multi-disciplinary perspectives, would inspire more practical and innovative ideas to inform future policymaking and contribute to a more age-friendly traffic environment.

Chang Shu-Ching, Secretary-General, Federation for the Welfare of the Elderly

Secretary-General Chang highlighted that Taiwan’s population aged 65 and over has exceeded 4 million. She emphasized that mobility is not only fundamental to seniors’ health and quality of life, but also essential for social participation and active aging. Despite motorcycles and walking being the primary transport modes for the elderly, issues such as insufficient pedestrian infrastructure and inadequate rural public transit limit their mobility rights.

She proposed several policy recommendations, including a tiered subsidy mechanism, expansion of accessible vehicle fleets, flexible transportation services, partnerships with community-based organizations for transport programs, and improvement of pedestrian environments (e.g., pedestrian refuge islands, longer green light durations). She also stressed the need for better training of public transport drivers in age-friendly practices, the establishment of interdepartmental coordination platforms, and the inclusion of elderly voices in policymaking. She concluded by affirming that the right to mobility is a fundamental human right, and every senior deserves safe, dignified, and autonomous travel.

Chang Yao-Hui, Deputy Director, Motor Vehicles Division, Directorate General of Highways

Deputy Director Chang noted that Taiwan is rapidly becoming a super-aged society. To support older drivers and ensure road safety, the government has implemented elderly driver management policies. The number of licensed drivers aged 70+ is projected to grow from 1.826 million in 2025 to 2.72 million in 2035. Since 2017, drivers aged 75+ are required to undergo physical and cognitive function assessments, with license renewals tied to their violation records and age.

To enhance convenience and accessibility, the Directorate has introduced an online license cancellation system and a cognitive test simulation platform, which has recorded over 300,000 visits. Over 870,000 license renewal notices have been sent, with a 94.1% compliance rate. Chang also noted that countries like Japan and South Korea have already initiated similar systems. Taiwan currently begins support services at age 70 and is planning four major updates: incentivizing voluntary license returns with TPASS transit subsidies, requiring real-world driving training for violators, mandatory safety education before renewal, and revisions to physical/cognitive assessments. These measures aim to build a more humane and comprehensive support system for elderly drivers.

Pai Chih-Wei, Professor, Institute of Injury Prevention and Control, TMU

Professor Pai emphasized that aging diminishes drivers’ reaction time, cognitive function, and vision, increasing both their own crash severity and the risk posed to vulnerable road users such as pedestrians and cyclists. Analysis of over 420,000 car accidents (2011–2023) revealed that drivers aged 75+ had the highest pedestrian fatality rate—2.44 times that of drivers aged 41–64. Each additional year after 65 raises the risk of pedestrian death by 4.5%, and by 11.3% for those over 75.

Furthermore, unlicensed elderly drivers present even higher risks. Fatal crash risk for vulnerable road users was 1.82 times greater for unlicensed drivers aged 65–74, and 3.18 times greater for those aged 75+. Professor Pai called for a scientific, risk-based system supported by improved road infrastructure (e.g., pedestrian refuge islands, protected left-turn signals), enhanced public transportation, and better data on licensing, violations, and comorbidities to guide policy.

Wu Chih-Ying, Director, Department of Family Medicine, Wanfang Hospital

Director Wu highlighted that the health risks faced by elderly drivers—such as cognitive decline, sensory impairments, muscle weakness, and delayed reaction—can lead to judgment errors or accidents. Medications commonly used by the elderly (e.g., sedatives, anxiolytics, painkillers) further increase risks due to side effects like drowsiness or confusion. Polypharmacy (taking 4+ medications) significantly raises these risks.

Wu recommended tools like “Driver 65 Plus” for self-assessment and advocated shifting from age-based to risk-based elderly driver management. She also urged for a medical-monitoring integration platform, early identification of high-risk individuals, and promotion of alternative transportation (e.g., subsidies, community shuttle services, senior-specific vehicles) to prevent isolation or healthcare inaccessibility due to driving cessation.

Policy Recommendations:

  1. Risk-Based Tiered Management System: Replace the age-based system with one that incorporates health status, medication history, traffic violations, cognitive and physical assessments for more precise risk identification and scientific policymaking.

  2. Enhanced Alternative Transport & Accessibility: Expand subsidies, develop community shuttle systems and senior-friendly transit options, especially in underserved or rural areas.

  3. Age-Friendly Traffic Support System: Invest in safety infrastructure (e.g., pedestrian refuge islands, longer traffic signals), upgrade public transit (e.g., low-floor buses, audio stop announcements), and prevent social isolation due to driving loss by promoting flexible transport services.

  4. Cross-Sector Collaboration Platform: Integrate transportation, social welfare, and healthcare departments to deliver holistic support and optimize resource allocation.

  5. Elderly Participation in Policymaking: Institutionalize elderly involvement in policy design and evaluation; draw from international experiences (e.g., Japan, South Korea) in smart transportation, community support, and legal frameworks to realize mobility equity in an aging society.

(From left to right: Deputy Director Chang Yao-Hui of the Motor Vehicles Division, Directorate General of Highways, Ministry of Transportation and Communications; Secretary-General Chang Shu-Ching of the Federation for the Welfare of the Elderly, R.O.C.; Professor Pai Chih-Wei of the Institute of Injury Prevention and Control, Taipei Medical University; and Director Wu Chih-Ying of the Department of Family Medicine, Wanfang Hospital)