Involvement in any form of accident, even a minor mishap, is a strong indicator of risk for a major crash within five years. Patients with medical contraindications to driving should be strongly counseled to voluntarily cease driving and be given information on alternative forms of transportation. The dangers do not end once the patient quits driving. Patients may require counseling about hazards of walking in high-traffic areas. Many elderly pedestrians overestimate their walking speed when approaching oncoming traffic or may be unfamiliar with the use of crossings and traffic markers.
Insomnia leads to fatigue and napping, adversely affecting daytime functioning.
Sleep disturbances are more common in elderly persons. Insomnia may have a genetic predisposition, but it is also associated with medical conditions including arthritis and other chronic pain conditions, gastrointestinal problems, dyspnea, Alzheimer's disease and Parkinson's disease. Use of certain medications as well as use of alcohol can also cause sleeplessness. The assessment of patients with sleep problems should include detailed sleep history and search for medical causes of insomnia. If no treatable cause is found, patients should receive advice that focuses on sleep hygiene to promote healthy, natural sleep.