The high fatality rate in the elderly population may be related to diminished physiologic reserve. There is often concomitant chronic medical disease, including cardiovascular, pulmonary and immunologic disorders. Osteoporosis increases the risk of fracture. Corrected for severity of injury, elderly patients are five to six times more likely to die of similar injuries than younger drivers. State reporting laws vary regarding potentially unsafe drivers.
Some states require physicians to specify conditions such as epilepsy or dementia.
All seven states give physicians who report unsafe drivers immunity from litigation. Ten states permit physician reporting, but Ohio and North Dakota do not grant immunity. Other jurisdictions permit physician reporting only after the patient has refused to report himself. In states without immunity, physicians may be reluctant to report a potentially unsafe driver. Confidentiality and respect for patient privacy are fundamental to medical care and the patient-physician relationship.