Older New Zealanders renewing their driver licence should no longer be put through a cognitive screening test simply because of their age, under expanded guidance for family doctors that Seniors Minister Casey Costello welcomed on Tuesday.
The guidance from the Royal New Zealand College of General Practitioners tells GPs that routine cognitive screening during fitness to drive checks is no longer recommended. Doctors can still use a screening test when there is a clinical reason, such as a concern about a patient’s memory or thinking, or when the patient is unknown to them and there is not enough information to judge.
“People should be assessed as individuals. A single screening test cannot determine whether someone is safe on our roads,” Ms Costello said in a government statement.
A New Zealand driver licence expires at age 75, again at 80 and every two years after that. To renew, drivers need a medical assessment from a doctor or nurse practitioner, and the appointment is not government funded, 1News explained in June. That assessment has covered physical health, medical history, memory and cognitive function.
The change rests on a review by Professor Ngaire Kerse and Dr Ruth Teh of the University of Auckland’s Department of General Practice and Primary Health Care, commissioned by NZTA and the Office for Seniors. Their report found that for older people who are physically and mentally healthy, “current evidence does not support the routine use of cognitive assessment as part of fitness to drive assessment”. It found that widely used general tests such as the Montreal Cognitive Assessment and the Mini-ACE give an indication of overall thinking ability but do not accurately predict how a person performs on the road.
The report does not pretend older drivers carry no extra risk. Using NZTA crash records for 2020 to 2022, it found older drivers cover fewer kilometres than younger drivers but have a higher rate of crashes per kilometre driven. The authors urged caution in reading that, writing that “ageing alone is not a contributing factor to road crashes; many older adults continue to drive safely into their advanced age.” They also noted that dementia becomes far more common with age, affecting around 4 percent of people aged 60 and over and about 14 percent of those aged 80 and over.
So the college’s guidance replaces a blanket test with clinical judgement. It says fitness to drive decisions should draw on the person’s health, function, driving history and safety risk. Where screening does seem warranted, it recommends the Mini-ACE in most situations, the MANA assessment for Māori patients aged 55 and older, and a tool called RUDAS where English is not the patient’s first language or literacy is limited. If screening points to impairment, the Trail Making Test is described as the better indicator of driving performance.
When doubt remains, GPs are pointed to the on-road safety test offered by VTNZ, the AA and VINZ, which the college lists as free, brief and available nationally, or to an occupational therapy driving assessment, where cost and region affect access. The college’s two-page guidance document keeps some firm lines too. “People with dementia of moderate severity or worse are not medically fit to drive,” it says. It closes with a reminder that “Knowing your patient remains key to deciding which assessments are needed for fitness to drive.”
Tuesday’s guidance is the last step in a change that began earlier this year. According to the Minister’s statement, the Ministry of Health updated its HealthPathways advice for clinicians in July. Grey Power, which had pushed for the review according to the NZ Herald, welcomed the new approach at the time. Grey Power North Otago president Andrew Dunn told the Otago Daily Times on 8 August, “At a time when driving remains essential for independence, social connection and everyday life in our rural communities, this is a positive and practical shift.” National president David Marshall said then, “For too long, many older drivers have been subjected to routine cognitive tests despite there being little evidence that these tests accurately measure a person’s ability to drive safely.”
Ms Costello made the same point about life outside the cities. “We know that being able to drive is vital for many older people wanting to stay connected and active in their community, particularly in rural areas,” she said. “These can be difficult decisions for health practitioners. Clearer guidance will help them make those decisions consistently and with confidence.”
Twenty years ago the argument was over a different test. On 18 June 2006 Prime Minister Helen Clark announced that the mandatory on-road driving test for drivers aged 80 and over would end on 4 December that year. The medical certificate stayed, and GPs were given the option of referring a medically fit driver aged 75 or over for an on-road safety test if they were worried. That same on-road test is now the fallback the new guidance points to.
The pressure on the system is growing. Figures obtained by 1News showed the number of licensed drivers aged 75 and over rose 53 percent over the past decade, against 17 percent growth in all licence holders. Ministry of Transport figures compiled in our road toll tool show people aged 60 and over accounted for 82 road deaths in 2025, more than any other age band, although that band is wider than the others and it counts everyone killed, whether driving, riding as a passenger or walking. 1News noted in June that older people are significantly more likely to be seriously hurt or killed when they are in a crash.
None of this changes the law. Licences still expire at 75, at 80 and every two years after that, a medical certificate is still needed to renew, and health practitioners keep the responsibility for deciding whether someone is medically fit to drive. If a doctor has concerns about a person’s thinking, they can still recommend further assessment or a practical driving test.
Families who are worried about a parent’s driving can still raise it with the GP, although a privacy law change in May means the doctor may have to tell the patient that the information was received, as we reported in July.
Have you or a parent been through the licence renewal medical at 75 or 80? Did it include a memory test, and did it feel fair? Tell us how it went in the comments below.
This article was written by AI, briefed to report the facts, hopefully without some of the bias people bring to the job 🙂
Leave a Reply