Objective. European countries practice a wide range of car driving license renewal procedures. These range from issuing lifelong licenses without subsequent medical checks, to issuing a license to age 70 and for 3- or 5-year periods thereafter based on self-declarations of medical fitness, to requiring medical examinations for renewal, to renewal every 5 years from the age of 45. This paper presents a case study of the different older driver licensing procedures in seven European countries and addresses the association between these procedures and older driver safety.

Method. The seven countries studied consist of France, The Netherlands, the United Kingdom, Denmark, Finland, Norway, and Sweden. The first-mentioned three countries have the most relaxed license renewal procedures and least demanding medical examination requirements.

Results. There is no evidence that any license renewal procedure or requirement for a medical examination has an effect on the overall road safety of drivers aged 65+, though undoubtedly there are individual drivers who should no longer be driving who might be detected by stringent renewal procedures. Considering the three countries with the most relaxed licensing procedures, The Netherlands and United Kingdom have the lowest fatality rate for car drivers aged 65+, and the rate for France is falling rapidly.

Conclusions. There is also evidence that stringent renewal procedures and demanding medical examinations at renewal reduce the level of car driving licenses among older people. France, The Netherlands, and the United Kingdom have the highest level of driving license holding by people aged 65+, which has direct implications for the independent mobility of older people. Reduced mobility also has safety implications: in about half the European countries for which road accident fatality data have been analyzed, people aged 65+ are at greater risk of death as a pedestrian than as a car driver.