Photo/Illutration The cognitive function test requires participants to view 16 images while listening to audio descriptions and then recall as many as possible. (Shoko Mifune)

At the Samezu Driver's License Center in Tokyo on a recent day, dozens of elderly individuals were lined up for the cognitive function test to renew their driver's licenses.

An 81-year-old business consultant passed the test but was visibly shaken, expressing concern about his declining cognitive abilities.

"I don't want to cause an accident at the end of my life," he said. "I'm considering voluntarily surrendering my license." 

Fifteen years after Japan implemented mandatory cognitive assessments for drivers aged 75 and older, questions remain about the effectiveness of the program.

On average, an exceptionally high rate of 97.6 percent of those taking the test pass.

Experts are concerned that the test may not be stringent enough to prevent accidents involving elderly drivers.

The assessment requires participants to view 16 images while listening to audio descriptions and then recall as many as possible.

The 81-year-old driver who passed the test at the Tokyo center said that he failed to remember four or five images. He noted that his performance has been declining with each test, which is required every three years when renewing his driver's license.

The cognitive function test was introduced in 2009 in response to a surge in fatal accidents involving elderly drivers. A failing grade requires a medical evaluation and individuals diagnosed with dementia are prohibited from renewing their driver's licenses.

However, experts are concerned that the test may not be sufficiently challenging to be effective.

"Driving is a complex task that requires various cognitive functions, such as memory, spatial awareness, attention and judgment," said Yoshihiko Koga, a professor emeritus of psychophysiology at Kyorin University. "These abilities decline with age, increasing the risk of accidents."

"An excessively high pass rate of the tests could lead to the program becoming a mere formality," he added.

In response to these concerns, the National Police Agency has implemented additional measures.

Since 2017, drivers who commit certain traffic violations must undergo cognitive function tests, even if their licenses are not due for renewal. In 2022, a driving skills test was introduced for drivers with a history of certain violations.

While accidents continue to occur in all age groups, accident rates among drivers aged 75 and older have actually declined since the introduction of the tests.

Last year, police reported 384 fatal accidents involving drivers in this age group, compared to 422 in 2009. Although the decline may seem insignificant, it is noteworthy considering that the total number of elderly drivers has more than doubled during the same period, from 3.24 million to 7.28 million.

However, as the number of elderly drivers increased, their proportion among all age groups of drivers also rose. Last year, fatal accidents involving drivers aged 75 and over accounted for 16.4 percent of the total, up from 9.5 percent in 2009.

While the data suggests that the current cognitive function tests may contribute to enhancing traffic safety, experts say reforms to the driver assessment system are needed.

Mika Yanagihara, a journalist who has extensively covered traffic accidents, argues that Japan needs to develop a more effective system for assessing driving skills and capabilities. 

"It is possible to create a test that is designed to weed out those who are not fit to drive," she said.

Yanagihara also suggested that there should be improved coordination between licensing authorities and medical institutions to share information about drivers with medical conditions that could impede their driving ability.

"It's important to consider that everyone will eventually lose the ability to drive safely," she said. "People need to plan for a life without a car, including where they will live."

(This article was written by Shoko Mifune, Daichi Itakura and Hiroshi Nakano.)

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