Summary

Medical conditions affecting driving ability become more common with age, raising concerns about road safety in older adults. Many countries impose medical examinations for license renewal, but policies differ widely, and the evidence base supporting such requirements remains unclear. In Israel, the age-based re-licensing policy is currently under review. We conducted a systematic search of all 38 Organisation for Economic Co-operation and Development (OECD) countries about requirements of age-related medical examinations for driver’s license renewal (September–November 2023). Searches were performed in English and local languages. Additional data were obtained from the OECD official website and by direct correspondence with representatives. Six countries (16%) had no stated age-related policy. Among the 32 countries with defined policies, 16 (50%) set the examination threshold at ≥ 70 years, five (16%) at ≥ 50, three (9%) at ≥ 75, and two (6%) at ≥ 80. Five countries (16%) explicitly declared no age-related requirements. The United States (3%) lacked a unified federal policy, with thresholds varying by state from 63 to 85 years. The frequency of reassessment also differed widely, and none of the policies provided an evidence-based rationale. The absence of data-driven justification underscores the need for research to establish consistent, evidence-based health policies that define appropriate medical evaluation requirements for older drivers.