OBJECTIVE A person's orientation in space-also of importance in road traffic-is largely dependent on hearing and sense of balance. These functions are subject to a physiological ageing process that needs to be taken into account. Major points: The effect of age and illness-related problems on a person's ability to cope with road traffic is discussed on the basis of a study of the literature. A detailed discussion of the effects of vestibular disorders on driving ability and the ability to cope with road traffic is discussed. CONCLUSIONS There is no such thing as an age-related general unfitness to cope with road traffic, merely an individual impairment. Nevertheless, it is our view that the recommendation that hearing and the sense of balance should be regularly checked in the elderly is not taken seriously enough. For it is only in this way that self-monitoring can be improved and the demands posed by modern traffic met.