The Importance of Driving for Seniors
The private automobile is the primary mode of transportation in the United States. Persons over age 65 make more than 90 percent of their trips by private vehicle, either as a driver or passenger. The trips they make connect them to the goods, services, and activities that make it possible for them to continue to live independently.
Not being able to drive has consequences for the individual and the family. Research shows that individuals who must stop driving experience "lower life satisfaction, poorer adjustment, loneliness, and lower activity levels.
"Families or friends may experience anxiety or guilt about not being able to meet the non-driver's transportation needs.
Growing Reliance of Older Persons on Driving
An increasing proportion of the older population has relied on being able to drive themselves through most of their lives. This is reflected in the growing rates of persons age 65 and older who are licensed drivers. In 1996, 74 percent of all persons aged 65 years and older were licensed drivers, compared to 61 percent in 1983. A significant segment of this population is aging in places where alternative modes of transportation, such as buses and walking, are not available. In 1995, 44 percent of older persons lived in suburban areas and 28 percent in rural areas. The remaining 28 percent lived in cities. Most suburbs are designed so that residents must drive from residential areas to shopping and services. The lack of public transportation in rural areas has further increased reliance on the automobile.
Older Drivers and Safety
As a group, persons age 65 and older are relatively safe drivers. Although they represent 14 percent of all licensed drivers, they are involved in only 8 percent of police-reported crashes and 11 percent of fatal crashes. This can be compared to drivers age 16 to 24, who are involved in 26 percent of police-reported crashes and 26 percent of fatal crashes, but represent only 14 percent of licensed drivers.
In fact, drivers age 65 and older have a lower rate of crash involvement per 1,000 licensed drivers than any other age group. They also drive fewer miles on average than any other age group.
When drivers over 65 are involved in crashes, the situations and reasons are generally different from those associated with crashes involving younger drivers. For older drivers, the situations in which crashes occur most frequently are when they are turning left, whereas for younger drivers, crashes occur most often while they are driving on a straight road or highway. The errors most often involved in older driver crashes are failing to yield right of way or not responding properly to stop signs and traffic lights. By comparison, the errors most frequently made by younger drivers are related to speed or to following too close.
Among all drivers age 65 and older, it is the oldest drivers who pose more risk to themselves and to public safety. For all adults age 25 to 64, and for adults age 65 to 69, the rate of crashes per miles driven is relatively constant. The rate begins to rise at age 70, and increases rapidly at age 80.
In addition, the risk of the oldest drivers dying if they are in an accident is substantially greater than it is for those age 65 to 69. In 1996, drivers age 80 to 84 who were involved in a crash were more than four times as likely to die as drivers age 65 to 69 who were involved in a crash. Drivers age 85+ were six times as likely to die in a crash as drivers age 65 to 69. When compared to crash-involved drivers of any age group under 65, the difference in the fatality rate is much more dramatic. For instance, drivers age 85+ are more than 11 times as likely to die in crashes than drivers age 40 to 49. Traffic safety experts attribute this large difference in part to the increased physical fragility of the oldest old.
Why Are Older Drivers at Greater Risk When They Drive?
As one ages, specific functions related to driving skills may be impaired. These functions include vision, hearing, sensation, and cognitive and motor abilities. For example, a decline in peripheral vision may affect the ability to pass approaching vehicles safely, and the decreased range of motion in an older person's neck may impair the ability to look behind when backing up. In addition, reaction time decreases by almost 40 percent on average from age 35 to 65.
The aging process may also affect cognitive skills. Short-term memory loss, for instance, can impair driving skills by interfering with a person's ability to process information efficiently when merging with traffic or changing lanes. Such difficulties are magnified when the older driver performs these driving skills under stressful conditions. The higher incidence of cognitive impairment, particularly dementia, among older adults produces an increased risk of accident involvement.
Environmental Barriers to Safe Driving
The surrounding driving environment may also interfere with the safety of older persons when they drive. For instance, the design and location of modern roadways can be intimidating to older drivers. Transportation planners have given little consideration to designing roads in ways that accommodate the increasing number of drivers with reduced vision or reaction time. Highways separate residential areas from commercial areas, thereby increasing both the complexity and distance involved in reaching necessary services.
Many traffic signs have not been designed for an aging population. Lettering is often small, signs with a large amount of information may be confusing, and the spacing of the letters may create a reading problem even for a person with a mild vision impairment.
Furthermore, the vehicles in which older persons find themselves may also impede extended years of safe driving. Modern instrument panels may provide a confusing array of information. Airbags may need fine-tuning so the force of inflation does not break older persons' more fragile bones.
Reducing the Risk for Older Drivers
There are several approaches to increasing safety for people who rely on the automobile as their major source of mobility. Transportation experts are seeking ways to improve the driver, the vehicle, and the driving environment.
Improving the Driver
Transportation experts at universities and in state and federal offices are conducting research and developing ways to improve driver assessment, so that impairments of driving skills can be accurately identified. A 1996 study shows that simulators can both identify impaired skills and teach the driver how to compensate for the impairment. Other research is attempting to develop predictive screening methods using both performance in skills tests and driving records.
In addition, driver retraining courses are available. AARP has developed a driver education program, the 55 ALIVE/Mature Driving program, which is completed by about 640,000 older drivers annually. Thirty-four states and the District of Columbia have laws that require insurance premium discounts or reductions in infraction points for older people who take an approved driving course like 55 ALIVE.
State licensing policies can also extend the period during which a person with minor limitations can drive safely. Sixteen states have enacted graduated licensing laws. These laws enable the state to identify driving conditions under which a particular driver might be unsafe and then to issue a graduated license that restricts the person from driving under those unsafe conditions. Holders of graduated licenses might be licensed to drive only under specific conditions relating, for example, to time of day, destination, or type of vehicle.
Some state licensing laws focus on physical or medical conditions. As of 1992, seven states had licensing laws that required physicians to report physical or medical conditions that might impair driving skills to the state licensing bureau.
Some states have enacted laws that use age as a screening tool to identify risky drivers. These states require special testing for renewal such as knowledge tests, vision tests, or road tests. However, researchers do not currently know whether age-based requirements result in removing unsafe drivers from the roads or in simply reducing the number of older drivers, whether they are safe drivers or not.
Older persons may also regulate their own driving behavior. They may stop driving or limit driving to accommodate their individual declining capabilities. On average, persons age 65 and older drive substantially fewer miles than drivers in any younger age group.
In addition, older drivers often adopt different travel patterns, driving shorter distances, driving less at night, and avoiding rush hours, major highways, and bad weather conditions.
Improving the Vehicle
Safety experts are giving special consideration to enhancing the safety of vehicles for older drivers. These changes can benefit all drivers. For instance, automobiles are being designed with special adaptations to make driving easier, such as wide-angle rear-view mirrors. In addition, new technologies such as crash avoidance alarms and night vision enhancement systems are being developed to supplement functions needed for driving.
Improving the Driving Environment
The driving environment can also be modified. The Federal Highway Administration has developed a handbook for state traffic officials on road design and management that improve the safety of the driving environment for older persons. The lettering, color, size, and location of traffic signs can be changed to significantly improve visibility and communication with the driver. Traffic and road design can enhance driver safety by including left-turn lanes or traffic signals that show who goes first. "Traffic calming" - slowing the speed of traffic through neighborhoods with special road design and planning - can enhance safety both for drivers and pedestrians. One example of traffic calming design is the traffic bump.