December 26, 2013

For many older adults, frailty, debilitating chronic disease, cognitive decline, worsening vision and other health problems are reasons cited for hanging up the car keys.  Despite public perception, older drivers do not pose a disproportionate threat on the roads according to the National Highway Traffic Safety Association. On average, drivers in their mid- to late-80s have lower crash rates per mile driven than drivers in their early 20s and roughly half the crash rate of teenagers.

elderly-driverIn 2012, those age 65 and older comprised 16 percent of all licensed drivers, 17 percent of all traffic fatalities and 16 percent of all vehicle occupant fatalities.  However, data from Berkeley’s Safe Transportation Research and Education Center shows that  per mile driven, the fatality rate for drivers 85 years and older is nine times higher than the rate for drivers 25 to 69 years old. That’s because older adults are more likely to die when they do crash since their bodies cannot withstand serious injuries as readily as younger people.

Researchers at this year’s Gerontological Society of America Conference looked at risk factors for driving cessation among older people over a four-year period.  They analyzed data from the Health and Retirement Study for 2006-2010 and found that older male drivers were less likely to stop driving than were female drivers. In 2011 there were 35 million drivers age 65 or older; more than three-quarters of male drivers and half of all female drivers were older than 80.

Percentage of Drivers by Age and Sex
Age Men Women
60–69 95.1% 88.2%
70–79 90.8% 77.1%
≥ 80 77.4% 52.4%
Adapted from the U.S. Department of Transportation 2009 National Household Travel Survey.© 2010-2013 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc

Should drivers be forced to hang up the keys at a certain age? Not necessarily. According to the AAA, that could lead to increased social isolation, depression, and a variety of other health issues.  It depends on the individual driver’s ability more than a pre-determined number. So what’s the solution?

Only one-third of states have stricter licensing requirements for seniors, and there is little consistency among them – some begin enforcement at age 68, others at age 80. Some require only more frequent vision or hearing exams, others mandate complete road tests.

Researchers at Berkeley found that pedestrian road fatalities increase among those who stop driving. Many older adults also shun public transit for fear of being victimized by crime. Taxis and car services are frequently out of the financial picture. A report by the Area Agencies on Aging called lack of transportation options “the silent need,” because no one wants to admit they need help getting around.

Some religious and civic groups have volunteers who will drive older adults to medical appointments, grocery shopping, or other activities. Area Agencies on Aging, Aging, Disability Resource Centers, and other social service organizations may provide fare assistance programs that enable qualified persons (usually low income older adults or persons with disabilities) to purchase vouchers for transportation services at a reduced rate.

For seniors who still think they’re safe drivers, the National Institute on Aging suggests asking themselves these questions before deciding if it’s time to stop:

  • Do other drivers often honk at me? Have I had some accidents, even if they are only “fender benders”?
  • Do I get lost, even on roads I know?
  • Do cars or people walking seem to appear out of nowhere?
  • Have family, friends, or my doctor said they are worried about my driving?
  • Am I driving less these days because I am not as sure about my driving as I used to be?
  • Do I have trouble staying in my lane?
  • Do I have trouble moving my foot between the gas and the brake pedals, or do I confuse the two?

As an adult child or relative of an older driver, this can be a difficult conversation  – experts recommend being respectful, using specific examples, helping them find easily accessible alternative forms of transportation, and show understanding about this major change in lifestyle. If they refuse to stop, further action on your part may be necessary. Speak with their clinician, social worker, or other health provider about your concerns. As a last resort, taking away the car keys, disabling the car or making an anonymous report to the State Department of Motor Vehicles may be called for.

As more people move into the 65+ age bracket daily, their safety and those of others must come first.