Wednesday, May 23, 2018

aging at THE wheel

Jerry Wiseman notices it's harder to turn and check his car's blind spots at age 69 than it was at 50. So the Illinois man and his wife took a refresher driving course — a good idea considering their state may have the nation's toughest older-driver laws.

More older drivers are on the road than ever before, and an Associated Press review found they face a hodgepodge of state licensing rules that reflect scientific uncertainty and public angst over a growing question: How can we tell if it's time to give up the keys?

Thirty states plus the District of Columbia have some sort of older-age requirement for driver's licenses. In Florida, people 80 and older must renew their license every six years, compared with every eight years for younger people. Also, Floridians 80 and older must pass an eye exam with every renewal.

Maryland starts eye exams at 40. Shorter license renewals kick in anywhere from age 59 in Georgia to 85 in Texas.

The issue attracted new attention when a 100-year-old driver backed over a group of schoolchildren in Los Angeles late last month. That's a rarity, but with an imminent surge in senior drivers, the federal government is proposing that all states take steps to address what the National Highway Traffic Safety Administration calls "the real and growing problem of older driver safety."

Here's the conundrum: "Birthdays don't kill. Health conditions do," said Joseph Coughlin, head of the Massachusetts Institute of Technology's AgeLab, which develops technologies to help older people stay active.

Many older people have health issues that can impair driving, from arthritis to dementia, from slower reflexes to the use of multiple medications. There's no easy screening tool that licensing authorities can use to spot people with subtle health risks. So some states use birthdays as a proxy for more scrutiny instead.

Older drivers don't crash as often as younger ones. But they also drive less. About 60 percent of seniors voluntarily cut back, said David Eby of the University of Michigan's Center for Advancing Safe Transportation throughout the Lifespan.

Measure by miles driven, however, and the crash rate of older drivers begins to climb in the 70s, with a sharper jump at age 80, according to the Insurance Institute for Highway Safety. Only teens and 20-somethings do worse.

And the oldest drivers, those 85 and up, still have the highest rate of deadly crashes per mile, even more than teens. More often than not, they're the victims, largely because they're too frail to survive their injuries.

• • •

Today, nearly 34 million drivers are 65 or older. By 2030, federal estimates show there will be about 57 million — making up about a quarter of all licensed drivers.

This summer, the National Highway Traffic Safety Administration proposed a national guideline for older driver safety that, if finalized, would push states to become more consistent. Among the recommendations: Every state needs a program to improve older driver safety; doctors should be protected from lawsuits if they report a possibly unsafe driver; and driver's licenses should be renewed in person after a certain age, tailored to each state's crash data.

• • •

Older drivers are less likely than younger ones to be in crashes involving alcohol or speeding. Instead, they have more trouble with intersections, making left turns, and changing lanes or merging, according to the National Institutes of Health.

Scientists are hunting screening tests to check for such things as early warning signs of cognitive problems that might signal who's more at risk.

But for now, in-person renewals are "the single most effective thing states can do to improve safety,'' said Jake Nelson, AAA's director of traffic safety advocacy and research. That's because workers in the driver's license office can be trained to look for signs of confusion or trouble walking.

A study found highway deaths among Florida's older drivers dropped 17 percent after the vision test for those over 80 was mandated in 2003.

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