A 4-year-old Florida law requiring that older drivers pass a vision test before getting a new driver's license appears to help save lives.
Since the law took effect, the death rate among drivers age 80 or older from car crashes has dropped by 17 percent, according to a study released Monday in the Archives of Ophthalmology.
During the same period, the crash death rate among drivers of all ages increased by 6 percent.
The drop in death rates surprised researchers because an earlier survey showed that 93 percent of elderly drivers who took the vision test eventually passed it and got their licenses.
"We went into this thinking that if that many people are going back to driving, it's hard to imagine we're going to have much impact on public safety," said Gerald McGwin Jr., the study's lead author and an epidemiology professor at the University of Alabama at Birmingham. "Well, we were wrong."
The study is one of the first to show a link between vision tests and lower death rates for older drivers.
The study is good news, said Elinor Ginzler, AARP senior vice president for livable communities.
The AARP offers safety classes for older drivers and supported the Florida law establishing the vision test.
However, Ginzler stressed the need for more research, "so that policymakers have the information they need to make our streets and highways still safer."
The study results are encouraging, especially because the vision test can make it easier for doctors to talk about driving abilities with their older patients, said Dr. Jose Santana Jr., a Dunedin internist with Morton Plant Mease Primary Care.
"Not a week goes by without this issue coming up," said Santana, who has served on an American Medical Association advisory board to help doctors judge whether their older patients should drive.
The problem may be vision, but it may also be reflexes or hearing. The topic is emotional for many people, who may equate driving with independence.
"Anyone is going to be reluctant to give up a driver's license," Santana said. "It may take more than one conversation to get through that initial shock. But in the end, everyone wants to be safe on the road."
Two things may have affected the drop in death rates, McGwin said. First, some older drivers may have decided to stop driving rather than take the test. A survey by his researchers showed about 20 percent of Florida drivers over 80 decided not to renew their licenses, and most of those said they didn't think they would pass the vision test.
Researchers also found that only 88 percent passed the vision test the first time. Most who didn't pass the first time got treatment, such as new glasses or cataract surgery, and then passed the test.
The study compared Florida death rates from 2001 to 2003 — just before the law took effect — with those from 2004 to 2006. The study also looked at fatality rates for older drivers in Alabama and Georgia during the same time and found no change.
The study's authors looked only at statistics for fatalities among the older drivers. But a check of Florida Department of Highway Safety and Motor Vehicles figures shows that, in general, the number of drivers over 80 involved in any kind of crash dropped after 2003. That year, for example, crashes involving 82-year-olds numbered 868 — or 102.41 per 10,000 drivers. In 2007, the number was 764 for a rate of 95.30.
Nine states and Washington, D.C., require a vision test for license renewal for elderly drivers.
McGwin predicted that states interested in similar laws will use his study to make a case. If so, he suggests they look for other ways to keep the elderly mobile. Loss of driving privileges has been linked to an increased risk of depression and even death, he said.
"I think it's vital that they also consider the need for transportation alternatives," McGwin said.
Times researcher John Martin contributed to this report. Lisa Greene can be reached at firstname.lastname@example.org or at (813) 226-3322.