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End of the RoadDung Hoang

End of the Road (continued)

States grappling with the issue have no clear path ahead, says John Kuo, administrator of Maryland’s Motor Vehicle Administration and the governor’s highway safety coordinator. “There’s no norm or best practice that’s surfacing. This is a national dilemma,” says Kuo. “We must develop a strategy that meets their needs and keeps them safely on our roadways.”

Last year saw the first of the baby boomers turning 65. Older Americans are now the fastest-growing segment of the driving population. Today, about one in seven motorists is age 65 or over. By 2025, that figure will be one in four.

In many ways, older people make ideal drivers, says Vanya Jones, PhD ’06, MPH, an assistant professor in Health, Behavior and Society and a CIRP faculty member. “They don’t drink and drive. They wear their seat belts and tend to stay within the speed limit. They do the good stuff,” says Jones who is a passionate advocate for the elderly. The problem, she and other researchers say, comes when age-related cognitive and physical changes start to affect the complex task of threading a one- or two-ton vehicle through a maze of moving traffic.

Jones is keenly aware of the impact that quitting driving can have on the elderly. She vividly remembers the day her grandfather reached his own painful decision to stop driving. “For me, as a child, he was sort of this larger than life man,” she says. “When he gave up his car, that was one of the few times in his life that I saw him cry.”

Later, while in college in Ohio, she was standing at an intersection when a car hit a pedestrian in front of her. She saw how a life could have been saved if the light had changed a few seconds later or if the driver or pedestrian had slightly altered their behavior. “Personal injuries and motor vehicle crashes are a huge, huge issue for me personally,” she says, saying her concern led to her work with colleagues at CIRP.

Some elderly drivers are as good or better than the average middle-aged motorist. But as we age, researchers say, we experience a gradual erosion of our vision, hearing, response time, mobility, strength and coordination, cognition and judgment. We can also develop a host of age-related illnesses, from glaucoma to diabetes to dementia. To treat what ails us, we may take an array of drugs that separately or in combination can cloud our judgment or slow our reflexes. These changes come sooner for some and later for others, but whenever they come they affect our ability to drive.

“I think there’s often a natural progression as we age,” says Jones, adding that the problem of declining driving skills is “one that we all will probably have to face if we live to be old enough.”

Teenagers and young adults have the worst crash statistics, victims of a cocktail of immaturity and inexperience. But as they spend time behind the wheel, their crash rates go down. Starting around age 75 or so, the process reverses gears, and fatal motor vehicle crashes involving elderly drivers begin to rise sharply. According to the Insurance Institute for Highway Safety, the crash rate per mile for drivers 85 and older is roughly the same as for teenagers. The rate of fatal collisions per mile traveled is close to double that for teens.

Given the physical effects of age, no one is in greater peril in a crash than an older motorist. Someone 80 years of age or older is six times more likely to die in a collision than someone 35 to 54 years old. Kuo points out that, nationally, while drivers 65 and over rack up just 8 percent of miles traveled, they account for 17 percent of traffic fatalities.

Because of this increased risk of injury-related deaths, Jones says, researchers and traffic safety experts need to find strategies to reduce collisions involving older adults. “You don’t want to be injured in a crash and you don’t want to injure someone else,” she says. “These are really terrifying things.”

The graying of America’s driving population seldom draws much attention until a high-profile tragedy strikes, like the case of George Weller, who in 2003 at age 86 killed 10 and injured 70 when his car barreled through a farmers market in California. In Texas, there were calls for tougher licensing regulations for the elderly after 90-year-old Elizabeth Grimes ran a red light in Dallas in 2006 and slammed into a car driven by 17-year-old student Katie Bolka, who died of her injuries. Likewise, the Krasnopoler case has inspired a call for Maryland to review its policies affecting older drivers.

A recent report by the Trust for America’s Health found that 33 states and Washington, D.C., had some limits for mature drivers, including required vision tests, shorter times between license renewals and limits on online or mailed renewals. That means about a third of states have no such requirements. Some safety activists want to see more restrictive laws on licensing older drivers, including mandatory age-related screening exams or road tests.

Following Nathan’s death in 2011, his grieving parents—lawyer Susan Cohen, an assistant attorney general for Maryland at the time, and her husband, engineer Mitchell Krasnopoler—launched a campaign to advocate new licensing rules. In response to public concern, the state Legislature has directed the MVA to conduct a two-year study of older drivers.

According to the Foundation for Traffic Safety at the American Automobile Association (AAA), Maryland requires drivers over age 40 who are renewing their license by mail to submit a report from a vision specialist and requires new drivers over age 70 to provide a medical report. The Krasnopolers want to go further and require drivers, as they age, to take routine cognitive screening exams that may help spot high-risk motorists before they have catastrophic crashes. But state governments are reluctant to demand additional testing for seniors until there is more data showing that these tests work. The Trust for America’s Health, in a May 2012 report, warned against passage of “reactive, unscientific legislation that overly restricts the driving privileges of older drivers.”

The American Association of Retired Persons (AARP) supports tightened testing policies and prelicense screening exams, but not if they’re required based on age. “The only screening method that has been identified that helps reduce crashes among older people is in-person license renewal, and AARP supports in-person renewal across the life span,” says Nancy Thompson, an AARP spokeswoman. “The issue about driving is about health, not age.”

Most older drivers now do what safety experts call “self-regulate,” limiting their driving to match their skills. Edward Ryan, an 89-year-old former engineer at Fort Meade, Maryland, avoids busy streets, the Baltimore Beltway and driving at night. He enjoys short hauls to nearby shopping centers but has no interest in driving on longer trips or in heavy traffic. “I don’t think I miss it, to tell the truth,” he says.

One of Vanya Jones’ chief goals is to find ways to encourage drivers to fine-tune their driving to match their skills and help them prepare to stop driving altogether if the time comes when they are no longer safe on the roads. “We are trying to help adults plan to retire from driving in the same way they would plan to retire from their jobs or change their housing,” she says.

She’s determined, she says, to find an approach to the problem that “honors the individual, that doesn’t disrespect them but also keeps society safe.” And a way to do that, she says, is to find ways to help older adults make their own decisions about driving, including when to stop.

Persuading drivers to take a hard look at their own abilities is not necessarily a straightforward matter.

Comments

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  • Isabelle Kargon

    Baltimore, MD 10/11/2012 10:48:47 AM

    The only really efficient solution is the implementation of a decent public transportation system and a shift away from this country's car-based culture.

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Driving Older

Driving Older

Researcher Vanya Jones seeks the best ways to help older adults prepare to “retire” from driving.

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