Driving and Vision in the Elderly

Older drivers and young drivers compete for the most traffic crashes and fatalities

At the Wheel

According to the Transportation Research Board, older drivers have more traffic crashes and fatalities than any other driving age group except the youngest drivers.  By the year 2020, it is estimated that there will be 50 million people over the age of 65 falling into the elder driver category.  Why are older drivers so prone to accidents?  Visual acuity and peripheral vision declines after 65.  Only about one-third of the light in the retina is received in the eye compared to a 20 year old.  Other troubles like cataracts and other age related eye diseases seriously impede vision.  A driver with cataracts is 2.5 times more likely to be involved in accidents as his counterparts without cataracts.  Add to that night time driving conditions and the risk becomes higher.

The National Highway Traffic Safety Administration has been looking into ways to make driving safer for older drivers.  One of the problems is that the current testing is not sufficient to screen for night time conditions and typically states set minimum standards for visual acuity and peripheral vision. According to research already done on persons over 65, many would not pass the test for night time vision.  However, they would be approved for daytime driving.  Standards differ from state to state.  Several different types of tests are being developed to help screen all drivers.  For instance, test of contrast sensitivity may be able to detect drivers that have lost some vision not detected by the initial vision test.  Some states have been satisfied with peripheral vision no better than 35 to 60 degrees. It has been suggested that 140 degrees would be a better measure.

When a elderly person loses their ability to drive, there are severe psychological and social ramifications.  It means they will be dependent on someone else for all of their needs.  It often means loss of independence.  It also means communities will have to provide more services to assist in safe transportation to necessary appointments, and other IADLs (Independent Activities of Daily Living).

Vehicle improvements increase senior driver safety

Some of the aids being developed to assist elder drivers include night vision systems which use infrared and thermal imaging to produce a black and white image on the dash of a car.  They help to extend driver reaction time to objects or animals in the road.  Navigational aids are available to assist with directions and help elder people in strange surroundings.  The elderly often have trouble backing up because they cannot turn their heads enough to provide clear view.  A number of technologies are being developed to help them in that endeavor.  Mirrors with wider angle viewing and sensors that warn when you are getting close to a collision are a few of the inventions being developed.  Also adaptive cruise control systems will automatically adjust speed when a vehicle is getting too close to another.  One concern is that the interface on all of these technologies must be simple enough that it will not add confusion and too much complexity to the driving situation.1

Authors Note:  This article relates to aspects troubling to the aged.  I chose it because of the experience I had with my mother.  Strokes had left her without sight in her right peripheral vision.  At the time we asked her to stop driving, we also moved her to an independent care center.  She had had several accidents in the last year.  Confusion, lack of vision and slower reactions contributed.

1Driving and Vision in an Aging Society, Kent E. Higgins, Generations, a Journal of the American Society on Aging, Spring, 2003.

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