Debate Rages Over Restricting Older Drivers
Should older drivers be subject to closer scrutiny, such as more frequent road tests, and perhaps even “reverse” graduated licensing that takes away privileges?
The debate continues, coast to coast.
Last month, Advocates for Highway and Auto Safety released the results of a Louis Harris poll in which nearly three-quarters of the 1,005 adults surveyed favored license testing for elderly drivers--including 80% of the survey respondents who were themselves 65 or older.
Results of the poll, which was commissioned by the Washington-based advocacy group, come on the heels of a spirited debate in California over the so-called senior driver bill. Opponents of the measure’s provision to test all drivers 75 and older claimed victory when Sen. Tom Hayden (D-Los Angeles), its sponsor, agreed to remove all references to age, instead targeting “at risk” drivers regardless of age. (The bill is expected to be taken up again in January when the Legislature reconvenes, says Rocky Rushing, a Hayden spokesman.)
Drawing on the poll results while remaining sensitive to the issues raised by the Hayden bill, Advocates for Highway and Auto Safety recommends that states consider graduated licenses that include individual evaluation of driving performance based on skills, not chronological age, says Judith Stone, the organization’s president.
“We’re looking on this as a state issue,” she says.
Statistics suggest how big a debate this will become. The population age 65 and older will grow 60% during the next two decades, according to government projections quoted by the National Highway Traffic Safety Administration. In the decade from 2020 to 2030, more than one in five Americans will be 65 or older.
In 1998, to cite a key statistic at the center of the debate, people 70 and older made up just 9% of the population but accounted for 14% of all traffic fatalities, according to NHTSA’s National Center for Statistics and Analysis.
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As legislators, pollsters and those on both sides of mandatory testing debate the issue, scientists have been taking a closer look at the visual impairments that can make older drivers safety risks.
Older drivers with cataracts, the opaque clouding of the eye’s lens, are more than twice as likely to have experienced a crash in recent years than those without a cataract, says Cynthia Owsley, a professor of ophthalmology at the University of Alabama at Birmingham. She presented her findings at a symposium on older drivers last month in Los Angeles sponsored by Research to Prevent Blindness, a New York organization that funds eye research.
Drivers with cataracts, she says, suffer reduced contrast sensitivity--that is, the ability to detect detail when there are subtle gradations in grayness between the object and the background. And that can be hazardous on the road.
Such drivers, Owsley says, are also more likely to report difficulty in dealing with rush-hour traffic, night driving and other typically challenging situations. But she also found that they are more likely to reduce the amount of driving they do as a result of their awareness of their shortcomings.
Owsley did find some good news in her study, which surveyed 288 drivers age 55 to 85 who had cataracts: The 187 who had cataract surgery, in which the cloudy lens is removed and an artificial intra-ocular lens is inserted to restore vision, demonstrated a crash rate 50% lower than the others.
Her Alabama-Birmingham colleague Melvin Shipp, an associate professor, has found that states that conduct vision testing report lower rates of older-driver traffic fatalities than those that do not require tests.
It may not be the mandated test, per se, that helps, Shipp says, but simply the knowledge that the test will be given. He cited the example of his own father, who makes it a point to get an eye exam from his own doctor before a vision test is expected to be required.
“The [vision testing] policies seem to work to protect older drivers,” Shipp says, noting that if nothing else, they remind drivers of the need to get vision checkups.
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In another study, Gary S. Rubin, now a professor of ophthalmology at University College in London, evaluated 2,500 residents of Salisbury, Md., age 65 and older. He found that visual acuity tests are not a good predictor of crash involvement. Such tests, conducted with an eye chart to assess how well the subject can distinguish object details and shape, are the type most often given by motor vehicle licensing departments.
Better predictors, Rubin says, are tests of visual field loss, which increase the risk of accidents by up to 60%. “Visual field,” also called field of vision, refers to the full extent of the area visible to an eye looking straight ahead.
One disturbing finding in Rubin’s research: Many of his subjects did nothing to correct their vision problems. About half the subjects, when told they needed new glasses or cataract surgery, returned for follow-up evaluations without having corrected the problem, he reported.
But as Owsley’s cataract study and other research efforts have shown, senior citizens who correct their vision problems can become safer drivers.
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Good Carma is a guide to automotive-related health and consumer issues. Kathleen Doheny can be reached at kdoheny@compuserve.com.
