Next time you’re tempted to shake a fist at an older driver, remember they might be safer behind the wheel than you

Despite stereotypes to the contrary, drivers 65 and older are among the safest on the road.    They are more likely to wear seat belts and less likely to drink or text while driving compared with any other age group, according to the Insurance Institute for Highway Safety. Yet they are more likely to die if they are involved in a crash.

The reasons are complicated by individual circumstances and medical conditions, but with 25 percent of all U.S. drivers expected to be 65 or older in just 10 years, balancing the health and mobility needs of an aging population with public safety is a topic of increasing interest.

“We know that aging drivers are not going away. Older people are living longer. They’re healthier, they’re more mobile, and we know there will be a lot more aging drivers on the road,” said Anita Lorz Villagrana, manager of community affairs and traffic safety for the Automobile Club of Southern California.

This spring, the AAA Foundation for Traffic Safety is launching the largest interdisciplinary study of aging drivers ever conducted in the United States. Led by Columbia University in New York in conjunction with UC San Diego; Johns Hopkins University in Baltimore; the University of Michigan; and the University of Colorado, the Longitudinal Research on Aging Drivers, or LongROAD, study will track 3,000 drivers between the ages of 65 and 79 for five years.

Recruited from the medical clinics associated with each university, participant drivers’ cars will be outfitted with GPS units to track their driving behaviors and correlated with individual medical records. Drivers also will be questioned about their cars’ safety features, such as blind-spot monitors and adaptive cruise control, to determine if they help or hinder older drivers.

“The approach of this study is to see from a long-term perspective: Are older drivers safe? What are their behaviors? What are their crash risks?” Villagrana said. “It’s important for us to understand because it not only impacts the aging drivers themselves but other motorists on the road as well.”

In 2012, 4,079 people age 70 or older died in traffic accidents – a 31 percent decline from 1997, according to the IIHS.

Older drivers are, however, more likely to die if they are involved in a crash. They have a higher death rate per mile driven than any other group, according to AAA, which cites “fragility” as the cause in more than half of senior traffic fatalities. A 70-year-old driver is four times more likely to die in a traffic accident than a 20-year-old in an accident of the same intensity.

Multiple-vehicle crashes at intersections begin to increase starting at age 60, according to the IIHS. Fatal crash rates begin increasing from age 70 to 74, according to the Centers for Disease Control and Prevention; they are highest among drivers 85 and older. The CDC attributes the higher death rate to older drivers’ susceptibility to injury and medical complications – not an increased tendency to crash.

“There are three big medical conditions and medications that influence driving safety that are pretty clear: vision, cognitive function and frailty,” said Dr. Linda Hill, director of the preventive medicine residency at UC San Diego’s Department of Family and Preventive Medicine, which will conduct the California portion of the study with 600 participants.

Twenty-five percent of people older than 80 have visual problems that cannot be corrected, Hill said. The negative impacts on driving include an inability to accurately see straight ahead or peripherally to negotiate intersections and take account of other cars, motorcycles, bicycles and pedestrians. Glaucoma and cataracts – both common as individuals age – impair night vision.

And dementia affects one-third of people older than 85, Hill said.

“It’s not completely clear how mild dementia affects driving, but people with moderate or severe dementia won’t have the cognitive function to be able to drive safely,” Hill said. Individuals who suffer from dementia may have difficulty determining the appropriate responses in intersections or even remembering where they are going.

As for the reduced bone and muscle mass that come with age and lead to frailty, “Most people think that with power brakes and power steering, if you get in the car you’ll be able to drive safely, but it’s been shown that people with frailty are more likely to be in crashes,” Hill said.

Beyond the medical conditions are the medications used to treat them. One of the goals of LongROAD is to understand which medications most adversely affect driver safety and determine strategies to mitigate that risk.

About 95 percent of senior citizens use medications that may impair driving, according to AAA, which offers a medication database for drivers called Roadwise RX. The interactive database helps drivers understand the side effects of individual medications as well as interactions between medicines that might impair driving.

Type in the cholesterol-lowering drug Lipitor, for example, and it yields three driver warnings, including “challenges staying within the lane markings and increased risk of leaving the roadway,” as well as “delayed reaction to on- and off- road events” and “lower levels of vigilance and awareness about road conditions and other vehicles.”

AAA offers other tools as well, including a CarFit program that helps seniors set up their mirrors and seats to drive more safely, and a Drivers 65+ Check Your Performance online quiz that prompts drivers with questions and rates their answers with scores of “go,” “caution” or “stop,” the latter of which means the driver engages in too many unsafe driving behaviors and could pose a hazard to themselves and other drivers.

The National Highway Traffic Safety Administration offers other assessment tools for passengers to observe an older driver’s behavior. And AARP offers a Smart Driver refresher course to help older drivers “manage and accommodate common age-related changes in vision, hearing and reaction time,” as well as negotiate safe lane changes, maintain safe following distances and minimize the effects of blind spots. Both organizations are among the many groups offering tools to help older drivers determine if they should still be driving and to help keep them safe if they do.

Whether seniors avail themselves of such tools is another matter.

In 2014 in Washington state, 12,148 drivers took the AARP Smart Driver Course, coordinator Gordon Olson said. Of those, 3,559 took the course online while the others took it in a classroom setting. Only 106 Washington drivers participated in the Car Fit program. Insurance companies generally will offer discounted rates to drivers who have taken the eight-hour course. Olson said Idaho only offers a 6-hour course so Idaho drivers have to take the Washington course to get insurance benefits. 

“We’ve done so well cutting death rates for teen drivers and figuring out ways to help them be safer through research and smarter policies,” Betz said. “Unfortunately, it’s much harder at the other end of the spectrum but equally important. Driving is so important for older adults because it’s the primary means of mobility.”

Older people who are no longer able to drive who are not provided adequate transportation options are at greater risk for depression, illness and early death, Betz said.

The average American male will spend the last eight years of his life without being able to drive; the average woman will spend the last 10 years without driving, according to Dr. Guohua Li, professor of epidemiology at Columbia University and LongROAD’s lead researcher.

“If the project goes as planned, hopefully we can shorten that period without compromising the safety of the public,” Li said.

The question of when to take the car keys away “is extraordinarily important,” said Paul Irving, chairman of the Milken Institute’s Center for the Future of Aging, in Santa Monica.

“All of our research suggests people want to age in place and at home,” Irving said. “Older people want independence just like younger people, and they want access to the full range of amenities that any city has. One’s ability to get from home to those places is extraordinarily important to a satisfying life and successful aging.”