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Increasing Mobility

Older people are more mobile than ever before. In particular, they are driving more miles to stay connected to the people and the things they love, as well as having to drive further to access shops and services as they move out of local village and town centres. There has been a huge rise in licence holding and miles driven In 1975, only 15% of people over 70 held a driving licence, in 2014, this figure was 62% (DfT, 2015). Staggeringly, people over  70 years of age are driving 77% more miles than they were 20 years ago (for the total population miles driven has fallen by 8% over that time).

Collisions

With such increases we need to ask the question are older drivers safe behind the wheel? There are often reports of older drivers causing serious collisions through eye-catchingly bad driving behaviour; recent examples include overturning a car and causing £60,000 of damage at Porsche garage and driving the wrong way on a motorway. However, I presented some data at the recent British Science Festival that suggests these are the exception. A closer inspection of the STATS19 dataset collected by the police at the scene of a road traffic collision suggests between the ages of 30 and 75 the collision rate per mile driven is pretty flat, with only a very small rise between the ages of 75 and 85.  Given the changes in physiology and cognition that happen as we age this is quite remarkable (for example, recovering from glare from a low sun or from another vehicle, for example, can change from 2 seconds of white out to as much as 9 seconds and reaction times  can be 22 times slower for an over 65 year old than someone under the age of 30). This shows a huge deal of compensatory and adaptive behaviour by older people.

Also, the collision rate does increase after age 85.  However in these cases closer examination reveals that where there are accidents in these oldest age groups they are almost all caused by frailty or fragility rather than poor driving per se

Older people do have different types of collision though. They are over represented at being at fault for collisions when turning right across traffic (in the UK) at non signalised junctions. This may well be due to time pressure. Older people can make correct judgements about when to make the turn but they take longer. Then if they are put under time pressure they tend to make more mistakes than younger people.

This is important because if we understand the causes of collisions, then we can think about ways to address those problems, and potentially keep those in later life driving safely for longer. We may be able to change infrastructure, change junction design or reduce speed limits, change vehicle design, educate  or train people,  or test people more appropriately based on what we know.

Testing Time

Indeed one thing that repeatedly gets discussed  is whether older drivers should re-take their test at a certain age. But evidence from countries where more stringent testing occurs, for example cognitive, medical or on-road practical tests, result in no difference in road traffic collisions for older people or the population as a whole. There is, though, evidence that places with more stringent rules about eyesight tests for older driver can make a difference, for example in Florida an introduction of visual acuity testing significantly reduced motor vehicle crashes in over 80s. There is also evidence that education and training make a difference, but only in the short term. More research is needed on long-term evidence and also on what kinds of education and training are most effective.

Knowing when to stop driving

It’s important to note that I’m not saying all older drivers are safe. There is a need to regularly check whether driving has become dangerous, don’t be afraid to tell someone their driving is bad and don’t be afraid to ask. We know that people who give-up driving successfully without having negative consequences do it earlier on in later life and do it with planning and the support of family and friends. A finding that comes out time and time again is that giving-up driving is too often associated with poorer health and wellbeing but that is much more likely where there aren’t good alternatives to driving and where practical and emotional support hasn’t been sought.

Charles Musselwhite spoke at the British Science Festival, 7th September 2016 on the subject.For press coverage on the talk see: