The number of elderly drivers behind the wheel will triple as the U.S. population ages over the next 15 years, becoming a growing problem for families, society, government and law enforcement in deciding when to take away the keys.
The first wave of baby boomers, those born in 1946, will reach retirement age in 2011. Demographers say the over-65 population will exceed 18 percent of the total U.S. population in 2020.
About 25 percent of all U.S. drivers will be seniors by 2025. Thirty percent of Japanese will be over 65 by 2030. More than 200 million people worldwide will turn 65 by 2025, and more than 400 million people will be seniors by 2050.
"We can't wait until 2010 and say, 'We've got a bunch of baby boomers. Let's decide what we're going to do," Dr. Robert Raleigh, a member of the Maryland Motor Vehicles Administration's Medical Advisory Board, told the Pittsburgh Tribune-Review.
Pennsylvania law requires a doctor to report any condition that impairs a patient's ability to drive. Of 21,000 reports on questionable drivers filed with Pennsylvania officials in 2004, nearly 6,000 resulted in license suspensions, with 181 of the suspensions because of neurological disorders like Alzheimer's disease.
Studies project nearly 6 million drivers will be affected by age-related illnesses as physical and cognitive abilities naturally decline.
A recent study by the AAA Foundation for Traffic Safety examined nearly 4 million traffic accidents. Drivers over 65 were almost twice as likely to die in vehicle crashes as drivers between 55 and 64. Drivers over 85 had a fatality rate four times higher, exceeded only by the vehicle fatality rate of 16-year-olds, the youngest driving cohort.
Fatal Accident Reporting System statistics released by the Federal Highway Administration said 6,730 drivers older than 65 died in car crashes in 2003.
Older drivers were more likely to die from injuries in crashes that would not kill younger drivers, and some older drivers were more likely to cause an accident.
"When you're older and you get hurt, there's a greater likelihood of dying," said Fred Griesbach, director of the AARP Pennsylvania office.
Police can't check for debilitating diseases like dementia, cataracts or macular degeneration at an accident scene, and a healthy 75-year-old is perfectly capable of being an exceptionally safe driver while an impaired 65-year-old may drive more like a 95-year-old.
Some experts say rather than taking elderly drivers off the road, vehicles and roads should be made as safe as possible.
The highway administration issued guidelines in 2001 to allow municipalities to improve roads and upgrade traffic controls with signals like turn-only arrows at busy intersections for older drivers.
Recent concept cars on the auto-show circuit feature rear-view and night-vision cameras and sensors so drivers don't have to twist their necks or torsos to look behind as they back up.
"Car makers don't like to admit they are making cars for people who are middle-aged or older," a spokesman for Mazda told the Times of London. "Their advertising is targeted at the young. But the fact is that customers are getting older."
A study by the National Highway Traffic Safety Administration, the federal agency that monitors vehicle safety, said people over age 70 comprised 9 percent of the U.S. population in 1997 but accounted for 14 percent of traffic fatalities and 17 percent of pedestrian fatalities.
Calls for more frequent screening of older drivers are being heard.
In Canada, drivers over 80 are required to take medical examinations before renewing driver's licenses in British Columbia. Ontario drivers over 80 may have to take a road test every two years.
Other provinces require doctors to report any condition that would make a patient unfit to drive.
Florida, the state with the largest percentage of seniors, issues licenses for six years, but drivers over 79 must pass a vision test. Illinois and New Hampshire require drivers 75 and older to take a road test.
Wisconsin Rep. J.A. "Doc" Hines, R-Oxford, who at 77 is the oldest member of the state Legislature, supports a bill that would require more frequent screening of drivers 75 and older.
Wisconsin driver's licenses currently are good for eight years.
"My license is still good in '06, so that would mean ... nine years from now under existing law I'd have to renew my license. Well, that's crazy," Hines told WMTV in Madison.
Drivers between 75 and 85 would have to renew licenses every three years and take a vision test under the proposed change. Drivers over 85 would have to renew their license every two years and take vision and traffic-skills tests.
Taking unsafe drivers off the road is tough. It's an issue of independence and mobility for seniors in rural areas who may not have access to public transportation. They would have to change their entire lifestyle -- maybe even relocating to an urban area, an assisted-living facility or a nursing home.
Only about 3 percent of seniors 60 and older use public transportation.
"It's impossible to live where I live if you don't drive," Wisconsin state Rep. Gary Sherman, D-Port Wing, told the Milwaukee Journal Sentinel.
A third of Wisconsin drivers are already over 55. The upper Midwest state has more than 216,500 licensed drivers between 75 and 85. Another 59,000 are over 85.
Tougher screening might have saved a life last month when a 99-year-old woman drove the wrong way on a Wisconsin Interstate at night and collided head-on with a pickup. She was killed and the 40-year-old truck driver was injured.
The woman, who had no health problems, had just 15,000 miles on her mint-condition 1975 Buick. She would have turned 100 Sept. 17. Her license was not up for renewal until 2006.
State Rep. Sheldon Wasserman, D-Milwaukee, said the intent is not to keep seniors from driving but to target people who shouldn't be on the road.
AARP and the Coalition of Wisconsin Aging Groups back tighter screening of senior drivers.
"Although age alone is not reason enough to restrict driving privileges, as we age there's a greater risk of suffering a medical impairment that can seriously affect safe driving," wrote Dr. Steven Yale of the Wisconsin Medical Society. "Vision problems, depth perception and hearing loss are just a few of the many medical issues that can hinder the ability to drive."
That said, insurance companies offer discounts to drivers over 55 because they are less likely to speed, drive aggressively or pick a tune on an iPod while talking on a cell phone and eating in traffic.
AAA says seniors, their doctors and family members have to understand how physical and mental changes that come with age affect, eyesight, hearing, reaction time and the ability of those in their sunset years to drive.
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