What if you are doing all you can to be a safe driver and still wonder if you should stop driving? This is a difficult decision. There are questions to ask yourself:

Do other drivers often honk at you?
Have you had some accidents, even "fender benders"?
Are you getting lost, even on well-known roads?
Do cars or pedestrians seem to appear out of nowhere?
Have family, friends, or your doctor said they were worried about your driving?
Do you drive less because you are not as confident about your ability as you once were?

If you answered yes to any of these, you probably should think seriously about whether or not you are still a safe driver.

HOW DOES AGE AFFECT DRIVING

Changes in our bodies

As you age, your joints may stiffen, and muscles weaken. Turning your head to look back or steering and braking the car may become hard to do. Movements are slower and may not be as accurate. Your senses of smell, hearing, sight, touch, and taste might grow weaker.

Vision, being able to see, is a vital part of driving, but age brings changes in the lens of the eye. Eyes need more light in order to see and are more sensitive to glare. Your ability to see things on the edge of the viewing area, peripheral vision, narrows. Vision problems include cataracts, macular degeneration, and glaucoma.

Cataracts: In cataracts the lens of the eye becomes cloudy, causing problems with the ability to see.
Macular Degeneration : A breakdown of material inside the eye that leads to a loss of vision in the central part of the viewing area.
Glaucoma: The rise in pressure inside the eye that develops in glaucoma may limit the ability to see things on the edge of the viewing area.

Changes in the way you think

You probably know your body may change with age. You may not be aware of changes in the way your mind works as you age. Some of you find your reflexes are slower. Or, you may have trouble keeping your attention fixed on one situation. You may have a hard time doing two things at once -- something you have to do to drive safely. When you drive, you have to take in new information from many sources and then react. Some of you react more slowly when you find yourself in a new situation.

These are all normal changes in how your brain works as you age. There are, however, two forms of mental problems that can also affect your ability to drive.

Depression, being "down in the dumps" for a long time, may happen to many older people, but it is not normal. It can, and should, be treated. The attention and sleep problems depressed people of any age sometimes suffer can interfere with safe driving. So can the medicine sometimes used to treat depression.
Dementia causes serious memory, personality, and behavioral problems that the person often cannot recognize. Someone with dementia may at first remember how to operate an automobile and how to travel to familiar places. However, at some point as the disease progresses, their driving abilities do become impaired. Unfortunately, people with dementia often cannot recognize when they should no longer drive.

Health problems

Other illnesses common among older people can affect your ability to drive safely. For example, having arthritis, Parkinson's disease, or stroke, makes it harder to handle a car safely. Sleep problems or fainting make you less alert at an age when you may already have a hard time focusing your attention. If you have an automatic defibrillator or pacemaker, your doctor might suggest that you stop driving. There is a chance that the device might cause an irregular heartbeat or dizziness while driving. Diabetes may cause nerve damage in your hands, legs, or eyes. The eye damage in diabetes is known as diabetic retinopathy. If you also have trouble controlling your blood sugar level and might be in danger of losing consciousness, you should think about giving up your license.

Medications

Older Americans take more prescription medicines than any other age group. They often have one or more long-term illnesses such as arthritis, diabetes, high blood pressure, and heart disease and may be taking several different drugs. Their bodies may be more sensitive to the effects of medicine on their central nervous systems. The older body may not use up (metabolize) a drug as quickly as a younger body does, so the drug can be active in them for a longer time. Sometimes a combination of medicines increases the effects of each drug on the body.

Several types of medication can make driving harder because they affect the central nervous system. Drugs that might interfere with your driving include sleep aids, medicine to treat depression, antihistamines for allergies and colds, strong pain-killers, and diabetes medications. If you are taking one or more of them, talk to your doctor. Perhaps he or she could change your prescription, or help you decide if the medicine is affecting your driving.

TIPS FOR BEING A BETTER DRIVER

Perhaps you already know some driving situations that are difficult -- night, highways, rush hour, and bad weather. You might avoid these types of driving and limit your trips to shopping and visits to the doctor. This lowers your chance of having an accident.
While driving, older drivers are most at risk while yielding right of way, turning, especially left turns, lane changing, passing, and using expressway ramps. Pay extra attention at those times. If there is not a left-turn light, look for alternate routes that do provide such lights.
Most of the advice for older drivers is helpful for all drivers. Plan your trips ahead of time. Stick to streets you know. Don't drive under stress. Keep distractions such as the fan, radio, or talking, to a minimum. Leave a big space between your car and the one in front of you. Don't drive when you are tired.
Think about taking a driving refresher class. Some car insurance companies reduce your payment if you pass such a class. The AARP (American Association of Retired Persons) sponsors the "55 ALIVE/Driver Safety Program." The AAA (American Automobile Association) has a similar class called "Safe Driving for Mature Operators." These are 8-hour classroom courses that talk about the aging process and help drivers adjust.
Certain features on your car can make driving easier. Power steering, power brakes, automatic transmission, and larger mirrors are all helpful. Keeping the headlights on at all times and having a light-colored car helps other drivers see you. Hand controls for the accelerator and brakes might be of use to someone with leg problems. Keep the headlights clean and aligned, and check the windshield wiper blades often. A rear-window defroster is a good way to keep that window clear at all times.
Air bags have saved many lives. Advanced age is not a reason for disconnecting an air bag. However, the National Highway Traffic Safety Administration suggests that air bags may not be as effective in preventing serious injury or death in people over 70 years of age as they are in younger people. Older people are more likely to be injured in a traffic accident. Their bones and blood vessels may be rigid. They might break easily. If the accident is minor, emergency personnel may not realize the possibility of internal bleeding in time. People of any age should push their seats as far back as possible from the air bags in both the steering wheel and the passenger side. Of course, everyone in the car should always wear their seat belts.

RESOURCES

These organizations have information for older drivers.

Administration on Aging
http://www.aoa.gov

American Association of Retired Persons
http://www.aarp.org

American Automobile Association
http://www.aaa.com

Eldercare Locator: 1-800-677-1116
http://www.eldercare.gov

Portions of the above information has been provided with the kind permission of the National Institute On Aging (www.nia.nih.gov).

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