As population ages, concern focuses on older drivers' ability

THE BALTIMORE SUN

Last month, an 83-year-old Pikesville man turning left into a shopping center on Liberty Road pulled in front of an approaching school bus, causing it to collide with his right rear fender.

The driver of the car, who had been cited for failing to obey a traffic signal several months earlier, was not hurt. Twenty high school students had minor injuries.

"He saw the bus coming and all that. He said he just thought that he had time to make it across the road," said Baltimore County Police Officer Joseph Gibson, the who investigated the crash.

Officer Gibson, 41, has seen a lot of accidents. And he called the Liberty Road mishap typical of those involving older drivers.

While seniors tend to be experienced and careful drivers, he said, some have trouble estimating distance and time, have vision problems or are slow to react to the unexpected.

"It doesn't take much to be off target, and then you are nailed," he said.

Studies by the American Automobile Association Foundation for Traffic Safety and other groups have shown that some older Americans remain good drivers all their lives.

But for others, the skills necessary for safe driving -- night vision, hearing, depth perception, peripheral vision, agility and other faculties -- begin to deteriorate at 55, perhaps dramatically so after 75.

About a decade ago, a number of state motor vehicle agencies adopted laws requiring drivers 65 and older to come in for special testing, said Sam Yaksich Jr., executive director of the AAA Foundation. But some senior groups objected, calling the laws discriminatory, "and states started to back away from it. They haven't stopped retreating," he said.

Today, pressure is again building for state governments to address the issue of older drivers, researchers and others say.

In part, this is because the number of older drivers is growing. In part, it is a result of a number of lawsuits filed recently against state motor vehicle agencies for licensing elderly drivers who later cause fatal accidents.

Mile for mile, drivers over 65 are involved in more accidents and fatalities than any group except those from 16 to 24, according to the AAA Foundation.

And, the foundation said, drivers over age 85 actually have a worse accident-per-mile-driven rate than any other group.

Other studies have shown that because age makes them more vulnerable, seniors are 2 1/2 times more likely to die after an auto crash than younger motorists.

Most accidents involving seniors, researchers say, involve intersections, left turns and freeway ramps -- all of which test judgment of speed and distance, and call for quick reactions.

Many older drivers whose skills have diminished voluntarily cut back on driving at night, in bad weather, on expressways or in heavy traffic, safety researchers say. Or they stop driving altogether.

"I think it's time, when you don't trust yourself, to get out from behind the wheel and let someone else do the driving, even though it's inconvenient as the devil," said Rosa Frances Weigate, 81, of Rodgers Forge, who stopped driving several years ago after having cataract surgery in both eyes.

But some refuse to admit they are less able to navigate an auto, perhaps because, like other Americans, most regard their cars as a symbol of their independence. In many areas, alternative transportation is not available.

"Without a driver's license, they can literally become prisoners in their own homes and communities," said James L. Malfetti, a retired Columbia University researcher who has studied senior drivers for the AAA Foundation.

Meanwhile, the number of older drivers is increasing, in step with thegrowing proportion of seniors in the U.S. population. By 2020, an estimated 50 million Americans 65 and older will be eligible to drive. Half of them will be at least 75.

"I don't know of any responsible individual who says that you should take driving privileges away from older drivers just because they're older," said Stephen Teret, co-director of the Johns Hopkins Injury Prevention Center.

"That wouldn't make any sense, and it wouldn't be constitutional," he said.

"But it may make some sense for motor vehicle agencies to assess the skills of older drivers more frequently than they are doing."

And, he said, vision, knowledge and road testing for seniors, along with everyone else, should be more sophisticated and extensive.

Maryland, Mr. Teret said, "is doing as doing as good a job as any other state does, but I think all of the states need to address the problem more directly."

A 1976 state law in Maryland forbids licensing authorities from using age as a criteria when judging the fitness of drivers.

But all drivers must appear in person for a vision test when they renew their licenses every four years. (Some states permit renewal by mail or have no vision test requirement.)

Police officers, friends or relatives, or motor vehicle agency workers who suspect that a driver is unfit can contact the MVA. An MVA Administrative Law Judge may, after an investigation, order that the driver retake the standard eye, written and road test.

Where there is concern for a drivers mental or physical fitness, a case may wind up before the MVA's Medical Advisory Board. After a medical evaluation, the board has the power to direct the department to reissue, revoke or restrict the license.

Common restrictions in Maryland include that the license holder wear eyeglasses, or use special mirrors in the vehicle or not drive at night.

Of 9,496 cases of driver fitness reviewed by the board in 1990, some 6,266 were medically approved for some type of license, MVA officials said. The board disapproved 3,230 people. (It's impossible to tell how many seniors were denied licenses because the board does not keep statistics by age, an MVA official said).

W. Marshall Rickert, the state Motor Vehicle Administrator, said he thinks the state's current methods of dealing with impaired drivers, elderly or not, are sufficient. "No blanket retesting is necessary," he said. ". . . I don't perceive that we have a problem."

Dennis R. Atkins, the governor's highway safety representative, said the state is just starting to look at the issue of older drivers. One program being considered, he said, is an effort to make state road signs and markings easier to see by making them larger and more reflective.

But special testing is another matter. "There are obviously a lot of issues associated with it concerning whether you should single out a segment of the driving population and give them special requirements that they have to meet," he said.

Some other states, though, are moving toward more extensive andfrequent testing for all drivers, as a way of weeding out the unfit of any age. The tests are expected to have the biggest effect on seniors.

The California Department of Motor Vehicles is planning what Mr. Malfetti said was one of the nation's most aggressive new testing efforts. The program includes new night and peripheral vision tests, video tests of a driver's ability to judge relative speed and distance and a longer and more complex written test.

The eye test used by Maryland and most other states is a lettered eye chart that measures visual acuity, but not much else, critics say.

Mr. Malfetti has proposed extending the notion of license restrictions that would apply not only the time of day a person could drive, but how far, on what roads and for what purpose.

Five states, Mr. Malfetti said, already have some form of what he calls a "graded" license. (Maryland is not among them.)

Rural residents who could not cope with city traffic could take his or her test locally, to measure skills on lightly traveled roads. But that same person might be restricted to driving to and from church, shopping and relatives' homes. Or the license might be good only within a five- or six-mile radius of the driver's home.

Maryland's rules

Maryland has no retesting requirement based on age for applicants for driver's license renewals. But it requires all drivers to take a standard vision exam every four years when their licenses are renewed.

It also requires applicants who are 70 or older and who have never held a license to submit a doctor's report attesting to their medical and physical fitness.

Drivers may also be referred to the Motor Vehicle Administration for re-evaluation based on the recommendations of police, friends, family members or MVA employees. The names of those asking for the re-evaluation are kept confidential.

Tips for older drivers

The AAA Foundation for Traffic Safety has a booklet to help people measure their own driving skills. Write for the booklet, "Drivers 55 Plus: Test Your Own Performance," to the foundation RTC at 1730 M. St. N.W., Suite 401, Washington, D.C. 20036. The foundations also offers these suggestions:

In shopping for a car:

* Avoid tinted glass.

* Look for vehicles equipped with air bags.

In driving:

* Always wear eyeglasses, if prescribed.

* Keep windshields, mirrors, headlights and tail lights clean.

* Install right-side view mirror and extra-large rear-view mirror.

* If you are confused in congested, complex, fast-moving traffic, avoid it. Plan trips to minimize left turns and rush-hour travel through intersections.

* If you have trouble turning your head to check traffic in other lanes, ask your doctor about exercises that can help.

* Wear a seat belt.

* Stay informed about changing traffic regulations.

* Avoid driving at dawn or dusk.

* Ask your doctor if the medications you are taking, or combination of medicines, could cause drowsiness.

States that have special tests, in addition to regular renewal requirements, for older drivers

* District of Columbia: requires drivers to submit a medical report at age 70. At age 75, it requires all drivers to retake both the written and driving tests.

* Illinois: requires drivers to retake both a written test and a road test at age 69.

* Indiana: requires drivers 75 and over to take written and road tests.

L * New Hampshire: requires a written and road test at age 75.

* Oregon: requires a vision test at age 50 and thereafter at the time of license renewal.

* Maine: requires a vision test at age 40 and thereafter at the time of license renewal.

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