Senior Driving: Understanding Mind & Body Changes

AAA | March 25, 2021

Vision

A driver’s eyesight is critical in preventing car crashes, because nearly all the sensory input you need to drive a car comes from visual cues. If your eyesight is diminished, so is your ability to drive safely. This is especially important to senior drivers.

That’s why most states require motorists to undergo vision tests as part of the driver’s license renewal process. Depending on where you live, you may have a vision test in person at a state licensing office or submit results of a vision test performed by an eye doctor. In Minnesota, motorists are required to renew their driver’s licenses in person and pass a vision test every four years.

Light Requirements

When behind the wheel, a driver’s eyesight is the most important tools you have. But by age 60, eyes need three times as much light to see as they did at age 20, so it’s much more difficult to see objects in the dark. If you have vision problems, driving at night can be particularly hazardous.

Research shows senior drivers need significantly more light to see than teen drivers. That’s because over the years, pupils get smaller and don’t widen (dilate) as much in dark conditions, making it harder to see. This diminished vision is a significant problem.

Your vision may test well in the eye doctor’s office but still be effectively reduced driving at night, where lighting is poor and more complex visual tasks are required. Ability to resist glare and see reflective road signs and markings also decreases with age, so senior drivers should take extra care when driving at night.

Sharpness of Vision & Changing Focus

To get a driver’s license in the United States, requirements for best-corrected visual acuity, or best distance vision with eyeglasses or contact lenses, varies widely from state to state.

People with normal visual acuity are considered to have 20/20 vision. This means being able to read a letter positioned 20 feet away. Not everyone has 20/20 vision, of course. For example, if you have 20/100 vision, that means you must be 20 feet away from a letter to read it, compared with someone with normal visual acuity who could read it from 100 feet.

If you have trouble with your vision and notice a change in what you see while you’re driving, it’s best to get a vision test to determine potential nearsightedness (myopia) or farsightedness (hyperopia). It is also possible to have both nearsightedness and farsightedness.

Myopia, or nearsightedness, occurs when the eyeball is slightly longer than usual from front to back. Nearsightedness runs in families and usually appears in childhood, but it affects senior drivers as well. This problem may stabilize at a certain point, although sometimes it worsens with age. This is known as myopic creep. Nearsighted people have difficulty reading highway signs and seeing other objects at a distance, but can see for tasks such as reading or sewing.

Nearsightedness may be corrected with glasses, contact lenses or eye surgery. People with myopia may need to wear glasses or contact lenses all the time or only for distance vision, such as when driving.

Hyperopia, or farsightedness, is a common vision problem. Senior drivers with hyperopia can see distant objects very well, but have difficulty focusing on objects that are close.

For senior drivers, farsightedness can be corrected with glasses or contact lenses to change the way light rays bend into the eyes. If your eyewear prescription begins with plus numbers, like +2.50, you are farsighted and may need to wear glasses or contacts all the time or only when reading, working on a computer or doing other close-up work.

As you age, your useful field of view gets smaller and you no longer see everything that may be a safety risk. Below is what your useful field of view probably was at age 16.

Driving at Night & Managing Glare

Driving at night presents challenges for all drivers. Senior drivers can face substantially increased risk, because of decreased visual distance and sensitivity to the contrast between darkness and bright lights along roadways.

Difficulties like these are the most common reasons older drivers limit or regulate their own driving. Many senior drivers also find they just don’t need to be driving at night as often as they used to and primarily drive during the day. This can result in driving under less stressful conditions, too.

If you cannot avoid driving at night, there are several ways to manage the risks.

To minimize challenges of driving at night:

Adjust your speed to the reach of your headlights. Do not “overdrive” your headlights by driving at a speed that wouldn’t allow you to stop for an obstacle at the far reaches of your headlights. Compensate for reduced visibility by decreasing your speed and increasing following distance to four or more seconds behind the car in front of you.
Keep your eyes moving. Do not focus on the middle of the area illuminated by your headlights. Watch for sudden flashes of light at hilltops, around curves or at intersections, because these may indicate the presence of oncoming vehicles.
Look at the sides of objects. In dim light during reduced visibility, focus on the edges or outlines of objects. Your eyes can pick up images more sharply this way than by looking directly at the object.
Protect your eyes from glare. Prolonged exposure to glare from sunlight or headlights can temporarily affect your visibility at night. It can also lead to eyestrain and drowsiness. Wear good sunglasses on bright days and take them off as soon as the sun goes down. After steady daytime driving, rest awhile before you begin driving at night. At night, look to the center of your pathway and use the painted edge lines to guide your vehicle.
Avoid being blinded by oncoming high beams. If the driver of an oncoming vehicle fails to dim the lights, look down toward the right side of the road to avoid being blinded. You should be able to see the edge of the lane or the painted edge line and stay on course until the vehicle passes.

Common Vision Problems

Vision, like other senses, gradually declines over time. Because changes may be hard to notice, it’s important to have annual vision tests. Common eyesight conditions related to aging are glaucoma, macular degeneration and cataracts.

Hearing

According to the National Institute of Health, hearing loss is one of the most common conditions affecting older adults. Roughly one-third of Americans over age 65 have age-related hearing loss.

Aging is the most common cause of hearing loss, which usually becomes more noticeable after age 50. Also, men tend to be affected more often than women.

Symptoms of age-related hearing loss can include:

Difficulty hearing things in noisy areas.
Difficulty distinguishing high-pitched sounds from one another.
More difficulty hearing men’s voices than women’s voices.
Voices sound mumbled or slurred.
Ringing sounds in the ears.

Other causes of hearing loss include ear infections, tumors that damage certain nerves and some types of brain injury. Some people are born with hearing loss, or it can be inherited.

Hearing loss can be dangerous, especially when in or near traffic. For example, the inability to hear high-pitched tones, such as sirens from emergency response vehicles, especially among background noise like horns or railroad warnings, can put you and other road users at risk.

Treatment options for hearing loss depend on the cause. If it is treatable, yet ignored, it can get worse or become permanent. Hearing loss that is identified early might be helped through treatment, such as hearing aids, certain medicines or surgery. If you suspect you have hearing loss, visit your health care provider.

Reaction Time

Even if you have excellent judgment while driving, it may be challenging at times to integrate information from several sources at once. This can slow driver reaction time and inhibit safe driving in dangerous situations. It’s also possible that pain or stiffness in muscles or joints could make it difficult to react quickly during emergencies. A combination of treating the cause and changing driving habits can help you be successful at safe driving.

Did You Know?

The average driver makes about 20 major decisions during each mile driven – and often has less than one-half second to react to avoid a potential collision.

Motor Skills

Safe driving habits is as much a physical activity as it is a mental one. In addition to physical and flexibility, coordination is required for safe driving. Together, these abilities define your motor skills.

As you get older, flexibility decreases, which means you may have to reposition mirrors or make a more conscious effort to turn from the waist to see behind you.

Strength can make a difference in safe driving as well. For example, a car without power steering or power brakes may have been a cinch to control when you were 25, but these days, making a tight turn or quickly stepping on the brakes can be more of a challenge due to more limited motor skills.

Your ability to safely operate a motor vehicle depends, in large part, on motor skills used to reach for and buckle your safety belt, turn to check blind spots, grip and control the steering wheel, depress the correct foot pedals and operate other controls such as those for headlights and windshield wipers.

To compensate the effects of aging on motor skills, you can:

Improve your flexibility, which will help prevent injuries and excessive fatigue and allow you to move with greater ease.
Select a vehicle with senior-friendly features, such as a low door threshold, to make it easier to enter and exit your vehicle, or a thicker steering wheel that requires less hand and wrist strength to use.
Enhance the “fit” between you and your vehicle by adjusting mirrors to minimize blind spots and adjusting your seat so you can reach and fully depress foot pedals without sitting too close to your vehicle’s airbag.

Manage Slower Reaction Times

Driving is a complex, fast-paced activity. For senior drivers, reaction time depends on your ability to process information in the driving environment (sense), use that information to choose an action (decide) and react based on your decision (act). Completing these three steps quickly requires a sharp mind and a fit and flexible body.

While the single most effective way to improve driver reaction time is to exercise your mind and body, there are ways to compensate for slower reaction times and eliminate driving distractions.

Increase your following distance. Senior drivers should allow a greater distance between you and the vehicle ahead of you, so you’ll have more time to slow down or stop.
Minimize left turns. Senior drivers age 65 and older are over-represented in crashes involving left-hand turns. If possible, make three right turns to avoid making a left. Or try to use intersections with designated left-hand turn lanes. These are much safer for drivers of all ages.
Eliminate distractions inside the vehicle. Adjusting radio volume, using a cell phone and interacting with passengers can distractions for any driver. Keep the environment inside your vehicle as calm as possible, eliminating driving distractions.
Plan your route before you get behind the wheel. Doing this will help senior drivers avoid making any last-minute decisions about which way to turn or how to reach your destination.
Try to steer clear of busy highways and congested traffic. High-speed driving can be stressful, so don’t hesitate to use local roads instead of highways. Also try to avoid rush hour traffic or highly congested areas. More vehicles on the road translate to a greater likelihood of a collision. Senior drivers should also consider using public transportation if it’s available to you.
Review your medications. Older drivers should remember that prescription and over-the-counter medications can slow reflexes, blur vision and cause drowsiness or dizziness, causing additional driver distractions. Talk to your doctor or pharmacist about making adjustments that aid in safe driving. If you have serious muscle or joint impairments, ask your doctor about anti-inflammatory drugs that can help permit safe driving.
Stay awake and alert. Drowsy driving is as dangerous as drunk driving and distracted driving. Be sure to get enough sleep before a long trip and take frequent breaks along the way.

Mind & Cognition

As you get older, your brain needs more time to process information, making it more difficult to ignore distractions. The good news is that mature judgment, years of driving experience and good driving habits often can help senior drivers compensate for some diminished cognitive abilities.

Cognition is the ability to remember information like locations or destinations and recognize and respond to things such as traffic signs and pavement markings. When driving, it involves being able to focus and make sound decisions in a hurry to avoid a crash.

Learn more about severe cognitive impairments such as dementia, and how driving can be affected. Also, learn how senior drivers can prevent aging-related cognitive decline by getting plenty of physical exercise and keeping your mind active.

Driving & Dementia

Dementia is not a specific disease, but rather a word used to describe symptoms caused by disorders that affect the brain. Alzheimer’s is the most common form.

If you have dementia, you will eventually become unable to drive, due to challenges with reaction time and decision-making. However, a diagnosis of dementia doesn’t necessarily mean senior drivers should stop driving right away. If you have been diagnosed with early-stage dementia, it’s very important that you discuss driving with your doctor and your family to determine when you need to stop and how you will get around without getting behind the wheel.

Warning signs that dementia is affecting your driving and that you need to stop:

Forgetting how to locate familiar places.
Failing to observe traffic signs and signals.
Becoming angry or confused while driving.
Often hitting curbs while driving.
Confusing the brake and gas pedals.
Forgetting your destination during a trip.

As an older driver, if you have experienced any of these warning signs, consult your doctor. You might be referred to an occupational therapy driver rehabilitation specialist for an evaluation to help determine your fitness to drive.

Medical Conditions & Medications

If not managed properly, medical conditions can increase your crash risk. Some of the most common conditions known to affect safe driving are impaired vision, physical limitations, dementia, diabetes, seizures and sleep disorders. Even if you have one or more of these medical conditions, if you work closely with your doctor, you often can continue safe driving.

Increased use of prescription and over-the-counter medications to treat temporary or chronic medical conditions also is common as you age. Some medications or combinations of medications can impact your ability to drive safely. Because of this, some states have made it illegal to drive while impaired by medications and other drugs.

Knowing the facts, understanding the risks and seeking help to properly manage your health will keep you safely behind the wheel and out of legal trouble.

Developed by the AAA Foundation for Traffic Safety, Roadwise Rx is a free online tool designed to allow you to record your prescription and over-the-counter medications in one central location, and to receive personalized feedback about how drug side effects and interactions between medications may impact your ability to drive safely.

Roadwise RX

Eight out of ten senior drivers age 65 and older take medications on a regular basis. And despite high prescription and over-the-counter medication use, almost half of senior drivers using medications have never talked with their health care providers about how the drugs might affect their safe driving abilities.

Roadwise Rx is a free, confidential tool developed by the AAA Foundation for Traffic Safety that adults can use to explore how medications may affect safe driving.

How it works

Roadwise Rx offers a way for you to record all of your medications in one central location. It also provides customized feedback on how your prescription and over-the-counter drugs, herbal supplements and foods, as well as their interactions with each other, can affect safe driving.

http://www.roadwiserx.com/

How Medications Can Affect Driving

Two-thirds of senior drivers age 65 and older take five or more daily medications that can affect their ability to drive safely.

Prescription and over-the-counter medications come with warnings about possible side effects, such as drowsiness or risks related to driving, yet many people ignore them, because they’ve never had a problem. In addition, side effects for an individual drug can change when combined with other medications, especially new prescriptions.

Medications known to impact driving include:

Tranquilizers
Narcotic pain pills
Sleep medicines
Some antidepressants
Cough medicines
Antihistamines
Decongestants

State Laws on Medication Use & Driving

“Driving under the influence” doesn’t just refer to the influence of alcohol. Most state laws do not differentiate between alcohol and other drugs when it comes to impaired driving. A driver impaired by prescription or over-the-counter medications could just as easily be arrested and charged with a DUI offense as someone impaired by alcohol.

Penalties of impaired driving while using alcohol or any other drug, including prescription and over-the-counter medications, include heavy fines, jail sentences and revocation of license. Make sure the medications you take will not result in impaired driving.

Quick tips

Read the fine print. If a medication you’re taking is labeled, “Do not use while operating heavy machinery,” let someone else drive.
Inform your doctor about nonprescription drugs you take. These include alcohol, which can interact with some medications and cause serious side effects.
Discuss your medication and its effects on driving with your doctor or pharmacist.
Always check with your doctor before stopping any medication.
If any medication makes you feel sleepy or disoriented, don’t drive.

Almost every state, including Minnesota, has a process for reporting a potentially unsafe driver to its licensing office or department of motor vehicles. Law enforcement officers and physicians represent the majority of individuals submitting reports, although concerned citizens also can do so. If a state agency finds a complaint reasonable and credible, it may ask the reported driver to submit additional information, which could be used to help determine if a screening or assessment is justified.

Visit the Minnesota Department of Public Safety website or call (651) 296-2025 to learn more about the process and possible outcomes. You will be required to provide your name and contact information.

MINNESOTA PARTNERSHIP FOR SAFE MOBILITY

AAA is a member of the Minnesota Partnership for Safe Mobility (MPSM), a collaborative of public, nonprofit and educational experts working to influence policy, create initiatives and promote research that will improve the safety and mobility of Minnesota’s aging population. Learn more >>

MATURE DRIVER COURSE (IN CLASSROOM)

Senior driver improvement courses are offered by your AAA club, as well as through the Minnesota Highway Safety & Research Center at St. Cloud State University. Completion of these courses allows seniors to become eligible for a 10 percent auto insurance discount. Classes are taught throughout Minnesota, including at AAA locations in St. Louis Park and Burnsville. Learn more about courses offered by your local AAA club >>

MATURE DRIVER COURSE (ONLINE)

AAA’s Mature Operators Driver Improvement class is created for drivers age 55 and older. The program provides tips and techniques to help experience drivers compensate for changing vision, reflexes and response time. The course provides a quick refresher on defensive driving skills and new traffic laws, road markings and signs.