The impact of advanced age on driver safety

Throughout the aging process, individuals can experience a decline in skills that are important for driving. This decline is not based on age alone. Changes in cognitive, visual, and physical functions may cause safety concerns. Additionally, there are specific medical conditions and medications that can affect one’s driving ability. If you notice changes in your patient’s vision, physical fitness, attention, and ability to quickly react, it’s important to understand how this may impact their ability to drive safely. (Visit the National Highway Traffic Safety Administration (NHTSA) website for additional information.)

The evaluation of an older adult’s functional capacity to drive often falls to their primary care provider or another clinician whom they see regularly. Recent Centers for Disease Control and Prevention research indicates that 82 percent of drivers older than 75 do self-regulate (for example, restrict driving at night, during poor weather conditions, and for longer distances). However, only 15 percent of drivers older than 75 limit driving for medical reasons, and none limit driving due to cognitive impairment.[1]

Several studies have identified specific medical conditions and functional deficits that predict motor vehicle crashes or adverse driving events in the older population, including:

  • A history of falls,
  • Visual and cognitive defects,
  • Prior history of motor vehicle crashes, and
  • Current use of medications, such as tricyclic antidepressants and benzodiazepines[2]

Chronological age and medical diagnoses are not as frequently associated with crashes as functional status and medications. For example, falling and car crashes have similar risk factors, such as the use of sedatives or psychotropic medications, cognitive impairment, and balance and gait abnormalities. Studies indicate that older adults who had fallen were 40 percent more likely to experience a subsequent motor vehicle crash than older adults who had not fallen. (Scott, K.A., Further, diminished capacity as individuals age can lead to two common motor vehicle violations—failure to yield right of way and failure to obey a traffic sign. These violations often result in accidents at intersections that require quick response, total peripheral vision, and interaction with other drivers.

[1] Carr, D.B. & Hill, L.J. (2022). Approach to the evaluation of older drivers. Retrieved March 27, 2023, from

[2] Scott, K.A., Rogers, E., Betz, M.E., Hoffecker, L., Li, G., & DiGuiseppi, C. (2016). Associations between falls and driving outcomes in older adults: A systematic review and meta-analysis: A LongROAD Study. AAA Foundation for Traffic Safety.