Drivers over age 70 number about 18 million today, up from about 13 million a decade ago. Though involved in fewer accidents than younger people because they drive less often, individuals over 65 are the most likely to die in car wrecks, says former National Highway Traffic Safety Administration (NHTSA) official John Eberhard.

Traffic fatalities involving older drivers, he adds, could triple by 2030. Such statistics have prompted studies of how aging might affect driving ability.

"As we get older, our general health tends to decline," says Susan Ferguson, senior vice president of research for the Insurance Institute for Highway Safety. "This is the most serious problem facing older drivers. When they get into a crash, they are much more likely to suffer serious or fatal injuries." Ferguson also notes a study suggesting there is "a modest increased risk of nonfatal injuries to occupants of other vehicles involved in collisions with vehicles driven by people 75 and older."

In response, many states-Arizona, California, Florida, Maryland, Michigan, Oregon and Pennsylvania, among them-are taking a hard look at various approaches to reducing risks for older motorists, from better medical screenings of drivers to installing more left-turn signals at busy intersections.

"The focus of such efforts should be to see if it's possible to get something remedied-to zero in on health and driving problems, not how old you are," says Audrey Straight, a senior policy adviser in AARP's Public Policy Institute. "Some people are safe drivers into their 90s."

In Maryland, the "mission is, how do we keep people on the road as long as they can be safe?" says Robert Raleigh, M.D., head of the medical advisory board to the state's Motor Vehicle Administration. "We're not here to take licenses away."

His research group has gathered information on 2,500 drivers who were renewing their driver's licenses and on 700 people referred by doctors and others for possible driving impairment to see how different health conditions affect the ability to drive.

Preliminary results from the research project show that while younger drivers "pass with flying colors" 95 percent of the time, problems that would likely hamper safe driving-slower reaction time, impaired vision, and less physical flexibility-show up much more frequently in drivers 50 and older.

Some older drivers, early findings suggest, may benefit from driver training, counseling, rehabilitation after a stroke or heart attack, or use of adaptive equipment in their vehicles. [See Brush Up on Your Driving.]

And some, depending on their capabilities, may need to limit their driving to, say, a 15-mile radius of their home. In certain cases-for instance, for people with advanced dementia-driver's licenses may have to be revoked.

Some states are concentrating their efforts on roadway enhancements to prevent common driving infractions and accidents.

Typical improvements include:

In Florida, the Elder Roadway User Program is using reflective pavement markers to better illuminate roads when it's dark or rainy. Street names are displayed well in advance of intersections. Stop, Yield and Warning signs have new, larger lettering.

States are also reviewing licensing requirements for older drivers. The Insurance Institute for Highway Safety counts at least 13 states that call for more frequent license renewals, along with other restrictions, once drivers reach a certain age.

Colorado, for instance, requires drivers 61 and older to renew every five years, while younger drivers renew every 10 years. Hawaii requires two-year renewals for drivers 72 and older, six years for others. In Illinois, it's one year for drivers 87 and older, two years for those 81 to 86, and four years for those under 81.

Maine drivers 40 and over must take a vision test every other time they renew their license until age 62, and every time after that. Oregon requires a road sign recognition test starting at age 50, while New Hampshire mandates a driving skills test at age 75.

All states ask driver's license applicants if they have certain health problems that could impair driving. For a "yes" answer, the applicant may be sent to a physician. Or a medical board may decide if driving restrictions are needed.

Nearly all states heed reports from doctors, family members, courts, police, and motor vehicle departments that identify motorists with health problems that could affect their driving ability.

At least five states-California, Delaware, Nevada, North Dakota, and Texas-require physicians to make these types of reports. Other states are considering similar legislation.

Although states are taking more steps to keep roads safe for everyone, most find that imposing driving restrictions based on age is politically difficult. But state lawmakers aren't likely to back off measures addressing older driver issues, says Eberhard.

"States should address transportation issues not only for their older constituents," he notes, "but with the next generation in mind as well."

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Originally published in the AARP Bulletin in September 2001.