Older Drivers - How Health Affects Driving

05/20/19 ·National Institute on Aging

It’s your health — not your age — that matters most in driving safely. As you get older, you may notice physical changes or changes in other abilities. For example, you may have difficulty seeing at night or may not react as quickly to sudden changes. These changes can affect your driving, especially in challenging situations like merging or changing lanes. 

Age-related changes that may affect driving include changes in vision, hearing, attention and reaction time, and strength, flexibility, and coordination. Medications and certain health conditions can also affect people in ways that make driving dangerous.

Age-related changes vary widely from one person to the next. That’s why some people can continue driving much longer than others.

Vision Changes 

Eyesight often worsens with age. Older eyes need more light and more time to adjust when light changes, so it can be hard to see clearly, especially at dawn, dusk, and night. Eyes become more sensitive to glare from headlights, street lights, or the sun, making it difficult to see people, things, and movements outside your direct line of sight. 

Peripheral vision — the ability to see to the side while looking ahead — often declines as people age, increasing the risk of crashes. In addition, field of vision — how much you can see all at once — narrows, making it harder to spot an object in a cluttered view.

Eye diseases such as cataracts, glaucoma, and macular degeneration become more common as people get older. It may be harder to read signs and see colors.

Hearing Changes

Age-related hearing loss can make it harder to notice horns, sirens, and noises from your car. That can be a problem because these sounds warn you of possible danger. 

Changes in Attention and Reaction Time

To drive safely, people must be able to pay attention to many things at once and react to sudden changes. They need to make decisions — sometimes very quickly — and act in time to avoid accidents and stay safe. 

As people get older, they process information and react more slowly. Their attention span may be shorter. It also becomes more difficult to do two things at the same time. As a result, older adults may feel overwhelmed by all of the signs, signals, pedestrians, and vehicles at intersections. Older adults may also have trouble judging gaps in traffic. This can make it more difficult to turn left at intersections or to merge with traffic when turning right.

Physical Changes

As people age, their joints may get stiff, and their muscles may weaken. Maybe they have trouble walking or feel pain in their knees, legs, or ankles. All of these symptoms can make it harder to drive safely. A person may not be able to turn his or her head to look back, turn the steering wheel quickly, or brake safely. 

Medications

Older adults generally take more medicines than when they were younger. Both prescription and over-the-counter medicines can affect the ability to drive safely by making you feel tired, dizzy, or nauseated. For example, certain cold remedies can cause drowsiness. Medications that treat depression, anxiety, stress, sleeping problems, heart disease, and muscle spasms can also cause problems. Not taking required medicines can cause problems as well. Studies have shown that using certain medications or many medications increases the chances of being in a crash.

Health Conditions

Some health problems seen in older people can interfere with driving. It is often possible to keep driving in the early stages of a disease. But, as the disease gets worse, a person may decide that it is no longer safe to drive. 

Any health condition that affects the arms, legs, neck, or back can affect someone’s fitness to drive. Serious impairments are associated with a higher risk of crashes.

Several age-related diseases and conditions can affect the ability to drive. Here are some of the most common ones. 

  •  Diabetes can make a person’s blood sugar levels too high or too low. That can make him or her feel sleepy, dizzy, or confused. It can also cause a loss of consciousness or a seizure. People with diabetes-related complications should consult their healthcare team for guidance on driving. 
  • Macular degeneration can distort a person’s central vision and lead to the loss of sharp vision. That makes it hard to see road signs, traffic, and pedestrians.
  • Arthritis can make a person’s joints swollen and stiff, limiting movement of the shoulders, hands, head, or neck. This can make it hard to grasp or turn the steering wheel, apply the brake and gas pedals, put on a seatbelt, or get in and out of a car.
  • People with Alzheimer’s disease or other kinds of dementia may not realize they are no longer safe drivers. They might get lost while driving, even in familiar places, and need lots of help with directions. It’s important to tell a family member or friend if you become confused when driving. People with severe dementia should not drive. Having a passenger guide someone with dementia through the driving task is not safe, either. 
  • Stroke can affect the ability to speak, think clearly, or control one’s body. It can cause weakness or paralysis on one side of the body. As a result, a driver may have trouble using the car’s controls, drift across lanes, or be confused by traffic. 
  • Parkinson’s disease can cause a person’s arms, hands, or legs to shake and affect balance and movement. A driver may not be able to react quickly to danger, turn the steering wheel, or push the brake pedal.
 
Having a particular health condition does not necessarily mean the end of driving. But you should pay attention to how well you drive. If you or someone you know is concerned about your driving, talk to your doctor and consider getting a driving evaluation.