Automobiles Are Inspected With Much Greater Scrutiny Than The Drivers Of Those Automobiles, Claim Authors
SAN FRANCISCO -- Licensed older drivers (over 60) in the United States have increased by almost 50 percent since 1985, according to the National Highway Traffic Safety Administration (NHTSA). Most of these drivers are safe drivers, but older adults with cognitive impairments and those above age 80 have a much higher risk for causing and/or being in a car accident, say psychologists who have been studying the determinants of auto safety in older drivers. These findings will be presented at the 106th Annual Convention of the American Psychological Association in San Francisco.
"These older adults with impairments are much more likely than younger adults to have crashes during daylight hours, on weekdays, in intersections, turning left and when merging," say neuropsychologists Robert Fields, Ph.D., of Allegheny General Hospital in Pittsburgh and Gale Valtinson, Ph.D., of the Biscayne Rehabilitation Institute in Miami. Furthermore, adults over the age of 80 have higher fatality rates (per miles driven) than any other age group except for 16-year-olds, according to the NHTSA.
Dr. Fields and colleagues contacted the Department of Motor Vehicles in all 50 states to find out what state policies existed for older drivers. "The findings were all over the map, literally," said Dr. Fields. "An example is the lack of uniformity in the driver renewal process. States vary tremendously in the number of years between renewals, the age at which any increased scrutiny of an older driver's abilities is initiated, whether the driver must renew in person, the types of driving fitness tests required (if any at all), and the nature and extent of any medical information which must be forwarded to the state."
The state with the most stringent standards is Illinois, which established empirically based graduated licensing for both younger and older drivers. At age 75, all Illinois drivers must renew their license in person and must take a vision and road test. In contrast, there are states like Oklahoma, where no medical information and no tests of ability are required to renew a license.
Somewhat surprisingly, there has been a recent trend toward lengthening the renewal period and reducing the assessment procedures for older drivers; decisions that are motivated by financial concerns rather than safety. Wisconsin, Nebraska, Louisiana and the District of Columbia have all increased the length of their renewal period. The state legislature in Texas determined that the risk of public safety did not merit the cost of instituting stricter procedures to screen older drivers. In Florida, the state with the most elderly drivers, an individual without a traffic conviction in the prior three years can renew their license through the mail and appear in person only once every 12 years.
Furthermore, states also vary considerably in what they require the medical profession to do. "In Alabama, physicians are required to tell their patients not to drive when they believe that they are unsafe, but have no authority to report unsafe drivers. In California, Oregon, Pennsylvania and Utah, physicians are required to report unsafe drivers to the state. In contrast, in Maryland a physician may not report their patient without that patient's written permission," said Dr. Fields.
Neuropsychological tests, which are extremely useful in assessing the presence and severity of brain damage caused by conditions such as Alzheimer's Disease and head injuries, are of limited value when assessing the specific skill of driving. "Driving is an over-learned behavior and we need to insure that the assessment tools we use measure accurately and fairly the behavior in question," said Dr. Fields. "The most promising development in this area is the "Useful Field of View" (UFOV) test. This test assesses the area of a person's visual field in which information can be rapidly extracted without eye or head movements."
"At present, it appears that automobiles are inspected with much greater scrutiny than the drivers of those automobiles," said Drs. Fields and Valtinson. "Even when drivers are tested for impairment, the methods used by most states to identify impairments (e.g., vision screening exams) are variable and not good at predicting poor drivers. Most older drivers are safe and use good judgment in adjusting their driving habits to age-related changes in visuo-motor capacities," said Dr. Fields.
"The goal of this research was to highlight the differences in state policies toward older drivers, to reduce the reliance on out-of-date or ineffective screening techniques, to encourage the use of tests which are fair to drivers of all ages and which actually measure the capacities necessary to drive safely and promote the passage of laws based on empirical findings," said the authors.
Presentation: "Assessment of Older Drivers: Neuropsychological Predictors and State Laws," Robert Fields, Ph.D., Allegheny Hospital in Pittsburgh, PA and Gale Valtinson, Ph.D., Biscayne Rehabilitation Institute in Miami, Session 2042, 8:00 AM, Saturday August 15, 1998, Moscone Center - South Building, Exhibit Hall B (D-7)
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