Seniors who stay behind the wheel may thrive

Older drivers less likely to need assisted living, but face more fatal risks


Elderly drivers may be the butt of jokes and a source of anxiety to their children, but new research shows that the very act of driving on that short trip to the grocery store may help keep them out of a nursing home.

A study by scientists at the Johns Hopkins School of Medicine suggests that senior citizens who continue driving are less likely to enter nursing homes or assisted-living centers than others their age who have stopped driving -- or who never drove at all.

On the other hand, a study by a University of Virginia researcher indicates that as they get older, seniors are more at risk for fatalities in accidents than all but the very youngest drivers -- which poses a safety challenge as baby boomers age.

The Hopkins study showed that nondrivers were four times as likely to enter long-term care as drivers; and those without drivers in the house were twice as likely to wind up in long-term care as those in households with drivers.

Funded by the National Institute on Aging, the study involved interviews with 1,593 seniors in Salisbury between 1993 and 2001. All were between the ages of 65 and 84.

In examining the role of driving, the scientists took into account age, race, health problems, marital status and other factors that can result in elderly people entering nursing homes. There was no significant difference between men and women in the findings.

Researchers say they are not trying to encourage seniors to continue driving if they can no longer navigate the roads safely.

"I think trying to drive in the current driving environment is very difficult for people who lose the ability to respond quickly and deal with multiple vehicles on the road," said Sheila West, a professor at the Johns Hopkins Wilmer Eye Institute. "If they don't feel comfortable, then maybe they shouldn't be on the road."

However, she said it's important to provide seniors with some form of transportation so that they can take care of their needs independently.

The study shows that seniors in rural areas have a particularly difficult time adjusting to life without transportation. Dr. Ellen Freeman, an epidemiologist, researcher at the Wilmer Eye Institute and lead author of the study in the American Journal of Public Health, said the findings are particularly relevant to those communities.

"Salisbury is a very small town that has no transportation," Freeman said. "The findings might not be the same somewhere like New York City, or any other urban setting with lots of public transportation."

Yet, there are doubts that many seniors use public transportation even when available.

"I know enough people to call," said 80-year-old Leoner Battle, a Randallstown resident who gave up her license five years ago. "Besides, it makes you look old when you're on those [senior mobility vans]."

West said another difficulty in attracting seniors to public transportation in the city and suburbs is safety. "Older people often don't feel as safe using public transportation," she said. She added that seniors don't want to deal with the sometimes-irregular schedule of public buses.

On the other side of the argument, driving can become more dangerous as seniors age. A report on that subject, also sponsored by the National Institute on Aging, noted that Americans 65 and older are the second most likely group to die in car accidents -- after 15-to-24-year-olds.

"The probability of people getting injured in a crash actually goes down with aging -- they're just more likely to die," said Richard Kent, a professor of mechanical and aerospace engineering at UVA and co-author of the report, "On the Fatal Crash Experience of Older Drivers."

The report blames the higher mortality rate on bodies that become more frail with age.

Kent found that car accidents involving young drivers are mostly single-car incidents resulting from high speeds, alcohol and the lack of wearing a seatbelts. Accidents involving seniors are more likely to occur because they are not paying attention -- such as crashes that happen when a driver creeps into an intersection after the light has changed.

In 2004 the Insurance Institute for Highway Safety calculated 5,062 accident-related deaths of people who were 70 or older -- compared with 4,642 deaths among 16-to-19-year-olds, a much smaller group.

Kent predicts that the number of elderly car accident victims will increase as the nation's 75 million baby boomers age and continue to drive.

He suggests modifying safety equipment such as air bags and set belts to deal with the anatomical differences that develop between senior citizens and younger drivers. "Part of it is understanding how people get hurt. How do we use what we know to prevent people from dying in a crash?" he said.

But he noted that cars equipped specifically for the elderly would have to be marketed creatively. "You don't want to sell something to people by saying, `Hey you're old,'" he said.

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