title: Older drivers' "high per-mile crash involvement": the implications for licensing authorities.
abstract: OBJECTIVE
  Determine what role motor vehicle administrators have in dealing with older drivers based on their crash risk and mobility needs.
  
  
  METHODS
  This article reviews both the recent crash, injury, and exposure trends from the National Household Travel Survey and other sources to help motor vehicle administrators set priorities in meeting the safety and mobility needs of older persons.
  
  
  RESULTS
  Older drivers have a higher crash risk per mile driven. The "risk" of dying in a crash is more likely attributable to the frailty of older drivers than the risks associated with the functional limitations that accompany aging. The research literature indicates that older drivers are not a risk to other road user age groups but primarily to themselves. Furthermore, recent fatality data indicate that the death rates for older persons, particularly those over 80 years of age, have been declining over the last 10 years. These results differ from recent fatality trend projections that predicted a significant increase in traffic fatalities associated with an aging driver population. Drivers over 80 are more likely to have a crash on a per licensed driver basis. There is new evidence, however, that only older drivers who drive infrequently are at increased risk. These drivers drive relatively short distances on local streets with complex traffic situations. Most of these drivers are also likely to be experiencing multiple functional limitations. Since those who stop driving reduce their mobility by over one half, motor vehicle administrators need to work more closely with the state departments of aging and transportation providers to help ensure mobility options for those who can no longer drive.
  
  
  CONCLUSIONS
  Older driver motor vehicle crashes are not a significant threat to other road users in vehicles or as pedestrians. It is the older drivers and their vehicle occupants who are at higher risk of dying when in a crash. Current evidence is that the drivers who pose the greatest risks are the teenage grandchildren of this older generation. Therefore, motor vehicle administrators can support their stand against increasing the licensing requirements of older drivers. When dealing with the older driver population they need to weigh the consequences of having someone stop driving and assist other responsible agencies in fostering sustained mobility for those who stop driving.
authors.affiliation: Aging and Transportation Issues, Howard County Commission on Aging, Columbia, Maryland 21045, USA. jeberhard2@msn.com
authors.forename: John
authors.initials: J
authors.lastname: Eberhard
mesh_terms: D000056:Accident Prevention / Q000379:methods*; D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000706:statistics & numerical data; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D012042:Registries; D012307:Risk Factors; D012449:Safety; D017678:Sex Distribution; D016019:Survival Analysis; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology