In the next 20 years, the number of elderly drivers — age 70 and older — is predicted to triple in the United States. Although many older motorists become more careful on the road, statistics show that they are more likely than younger drivers to be involved in multi-vehicle crashes.

“The majority of elderly individuals believe that they can drive, and most of them are capable of doing this,” says Ronan Factora, MD, of Cleveland Clinic’s Center for Geriatric Medicine and Co-Director of the Aging Brain Clinic.

“The difficulty arises when they display physical or cognitive problems associated with driving impairment. It is often difficult for them to recognize the problem and its impact on driving safety,” he says.

4 things that can affect driving

1. Vision changes — Glaucoma, cataracts, macular degeneration and diabetic retinopathy are among the vision-related conditions associated with aging. Some are treatable; some are not. “The most important point is to make sure that vision is assessed by your ophthalmologist at least every one to two years,” he says.
2. Memory problems — Normal changes, such as delayed recall and problems with multitasking, may not affect driving ability. However, individuals with diseases such as dementia are at higher risk of getting into motor vehicle accidents. Problems with memory processing speed, or planning and organizing thoughts can impede driving.
3. Hearing loss —This impairment, so common among the elderly, can hinder the ability to hear police or ambulance sirens and drivers’ horns.
4. Slower reflexes — Older adults may not be able to react as well to sudden changes in traffic or to plan turns correctly. “Although this can be difficult to discern during a physician’s examination, the family should report any problems to the doctor,” Dr. Factora says.

There is no particular age at which elderly individuals should stop driving. “If there are physical, sensory or cognitive issues that would impair driving, I recommend a formal driving assessment to determine risk,” says Dr. Factora.

Signs a driving risk assessment may be necessary

• Getting lost while driving
• More frequent accidents/fender benders
• Inability to follow road rules
• Unexplained dents or scratches on the car

Because driving equals independence for most people, the family should approach the issue sensitively, Dr. Factora says. Offering transportation is a start. He has suggestions for when you decide to approach your loved one about giving up the wheel.

How to talk to your loved one

1. Emphasize alternatives. Explore public transportation and other available senior services.
2. Express yourself. Tell them what you have observed and that you fear for their safety.
3. Accentuate the positive. Help the individual to stay involved in activities outside the home to avoid feeling the loss of independence.
4. Involve others. If your loved one is ignoring serious issues, bring them to the attention of his or her physician.

“Do not ignore or discount your concerns,” Dr. Factora says. “Problems may have been going on for longer than the family has noticed.”

If it’s time for a direct discussion with your elderly loved one, don’t put it off. Lives could be at stake.