The older driver comes of age.
As the senior citizen population increases, activities around the country are addressing transportation and mobility challenges. Aging is a fact of life. However, the number of seniors in the United States will reach an apex over the next 20 years. According to census data in 2000, the U.S. population included approximately 35 million people who are aged 65 years and older, making up 12.4 percent of the total population. Baby boomers born between 1946 and 1964 will reach the age of 65 beginning in the year 2011. Projections indicate that the population of older Americans in the United States will more than double by 2030.
Along with this large population shift also will come a shift in vulnerabilities: because of their fragility, older people are more easily injured and killed in crashes, and are more prone to trauma resulting from crashes. In 2003, the National Highway Traffic Safety Administration (NHTSA) indicated that older citizens accounted for 12 percent of all traffic fatalities and 16 percent of all pedestrian fatalities.
"This aging population increases the challenges and responsibilities of numerous organizations, including those in the transportation community," says Michael Trentacoste, director of the Office of Safety Research and Development at the Federal Highway Administration (FHWA).
The burgeoning of the Nation's senior population is driving government at all levels to reexamine services such as Social Security, health care, and transportation. Professionals who help shape transportation policy and programs have been at work for some time to address one of seniors' greatest needs: retaining their safety and mobility in later years.
The transportation community is looking at safety improvements in a number of areas that address some of the challenges facing the Nation--including highway and vehicle design. For example, highway design alternatives might incorporate safer and easier methods for senior usage because perceiving and judging the dynamics of traffic movement may be among the limitations experienced by some older drivers. Safer, easier-to-use automobiles, as well as roadways and walkways designed to accommodate the special needs and functional requirements of older drivers and pedestrians can greatly reduce both the number and severity of crashes. Safe, well-designed, and well-lighted pedestrian facilities encourage walking, which is the second most widely used mode of travel by those 65 and older. Design standards that meet the needs of all road users--drivers, passengers, pedestrians, and bicyclists--will provide a safer transportation system for all.
This article is the first in a PUBLIC ROADS series that will look at how various groups across the country are managing issues related to the older road user, including program development, projects, and activities.
The Demographics of Older Road Users
Aging is an individual process that affects each person differently, at different ages and at different rates. Aging may bring maturity with seasoned judgment and reduced risk-taking behavior, but it also may bring varying degrees of reduced functional abilities from multiple, chronic illnesses. Physical and cognitive abilities may decline. Physical functions such as strength, flexibility, and range of motion may be reduced. Visual limitations are often, but not always, noted in acuity and contrast sensitivity. Cognitive capabilities may slow in terms of the speed of processing information and ability to address multiple claims on attention. On the other hand, over time many older road users learn to compensate successfully for at least some of their functional limitations.
FHWA and NHTSA, agencies that maintain the national transportation data on this subject, define "older" to mean people 65 or more years of age. Members of the older population, like everyone else, largely depend on the automobile for the bulk of their travel. Although this varies from rural to suburban to urban regions, overall people over 65 years of age make roughly 90 percent of their trips by car, more than 65 percent as drivers, and another 22 percent as passengers in a vehicle.
Data from the National Household Travel Survey indicate that compared to younger people, older adults make a greater percentage of their trips as drivers. Sandra Rosenbloom, professor of planning and adjunct professor of gerontology at the University of Arizona, Tucson, says, "Regardless of where they live, most older people are extremely dependent on the private car, either as a passenger or a driver, and increasingly the latter."
In 2002 there were 19.9 million older licensed drivers; a 29 percent increase from 1992. During that same period, the number of drivers of all ages increased just 12 percent.
Maintaining safe mobility through the latter years is one of the highest priorities for many Americans and has obvious impacts on health and well being. According to a U.S. Department of Transportation (USDOT) report, Safe Mobility for a Maturing Society: Challenges and Opportunities, most older adults continue to live in the same homes or localities where they lived before they retired, close to family and friends, leading active lives, and aging in familiar surroundings. More than three-fourths of the older population live in the suburbs and rural areas, where automobiles are the primary mode of transportation.
Although the data show that many older drivers are quite responsible (high safety belt usage and low rates for both alcohol-related crashes and speeding), fatality rates per 100,000 populations for older road users parallel the high rates for teens.
The Insurance Institute for Highway Safety conducted a study of the present and future impacts of older drivers and predicted that by the year 2030 drivers 65 and older will account for 16 percent of all crashes and 25 percent of all fatal crashes. According to the Institute's study, Older Driver Involvements in-Police-Reported Crashes and Fatal Crashes: Trends and Projections, "The annual number of older driver fatal crashes is expected to more than double."
An effective transportation system will offer safe mobility to users and enable older persons to remain independent and "age in place" (grow older without relocating) if they so desire. Medical and social service workers, transportation managers, motor vehicle administrators, caregivers, and others interested in the safety of seniors can work together to promote safe driving and to ensure that other convenient, affordable, and safe transportation options are available when driving or walking must be curtailed. Public and private organizations can form new partnerships to enable all citizens to enjoy safe mobility for life. Safer roadways, safer automobiles, better transportation options, and improved competency of older drivers will lead to a safer transportation system for everyone.
Selected National Activities Related to the Older Road User
The changing demographics of the United States have immense national implications. As early as 1988 the Transportation Research Board (TRB) documented the problem in TRB Special Report 218, Transportation in an Aging Society, and warned that transportation practitioners would face a wide range of design issues related to older road users. It should be strongly noted that changes that might be needed in road infrastructure or operations to accommodate seniors, would also benefit other transportation users.
Selected examples illustrate how Government, industry, associations, and academia are addressing these concerns. The examples are not necessarily mutually exclusive; a Government entity and an association group could be working on the same effort.
At the Federal level, the surface transportation legislation, Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU), enacted in August 2005 contains provisions specifically emphasizing the transportation needs of older people. One such provision, "Roadway Safety Improvements for Older Drivers and Pedestrians" (Section 1405) authorizes a program to improve traffic signs and pavement markings in all States consistent with the recommendations in the FHWA 2001 publication, Guidelines and Recommendations to Accommodate Older Drivers and Pedestrians (FHWA-RD-01-051) available at www.tfhrc.gov/humanfac/01105/cover.htm.
White House Conference on Aging
The 2005 White House Conference on Aging (WHCoA) was held in December, which was just the fifth time the conference convened in its nearly 50-year history. Underscoring the importance of transportation to seniors, Secretary of Transportation Norman Y. Mineta was invited to address the conference in the opening ceremonies. He delivered the Administration's message about the importance of safe mobility in latter years, and urged delegates to include recommendations on transportation solutions in the list of recommendations they forwarded to the U.S. President and Congress.
Attendees at the WHCoA included about 1,200 voting delegates who were appointed by the governors in their States, their senators, or their congressional representatives. Other attendees participated but were not eligible to vote on recommendations. These included cabinet secretaries, invited international observers, congressional staff, and other dignitaries.
The format for the WHCoA called for a large number of independent preconference events to be held in the year leading up to the 2005 conference. At these events, attendees were asked to provide input to WHCoA about those recommendations they believed were important to seniors. Each event could only forward a maximum of five recommendations to the WHCoA. Although approximately 400 preconference events were held on topics from housing to mental health to technology, only 5 were devoted exclusively to transportation. Despite the breadth of topics, in about half of all the events attendees nonetheless raised transportation as among the top five issues of concern to seniors.
The conference was organized so that the delegates voted for their top recommendations just after the opening ceremonies. That left the bulk of the conference time for devising implementation strategies for the top recommendations.
Recommendations specifically addressing transportation included those devoted to finding ways to keep older drivers on the road safely and for longer periods, and ways to ensure that sufficient alternative forms of transportation are available when driving or walking must be curtailed. The final recommendations selected by the delegates and their implementation strategies are posted on the WHCoA Web site at www.whcoa.gov.
Another Federal effort is the White House Conference on Aging (WHCoA), which is just a once-in-a-decade event. Held in December 2005, its purpose is to develop policy recommendations for Congress and the White House on the range of issues that will affect seniors for the coming 10 years. Delegates to the WHCoA voted on a number of recommendations, including some that were devoted to continued safe senior mobility.
Also at the Federal level, USDOT published a report in November 2003, Safe Mobility for a Maturing Society: Challenges and Opportunities, which identified priorities including roadway designs that take into account the needs and limitations of older road users, vehicle designs that protect fragile older occupants, and effective assessments of older-driver competencies.
FHWA has had a broad involvement with older road users. During the 1980s and 1990s, FHWA's dedicated research program on older road users culminated in publication of the Highway Design Handbook for Older Drivers and Pedestrians (FHWA-RD-01-103), first published in 1998 and revised in 2001 (www.tfhrc.gov/humanfac/01103/coverfront.htm). The handbook's recommendations and supporting evidence focus on at-grade intersections, grade-separation interchanges, roadway curvature and passing zones, construction work zones, and highway-rail passive grade crossings. Elizabeth Alicandri, FHWA's director of the Office of Safety Programs, says, "These design changes make it safer not only for older users of the highway system, but for all users." Since the handbook's publication, FHWA has conducted workshops across the country to educate practitioners about the needs and limitations of older road users.
Today, FHWA is continuing the workshops and initiating studies that focus on intersections, visibility, pedestrians and bicyclists, speed management, and various operational topics, such as experiments on traffic control devices that can assist older drivers and pedestrians. In the research, the performance of older road users is measured and considered in design and operational recommendations.
In other Federal efforts, NHTSA has several programs underway with partner organizations to improve safety for older road users. Programs include activities that assist law enforcement officers to better identify older persons' physical and mental changes related to driving and help licensing and allied health professionals to assess drivers' abilities. Additional efforts have involved research and production of a range of printed materials that help older drivers and their families make sound choices about safe driving. These printed materials and research reports may be downloaded from the NHTSA Web site at www.nhtsa.dot.gov.
At the State level, one of the primary interests relates to driver testing and licensing. States are considering questions such as: Should older drivers be required to undergo more frequent testing? If so, what should the testing cover? Should certain older people have restricted drivers' licenses? If so, who should determine the type of restrictions and the conditions? Should older drivers be required to renew in person rather than by mail or online? Should older drivers be subjected to evaluation after being involved in a crash? If so, who should conduct the evaluation? In looking at these questions, States are attempting to strike a proper balance between the safety needs of older drivers and other road users, as well as to ensure continued mobility for seniors.
Through the American Association of Motor Vehicle Administrators (AAMVA), in 2003 State motor vehicle administrators and their departments or divisions of motor vehicles (DMVs) initiated a pilot public awareness campaign for older drivers in the Washington, DC, metropolitan area. Known as the GrandDriver[R] program, the 6-month public relations and advertising effort encouraged older drivers and those who care about them to learn more about aging and driving by calling a toll free number or visiting the program's Web site at www.granddriver.info. Following statistically sound postcampaign research, AAMVA tweaked the public relations elements and fashioned a turnkey kit for State DMVs and State patrols. Today, Arizona, Florida, Maryland, Nebraska, and Virginia all have adopted portions of the GrandDriver program.
In June 2002, Iowa held an NHTSA-sponsored Older Driver Conference to identify problems and solutions for the older driver. Among the actions identified for support were safer and easier-to-use infrastructure, safer and easier-to-use automobiles, and improvement of older driver competencies.
In 2004 the Michigan Governor's Traffic Safety Advisory Commission partnered with a host of Michigan State agencies and other entities such as FHWA, TRB, AARP[R], and AAA to host the North American Conference on Elderly Mobility: Best Practices from Around the World. The practices discussed were national in scope for the advancement of safe, considerate, and effective senior mobility.
Many States, such as California, Florida, Iowa, Maryland, and Virginia, have established joint task forces with aging and licensing communities working together to address safety and mobility for older people. Currently three States are demonstrating and evaluating the effectiveness of the older road user guidelines contained in the Highway Design Handbook for Older Drivers and Pedestrians. Washington State is addressing pedestrian safety. Arizona is looking at signs, signals, and pavement markings. And the Commonwealth of Massachusetts' Governor's Safety Bureau is studying work zone safety.
Car manufacturers and after-market vendors worldwide are designing products to appeal to the needs and desires of older drivers. To support those efforts, Ford Motor Company developed a Third Age Suit that, when worn, permits young designers to gain first-hand knowledge of some of the physical difficulties experienced by older road users. The designers also employ a simulator to conduct research on performance by older drivers. In addition, the company is looking into technologies that help compensate for age-related limitations and help protect older drivers and passengers in crashes.
General Motors developed and evaluated an older driver program intended to identify driving problems and increase self-awareness and driving knowledge. The program was described in a 2003 article in the Journal of Safety Research, "Improving Older Driver Knowledge and Self-Awareness Through Self-Assessment: The Driving Decisions Workbook."
In another example, Motorola and DaimlerChrysler are developing in-vehicle driving aids that may assist older drivers. The Driver Advocate[TM] system presents information in a way designed to help prevent excessive cognitive overload. The intent of the other system, Driving Coach, is to help older people maintain their driving skills. Both products are still in development phases and have yet to be fully tested.
Organizations and Associations
Professional organizations such as TRB and associations such as AARP that serve both industry and consumers are looking at ways to help older road users.
The TRB Committee on the Safe Mobility of Older Persons focuses on cognitive impairment, driving performance, and driver self-awareness; older road user needs and capabilities; alcohol and other drug use among older road users; and engineering solutions to improve older driver and pedestrian mobility and safety (www.eyes.uab.edu/safemobility).
The TRB Committee for a Future Strategic Highway Research Program responded to a directive in the 1998 Transportation Equity Act for the 21st Century (TEA-21) calling for a focus on the older road user as one of the key emphases of a new strategic highway research program. Committee interests include older road users and perception/decision/reaction times during the yellow phase of intersection signals, left turns and gap size, lane-keeping and age, and intersection maneuvers and age (www4.trb.org/trb/newshrp.nsf/web/committee?OpenDocument).
In addition to the two committees, TRB is involved with older road user issues via the National Cooperative Highway Research Program (NCHRP). The recently completed NCHRP Report 500, Volume 9: A Guide for Reducing Collisions Involving Older Drivers offers strategies for accommodating older drivers on the roadway and sustaining their proficiency (www.trb.org/news/blurb_detail.asp?id=3844). And TRB's Improving the Safety of Older Road Users: A Synthesis of Highway Practice documents the range of strategies and programs available at the national, State, and local levels to improve the safety and mobility of older road users (http://trb.org/news/blurb_detail.asp?id=5479). Another association effort is a CD-ROM developed by AAA and transportation safety researchers. Roadwise Review[TM]: A Tool to Help Seniors Drive Safely Longer is an interactive computer-based screening tool that enables seniors to measure their driving skills in the privacy of their own homes. Eight functional abilities shown to be the strongest predictors of crash risk among older drivers are assessed, including leg strength and general mobility, head/neck flexibility, high- and low-contrast visual acuity, working memory, visualization of missing information, visual search, and visual information processing speed. The CD-ROM is available from www.aaapublicaffairs.com or most local AAA clubs.
The consumer organization AARP offers a driver safety course designed to increase road safety for motorists aged 50 and older. Taken by more than 9 million older drivers, the course aims to improve driving skills, update attendees on rules of the road, and reduce crashes and associated injuries and fatalities. The National Safety Council and other organizations also offer older driver skill refresher courses similar to that offered by AARP.
In addition, AARP recently established a National Older Driver Safety Advisory Council to serve as an independent voice on current developments and research in mobility, safety, and aging and to provide other services for seniors. (http://mit.edu/agelab/driver-safety/overview.shtml).
A number of health-oriented organizations are addressing older road user concerns. The American Medical Association (AMA) views the safety of older road users as a public health issue and encourages physicians to be proactive in addressing road safety with their older patients. In that regard, AMA and NHTSA developed the Physician's Guide to Assessing and Counseling Older Drivers, which assists physicians in such areas as assessing the medical fitness of older people for driving, offers information on medical conditions and medications that may affect driving, and recommends rehabilitation options (www.ama-assn.org/ama/pub/category/10791.html).
NACEM-Best Practices From Around the World Conference
In September 2004, experts from 17 States and 7 countries gathered in Detroit, MI, to attend the North American Conference on Elderly Mobility (NACEM). Sponsored by the Michigan Governor's Traffic Safety Advisory Commission, this meeting marked one of the first times a conference took a strong interdisciplinary approach to help improve the mobility of older people in the United States. In planning the conference, NACEM committee members launched a nationwide search for best practices in the areas of roadway design, alternative transportation, education and training, housing and land use, and driver screening and assessment.
As an engineering highlight of the conference, the Michigan Department of Transportation, in collaboration with AAA Michigan, developed a "senior driver showcase roadway" in which signs, signals, and markings were modified on a nearby freeway and arterial road system. Improved treatments, better crafted for use by an aging driving population, were on display--including new Clearview font for signs, freeway diagrammatic sign design, increased letter height, brighter sign sheeting, wider pavement markings, brighter traffic signal lenses, back plates on signals and selected signs, pedestrian countdown signals, and painted curb islands. To the extent possible, all of these treatments were placed side-by-side with existing standard treatments for comparison viewing by the conference participants.
"This was a conference in which the participants emerged having more energy than they started with," says David Morena, safety and traffic operations engineer, FHWA Michigan Division Office. "Everyone left excited about what their discipline can do and what is going on in other disciplines. The common feeling was--'I can do more.'"
The American Occupational Therapy Association (AOTA) also is engaged in evaluating the ability of older people to drive safely. Specially trained occupational therapists conduct behind-the-wheel driver assessments and remediations in a variety of outpatient settings around the country. AOTA provides training and information for their members to help them strengthen driving skills related to various physical, visual, and cognitive driving tasks (www.aota.org/olderdriver).
Academic institutions across the country are engaged in studies and research projects concerning older drivers and road users. The following list of higher education institutions, although not a comprehensive list, features some of the programs available across the Nation.
The Massachusetts Institute of Technology (MIT) created the AgeLab to bridge the gap between technology and support for older road users (http://web.mit.edu/agelab). The AgeLab uses a multidisciplinary approach including cognitive psychology, gerontology, medicine, engineering, and planning to conduct research related to older drivers. Research topics include driver decisionmaking, the effects of in-vehicle technologies on older drivers, and the politics and policy of older driver licensing and retesting. The lab's projects include a Driving and Personal Mobility Program and a National Older Driver Safety Advisory Council, created by MIT and AARP.
At the University of Iowa, researchers are using a National Advanced Driving Simulator to conduct validation research on simulated driving performance by older drivers and other motorists.
The University of Florida established the National Older Driver Research and Training Center (http://driving.phhp.ufl.edu) to help older citizens stay independent as long as possible. To accomplish this, the university developed a multifaceted program that evaluates fitness for driving, age-related physical and cognitive decline and driving performance, driver risk factors associated with unsafe driving, and driving performance at night and during inclement weather.
And the Center for Research on Applied Gerontology at the University of Alabama at Birmingham focuses on development and evaluation of interventions, which will allow seniors to remain independent and to experience a high quality of life. The center's programs cover areas that include enhancing driving performance through cognitive training, glaucoma and driving in older adults, safety and mobility assessment in older drivers, advanced cognitive training for independent and vital elderly, knowledge that enhances safety, and improvement of visual processing in older adults.
Subsequent Articles in the Senior Mobility Series
Additional articles are currently planned for this series in PUBLIC ROADS magazine. The next article will discuss age-related physical and cognitive changes, including reductions in peripheral vision, loss of visual acuity, and yellowing of the cornea; physical changes, such as restricted neck movement; and cognitive changes, including selective and divided attention, plus slower response time. It will discuss how these changes affect specific driving tasks from a human factors perspective. This article also will include a discussion of how FHWA's human factors researchers are using their knowledge of age-related ability changes to investigate ways to modify or develop infrastructure to be more understandable and easier to use for the older road user.
Another article will discuss the American Association of State Highway and Transportation Officials' guide for reducing collisions. It will highlight key strategies for improving highway infrastructure to safely accommodate older road users, implementing a comprehensive approach to improving older road user safety, and assessing the feasibility of Advanced Traveler Information Systems and Advanced Vehicle Control Systems for sustaining mobility and enhancing proficiency.
The best infrastructure practices from around the Nation and their associated benefits will be described in yet another article in the series. The practices, which include signing, marking, and signaling practices for highways and roadways, were gathered during a series of conversations with engineers in 40 States and 10 cities and towns. It is anticipated that the practices already employed in these locations will benefit older road users and other motorists.
The overall thesis of another future article will be that almost any countermeasure used by engineers to reduce cognitive and visual demands at intersections will benefit not only older motorists but also the driving public at large. Specific examples of operational improvements that will be discussed include four-lane to three-lane conversions, addition of left-turn lanes and left-turn phasing, removal of the left turn from the intersection proper to an indirect turn location, and roundabouts.
Another article will focus on some of the problems and issues experienced by the international community and solutions that are being developed to address them.
The integration of older pedestrian needs with planning will also be looked at in a future article. The successful and widespread use of pedestrian lead countdown signals and leading pedestrian intervals, which allow pedestrians to begin crossing prior to the release of turning vehicles, at many locations in the city will be described.
Another article shows how in-vehicle navigation and collision avoidance technologies may help counter some of the performance changes associated with aging. The authors will discuss research findings related to older drivers' acceptance of in-vehicle enhancements for systems involving collision avoidance, navigation, and vision enhancement.
Moving Forward ...
It is widely known that Americans today are living longer than past generations. What is not always known is how to make sure those additional years of life are productive and enjoyable. A major factor continually cited by seniors themselves is their need for continued safety and mobility as they age. The vast majority of seniors prefer to age in place, to grow old in the communities where they raised their families, where they have roots. Transportation that enables seniors to remain in their homes, to remain engaged in community life as active and contributing members, has been cited as the critical link that makes all else in life possible.
Although many segments of Government, industry, community organizations, professional associations, and academia already are exploring and studying a variety of approaches that aim to make those later years fruitful, there is far more that the engineering community can do to make the road environment safer for senior users. The remaining articles in this series will provide more detailed information on how the transportation community and others are making and can make that goal become a reality.
Thomas M. Granda, Ph.D. holds an M.A. from California State University, Long Beach, in experimental psychology and a Ph.D. in human factors psychology from The Catholic University of America in Washington, DC. Granda is the human centered systems team leader in FHWA's Office of Safety Research and Development at the Turner-Fairbank Highway Research Center in McLean, VA.
Shirley Thompson is a transportation specialist in the FHWA Office of Safety Programs in Washington, DC. She primarily manages the older road users program, oversees recommendations issued by the National Transportation Safety Board, coordinates international technology transfer activities, administers grants mandated by legislation, and collaborates with safety partners on initiatives to promote transportation safety. Thompson has an associate degree in business management from Prince George's Community College in Maryland.
For more information, contact Thomas M. Granda at 202-493-3365 or email@example.com.
This article is the first in a series on older drivers and road users that will run in upcoming issues of PUBLIC ROADS.