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tests for Older Drivers not proven to
Newswise — Recent automobile accidents with
tragic results have prompted questions about
the eyesight of elderly drivers, but
researchers say they are unable to determine
whether vision tests actually lead to fewer
“We have this hypothesis that [as years
pass] you have more age-related eye
conditions,” said lead reviewer Sayed
By this line of reasoning, elderly drivers
are theoretically more accident-prone.
However, the review found little evidence to
make that case.
The new review appears in the latest issue
of The Cochrane Library, a publication of
The Cochrane Collaboration, an international
organization that evaluates medical
reviews like this one draw evidence-based
conclusions about medical practice after
considering both the content and quality of
existing medical trials on a topic.
Subzwari, a family physician and researcher,
led a team from the British Columbia Injury
Research and Prevention Unit, Centre for
Community Health Research in Vancouver,
They screened more than 4,500 published and
unpublished studies. However, none met the
rigorous criteria that the researchers had
set for review inclusion.
“Three relevant studies were identified, but
they did not meet the predefined study
design criteria,” Subzwari said.
Outside data suggest that advanced age does
not necessarily translate into poor driving
In December, the Insurance Institute for
Highway Safety reported that fewer older
drivers died or were involved in fatal
collisions from 1997 to 2006 than in past
Yet doctors, health advocates and family
members routinely debate how long elderly
drivers should stay on the road.
A fast-growing proportion of the population
is over 65. According to the U.S. Census
Bureau, about 37 million Americans are
currently in that age group.
The recital of letters and numbers from the
Snellen Chart of Visual Acuity is a senior
rite of passage at motor vehicle departments
in many states. Still, Snellen charts are
“not that sensitive,” Subzwari said, and
someone with cataracts might pass the exam.
In addition, elderly drivers might suffer
other vision-related impairments. For
example, the Snellen chart does not measure
glare sensitivity, so different tests are
Jurisdictions struggle to understand vision
issues involving older drivers, said Anne
McCartt, senior vice president for research
at the Insurance Institute for Highway
problem with older drivers is that yes,
there are age-related impairments that, on
average, we experience when we get older,
but there are a lot of differences [among
elderly drivers] too.”
Some elderly drivers experience no vision
problems and – unlike past generations –
American families no longer live in one
Younger family members are not available to
taxi grandparents about town. “Many older
drivers rely on their driving to have
mobility,” McCartt said.
“It’s a significant thing to take someone’s
license away. You want a process that is
Older drivers who want to stay behind the
wheel can point to some statistics in their
favor: A 2008 Insurance Institute report
revealed that crash deaths among drivers 70
and older fell 21 percent from 1997 to 2006,
even as the population in that age group
rose 10 percent.
to drivers ages 35 to 54, the Institute
found that older drivers experienced larger
declines in fatal crash involvements.
“We’re not sure why older drivers are doing
better,” McCartt said. However, she added
that older drivers are less likely to be in
“They don’t talk on the phone to the same
extent [as younger drivers].” Few elderly
drivers steer while sending text messages,
she said. “My parents don’t know what text
Compared to drivers between the ages of 20
and 69, fewer people 70 and older have a
license to drive.
They drive fewer miles per licensed driver,
according to the Insurance Institute.
Researchers point out that older drivers
have a lower crash rate because they simply
do not get behind the wheel as often.
In addition, some states allow mail-in
license renewals. When required to come into
the motor vehicle department to take an eye
exam, some elderly drivers opt out in fear
“They self-regulate,” said Ediriweera
Desapriya, a researcher with the BC Injury
Research and Prevention Unit.
Many of the elderly are selective about
their trips, driving only when required.
“They go to the doctor’s appointment and
come back home.”
Still, considering the growing proportion of
elderly drivers, the Canadian researchers
propose a study using randomized selection
to assess whether vision screening can
effectively result in fewer crashes.
The Cochrane Collaboration is an
international nonprofit, independent
organization that produces and disseminates
systematic reviews of health care
interventions and promotes the search for
evidence in the form of clinical trials and
other studies of interventions. Visit
for more information.
Subzwari S, et al. Vision screening of older
drivers for preventing road traffic injuries
and fatalities. (Review). Cochrane Database
of Systematic Reviews 2009, Issue 1.