If these and other geriatric conditions are confirmed as risk factors for motor vehicle crashes, medical guidelines for license renewal may need updating and health professionals may need new instruments to detect older patients at high risk for unsafe driving.

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The number of licensed older people will more than double in the next 25 years in the United States. There is a need to focus on ways of ensuring the safety of all road users without unduly restricting the mobility of older drivers. At present, it is extremely difficult to identify older driver groups who pose an undue risk to others and to assess their driving capabilities.Older drivers as a group are not a significant risk to others based upon their number of crashes per licensed driver. However. they do have a higher crash and fatality rate per mile driven than all but the youngest (16-20) driver age groups. Driving patterns and crash involvement of the elderly are reviewed, with emphasis on the role of medical conditions and functional limitations. Drivers who understand their own limitations tend to change their behavior to accommodate declining capabilities.Those unaware of limitations tend not to take corrective action, placing them at higher risk of crashes. Those who stop driving travel much less. are less satisfied in reaching their mobility needs and are more likely to be depressed. Research is under way to differentiate groups who are at higher risk and to develop ways to identify and assess their performance.

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