Older driver safety: how to keep driving safely and confidently
How aging affects driving and practical ways to stay safe and independent
Picture a 79 year old who still drives to church, the pharmacy and her grandson’s ball games. Lately, oncoming headlights leave halos. She now skips evening events. Is that a sign to quit, or a problem with a fix?
Often it’s a problem with a fix. Geriatricians and driver rehabilitation specialists see aging as a set of specific changes, not a deadline. Guidance from the National Highway Traffic Safety Administration (NHTSA) stresses that driving performance, not age, decides fitness to drive [13].
The U.S. had 61.2 million people 65 and older in 2024, 28% more than in 2015 [1]. That year, 8,019 of them died in traffic crashes and 284,525 were injured [2]. This guide covers the changes that matter, then a self check, car fit, evaluations, family talks and other ways to get around.
What the numbers say about age and crash risk
How you measure risk changes the picture. Per licensed driver, people in their 70s have lower fatal crash rates than middle aged drivers, the Insurance Institute for Highway Safety (IIHS) reports [4]. In 2015, drivers 70 to 79 dipped below drivers 35 to 54 on that measure for the first time [4].
Per mile, rates start climbing at about age 70, partly because older adults drive fewer miles, often on city streets full of intersections [4]. In 2022, drivers 85 and older had the highest rate of any age group [3]. They had 7.9 fatal crash involvements per 100 million miles, versus 1.6 for drivers in their 60s [3].
The bigger factor is fragility. IIHS attributes most of the extra risk to a greater chance of serious injury, especially to the chest, and of medical complications [3]. It is not mainly a greater tendency to crash [3]. That’s why crash protection matters so much later in life.
There’s good news, too: in 2024, 5,679 people 70 and older died in crashes, 50% more than in 1975, largely because the older population has grown [3]. Yet the death rate per person in that age group has fallen 47% since 1975 [3].
Vision: glare, contrast and eye disease
Aging eyes need more light and recover more slowly from glare. NHTSA notes that older drivers may struggle to read signs and feel more discomfort from headlight glare at night [7]. Low contrast hazards, such as a gray car at dusk, also get harder to spot.
NHTSA lists three common eye diseases among conditions that can affect driving [1]:
- Cataracts cloud the eye’s lens, causing blur, faded colors, glare, halos and poor night vision [8]. They’re very common by age 80. About 9 in 10 people see better after surgery [8].
- Glaucoma damages the optic nerve and tends to narrow side vision, needed to spot cars coming from the side.
- Macular degeneration blurs central vision, the part you use to read signs.
If you’re 60 or older, NHTSA advises seeing an eye doctor every year [7]. Tell the doctor you drive. Describe specific problems, like halos or trouble seeing lane lines in rain. A chart read in a bright room can miss them. Our night driving guide covers glare and headlights.
Thinking skills: attention, speed and memory
Driving asks your brain to track traffic, read signs, judge gaps and decide quickly, all at once. The Centers for Disease Control and Prevention (CDC) notes that age related changes in reasoning and memory can affect some older adults’ driving [6]. Many people first notice it when a busy intersection feels overwhelming [7].
IIHS finds older drivers in crashes are more likely than middle aged drivers to look without seeing or to misjudge a gap or speed [4]. In 2024, 43% of fatal crash involvements for drivers 80 and older were multiple vehicle crashes at intersections [3]. For drivers 20 to 64, the share was about 24% [3].
Choose routes with left turn arrows, or make three right turns instead of one unprotected left. Scan far ahead and to both sides as you approach each intersection [7].
When to get checked. See your doctor if you get lost on familiar roads, miss signs or signals, or feel confused about directions [7, 13]. Dementia is a special case: IIHS notes that some people with significant cognitive impairment don’t limit their own driving [4]. Families can’t rely on self awareness alone.
Strength, flexibility and hearing
Checking a blind spot takes neck rotation. Getting from gas to brake quickly takes leg strength and ankle motion. Arthritis and stiffness can slow both. NHTSA flags trouble looking over your shoulder, trouble moving your foot between pedals, and a fall in the past year as warning signs [7].
What helps:
- Move every day. CDC and NHTSA recommend regular activity, such as stretching and walking, cleared by your doctor [6, 7].
- Ask for therapy. A physical or occupational therapist can target the neck, hip and leg motion driving needs.
- Set up the car. Adjust mirrors to shrink blind spots, and favor automatic transmission and power steering [7].
Hearing. Horns, sirens and train signals carry warnings. NHTSA suggests keeping the radio and conversation low so you hear outside sounds [7].
Many common medicines can cause drowsiness, dizziness or slower reactions. The AAA Foundation’s LongROAD study followed nearly 3,000 drivers ages 65 to 79. It found 18.5% used at least one medicine on the Beers Criteria, the American Geriatrics Society list of drugs older adults should generally avoid [9]. The most common were benzodiazepines, other sleep medicines, antidepressants and older antihistamines [9].
Clinicians recommend a “brown bag review.” Once a year, and whenever something changes, bag up every prescription, over the counter product and supplement. Take it to your pharmacist or doctor, as CDC advises [6], and ask:
- Could any of these, alone or together, affect my driving?
- Is there a safer option or a better time of day to take it?
- Should I skip driving after starting a new medicine, and for how long?
Your driving self check
Answer these every few months. Ask someone who rides with you to answer too.
An unchecked box is a cue to act, not a verdict, so bring the list to your next medical visit.
Smart self limits: helpful, but not a cure
Many older drivers adjust on their own. In the first year of the LongROAD study, 39% of drivers avoided bad weather, 32% avoided night driving and 20% avoided rush hour [10]. Fewer avoided left turns (10%) or freeways (7%) [10]. About 81% used at least one trip planning strategy [10].
The surprise: over several years, these habits didn’t predict fewer hard braking events or crashes [10]. The researchers note the group was healthy and nearly everyone limited their own driving, which made differences hard to detect. They still recommend the habits [10].
The clinical lesson is that self limits buy margin but don’t fix a vision, thinking or strength problem. Good options include daylight driving in good weather, well lit routes and a long following distance [6], plus skipping rush hour [7].
Make your car fit you
A car that fits your body is easier to control and protects you better. CarFit, created by the American Occupational Therapy Association (AOTA), AAA and AARP, is a free check that takes about 20 minutes [11]. Trained volunteers, including occupational therapy practitioners, use a 12 point checklist covering items like seat belt fit, steering wheel distance, mirrors and pedals [11]. Find events at car-fit.org.
Comparison compiled by Safety Behind the Wheel Foundation
| Feature | How it helps an aging driver | What the evidence says |
|---|---|---|
| Rearview camera, parking sensors | Less neck twisting when backing | Especially effective for drivers 70 and older in preventing police reported backing crashes [4] |
| Automatic emergency braking, blind spot warning, lane departure warning | Backup for a missed car or a drift | Together, may be relevant to up to a fifth of older drivers’ crashes and a quarter of their deaths [4] |
| Side airbags with head and torso protection | Protects fragile chests and heads | Estimated 45% fewer deaths in near side crashes for front seat occupants 70 and older [4] |
| Power seat with height adjustment, tilt and telescope wheel, adjustable pedals | Better view, safe airbag distance, easier pedal reach | Items CarFit volunteers check [11] |
| Large mirrors, good headlights, push button start | Fewer blind spots, better night view, easier on stiff hands | With push button start, confirm the engine is off before leaving a garage |
Older drivers tend to keep older vehicles that may lack newer protection [4]. When you replace a car, rank these features high. Practice with any warning system in an empty lot first. Our ADAS guide explains their limits.
If a health condition limits strength or motion, a driver rehabilitation specialist can recommend equipment such as hand controls or swivel seats [12]. NHTSA stresses on road training with any new equipment [12]. See our adapted vehicles guide.
Refresher courses: add time on the road
AARP, AAA and the National Safety Council offer refresher courses, usually 6 to 10 hours in a classroom or online [14]. NHTSA’s research review found that classroom teaching alone isn’t effective at reducing crashes [14]. Pairing it with on road training and personal feedback improved driving performance [14].
So take the course, then add a few lessons with a driving instructor or rehabilitation specialist. Some courses may earn an insurance discount [13]. Ask your insurer.
Getting a professional opinion
- Your doctor. A primary care doctor or geriatrician can review vision, thinking, strength, conditions and medicines, then treat what’s fixable or refer you.
- A comprehensive driving evaluation. An occupational therapist driver rehabilitation specialist, often a Certified Driver Rehabilitation Specialist (CDRS), tests strength, range of motion, coordination, reaction time, judgment and vision [12]. Most evaluations include a drive on real roads. Written recommendations follow [12]. They may mean driving as before, driving with limits, training, equipment or stopping. Find specialists through the Association for Driver Rehabilitation Specialists (ADED) or AOTA [12]. Ask about cost first.
- The licensing agency. Family members can send concerns to the state driver licensing agency in writing [13]. Our medical conditions guide explains how state reviews work.
Talking with a parent or partner about driving
NHTSA suggests that families gather information, make a plan and follow through [1]. Here’s how a clinician would coach a family:
- Start before there’s a problem. Ask in a calm moment: “If driving ever gets harder, how would you want us to handle it?”
- Gather facts. Ride along a few times and note specifics, such as a rolled stop sign or a lane drift.
- Lead with shared goals. Talk about safety and independence. Use “I” statements, like “I worry when…,” rather than blame [13].
- Discuss observations, not age. A birthday proves nothing. A missed red light is worth discussing.
- Bring in the clinician. Ask the doctor to address driving and order an evaluation. Clinicians may need the driver’s signed release before talking with family [13].
- Line up rides first. Show how errands and visits would still happen before asking anyone to drive less.
- Offer middle steps. Daylight only driving, local routes, CarFit or refresher lessons may be enough for now.
- Expect several talks. Follow through, and revisit the plan as health changes.
Comparison compiled by Safety Behind the Wheel Foundation
| Instead of saying | Try saying |
|---|---|
| “You’re too old to drive.” | “I noticed you missed that stop sign. Can we talk about it?” |
| “You have to give up your keys.” | “Let’s get an expert opinion so we both know where things stand.” |
| “We’ll figure out rides later.” | “Here’s how you’d still get to church and the store.” |
If someone is getting lost or having close calls, call their doctor now.
Keeping mobile: plan before you need it
Stopping driving is a big change. A AAA Foundation review found it was linked with almost twice the risk of worsening depressive symptoms [15]. Former drivers were also nearly 5 times as likely to move into long term care [15]. Poor health can drive both, so these links don’t prove cause, but they show why a mobility plan matters.
Options to explore now:
- Public transit buses and trains
- Paratransit, often called ADA paratransit: shared rides for people whose disability makes regular buses hard to use
- Ride hailing apps and taxis
- Volunteer driver programs, often run by senior centers or faith groups
- Scheduled rides from family and friends
Area Agencies on Aging can point you to local transit and paratransit [13]. Reach yours through the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov [13]. CDC’s free MyMobility Plan can help you plan ahead [6].
Comparison compiled by Safety Behind the Wheel Foundation
| Trip you make now | How often | Backup option to test | Try it by |
|---|---|---|---|
| Groceries and pharmacy | Weekly | Delivery or senior center shuttle | This month |
| Doctor visits | Monthly | Paratransit or volunteer driver | Next appointment |
| Worship, clubs, volunteering | Weekly | Ride with a friend or ride hailing | Next 2 weeks |
| Visiting family and friends | Varies | Transit, ride hailing or scheduled family rides | Next visit |
Try each backup once while you’re still driving, so familiar options feel like choices, not losses.
Frequently asked questions
At what age should you stop driving?
There’s no set age. NHTSA’s guidance is that driving performance, not age, determines fitness to drive [13]. Watch for warning signs, and get an evaluation if concerns arise.
Do older drivers have to retake the driving test?
Rules vary by state. The most common age based rules are shorter renewal periods, vision tests and in person renewal [5]. Check your state DMV for current requirements.
What is a driving evaluation for seniors?
A driver rehabilitation specialist, often an occupational therapist, checks vision, strength, motion, reaction time and judgment [12]. Most include a road drive. Afterward, you get written recommendations [12].
How do I talk to my parent about giving up the keys?
Start early, use specific observations and “I” statements, and involve their doctor [13]. Have transportation options ready before asking them to drive less.
How can I get around if I stop driving?
Look into transit, paratransit, ride hailing and volunteer drivers. The Eldercare Locator, 1-800-677-1116, connects you to local services [13].
The bottom line
Recommendation from Safety Behind the Wheel Foundation
Judge driving by ability, not birthdays. Keep your eyes, medicines and body in good shape with yearly checks. Make your car fit you. If doubts arise, get an objective evaluation and build a transportation plan early. That way, safety and independence stay on the same side.
Related articles
- Night driving safety: how to see hazards and stop in time after dark
- Drug and medication impaired driving: know your risk before you drive
- Medical conditions and driving: why function, not diagnosis, decides
- Driving with a disability: adapted vehicles, hand controls and next steps
- ADAS and partial automation: how to use Level 2 systems safely
Sources and further reading
- 1National Highway Traffic Safety Administration (NHTSA). Older Drivers. Accessed October 2026 (2024 data). nhtsa.gov/road-safety/older-drivers
- 2NHTSA. Quick Facts 2024. DOT HS 813 809. June 2026. crashstats.nhtsa.dot.gov/…/813809
- 3Insurance Institute for Highway Safety (IIHS). Fatality Facts 2024: Older People. Posted June 2026. iihs.org/…/older-people
- 4IIHS. Older Drivers (research area). Updated July 2026. iihs.org/research-areas/older-drivers
- 5IIHS. License Renewal Procedures for Older Drivers (state table). October 2026. iihs.org/…/license-renewal-laws-table
- 6Centers for Disease Control and Prevention (CDC). Older Adult Drivers. Last reviewed January 28, 2026. cdc.gov/older-adult-drivers
- 7NHTSA. Driving Safely While Aging Gracefully. Accessed October 2026. nhtsa.gov/node/33936
- 8National Eye Institute (NEI). Cataracts. Updated August 19, 2026. nei.nih.gov/…/cataracts
- 9AAA Foundation for Traffic Safety. Prevalence of Potentially Inappropriate Medication Use in Older Drivers: Findings From the AAA LongROAD Study. November 2018. aaafoundation.org/…/prevalence-of-potentially-inappropriate-medication-use…
- 10AAA Foundation for Traffic Safety (Kasha, Arnold, Yang). Does Older Adults’ Self-Regulation of Driving Improve Safety? An Examination of Objective and Subjective Driving Patterns in the AAA LongROAD Study. October 2024. aaafoundation.org/…/does-older-adults-self-regulation…
- 11American Occupational Therapy Association (AOTA). CarFit. Accessed October 2026. aota.org/…/carfit
- 12NHTSA. Adapted Vehicles. Accessed October 2026. nhtsa.gov/road-safety/adapted-vehicles
- 13NHTSA. How to Understand and Influence Older Drivers. Accessed October 2026. nhtsa.gov/node/33911
- 14NHTSA. Countermeasures That Work: Older Drivers, Formal Courses for Older Drivers. Accessed October 2026. nhtsa.gov/book/countermeasures-that-work/…
- 15AAA Foundation for Traffic Safety (Chihuri, Mielenz, DiMaggio, Betz, Jones). Driving Cessation and Health Outcomes in Older Adults. July 2015. aaafoundation.org/…/driving-cessation-health-outcomes-older-adults
This article reflects the safety priorities of geriatric medicine, occupational therapy and driver rehabilitation. It is general education, not legal, medical or professional advice for any individual. Talk with your own clinician about your health and driving. Laws, data and vehicle features change, so verify details with official sources. Reviewed October 2026.
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