Citation

Freed SA, Staplin LK, Sprague BN, Ross LA. Washington DC: US National Highway Traffic Safety Administration, 2024

Affiliation

TransAnalytics, LLC

Copyright

(Copyright 2024)

The full document is available online.

Abstract

The research team conducted a systematic literature review to identify the current state of knowledge on older driver safety and performance based on research published from 2000 to 2020. Researchers identified eligible articles through searches in TRID, PsycINFO, and PubMed databases, as well as published literature reviews. In total, 225 eligible articles reporting safety and/or performance outcomes among drivers 65 and older were included in the review. The results indicate that older-driver crash rates in the United States have declined over the past 20 years yet remain comparable to the rates of young drivers. Older-driver crashes are more likely to occur in clear weather, during the daytime, and at intersections than to drivers of other ages. Cognitive, physical, and visual functions are related to driving safety and performance, though the strength of the association depends on the domain and the way it is measured. A quantitative meta-analysis of selected articles indicated that speed of processing/attention measures of cognition have the strongest association with driving performance. Certain medications including benzodiazepines, selective serotonin reuptake inhibitors, and Z-drugs (nonbenzodiazepines) are also associated with crash risk, as are untreated eye disease and Alzheimer's disease. Some interventions designed to change driver behavior appear to be associated with better older driver safety, including certain types of training; others, including licensing restriction programs and the use of advanced driver assistance and automated vehicle technologies, have not been evaluated sufficiently to draw reliable conclusions about their impact.


This report described a systematic literature review that summarizes, evaluates, and synthesizes research published since 1999 on the safety of older drivers. It describes the selected studies, produced results across studies, and weighs study quality of the best evidence to date. It can be a reference document for both in-house use and use by other Federal agencies, State Highway Safety Offices, and other partners. The report is also useful to officials involved in licensing decisions, healthcare practitioners who advise older patients about fitness-to-drive, and researchers in the field of aging and older-driver safety.