Sensory and physical changes
in older drivers

Some changes in your vision are a normal result of aging. These include:

• Presbyopia—Most people past the age of 40 experience presbyopia, or an increased difficulty focusing on objects up close. This shouldn’t impact your driving ability.
• Reduced pupil size—Because the muscles that control pupil size in reaction to light get weaker as we age, a person in their 60s needs three times more ambient light to read comfortably than a person in their 20s. This also makes seniors more sensitive to bright light and glare when driving.
• Decreased peripheral vision—Peripheral vision decreases over our lifetime by about one to three degrees per decade. By the time you are in your 70s, you may have lost as much as 25 degrees of your field of vision. This means an older driver will need to turn their head more to view cars and objects to the left and right.
• Decreased contrast sensitivity—Contrast sensitivity is the ability to distinguish an object from its background. Because it decreases with age, older drivers should avoid driving in low-contrast conditions: fog, morning haze or glare, and dusk.  
• Decreased depth perception—A decrease in depth perception may occur with age, especially among drivers who need multi-focal lenses (bifocals or trifocals). Eye conditions such as cataracts or glaucoma can also negatively affect depth perception, which can make it harder for some older drivers to judge how far away objects are from their car.           

Other eye conditions are not inevitable, but the risk for them increases with age:

• Cataracts—About half of 65-year-olds have some degree of cataract formation, and percentages increase with age. Fortunately, cataract surgery is safe and very effective at restoring vision.
• Macular degeneration—Age-related macular degeneration affects the center of the retina, and is the leading cause of vision loss in seniors. Driving may still be possible in the early stages of the disease but, will eventually become unsafe.
• Diabetic retinopathy—About 40% of diabetics over the age of 40 have some degree of diabetic retinopathy. The disease can lead to blindness, but it can be treated. Your ability to drive will depend on the severity of your condition. 
• Glaucoma—Caused by increasing eye pressure that can damage the optic nerve, glaucoma can cause vision loss if not detected early. Because there are few noticeable symptoms before significant vision loss has occurred, it’s critical to have your eyes checked regularly. If found early, glaucoma can be treated and managed so that you may continue to drive.   

Obviously, accurate vision is critical to driving safety, allowing drivers to quickly spot hazards, read street signs and maintain their positioning on the road. Older adults should visit their eye care professional regularly for exams and keep any corrective lens prescriptions up to date.  

Age-related hearing loss (presbycusis) is a gradual loss of hearing; it often runs in families. It is caused by a degeneration of inner ear structures over time. 

Other causes of hearing loss include:

• Regular exposure to loud noises
• Illnesses that result in high fevers (such as meningitis)
• Medications—Sildenafil (Viagra), certain antibiotics and some chemotherapy drugs can damage the inner ear 

Hearing loss makes it harder to notice horns, sirens and problematic noises from your car, which may make driving unsafe.  

Stiff joints, weakening muscles and arthritis are all age-related conditions that can make driving more difficult. It may be harder to turn the steering wheel, push the brakes or turn your head far enough to look behind you when backing out of a parking space.

Not all these conditions are inevitable, however. Regular exercise can improve your strength and flexibility and make you a better driver.    

More importantly, newer model cars have sensors, back up cameras and other technology that can assist with physical changes. Consider upgrading to the best technology you can afford.

Older adults typically take more medications. Some of these can affect your ability to drive safely. Read labels carefully and discuss any possible side effects or interactions with your doctor and/or pharmacist. If you find that a medication makes you feel lightheaded or sleepy, don’t drive while taking it.