Blog Harvey A. Friedman Center for Aging

Shifting gears: aging & transportation planning

Written by Bailey Widener, graduate assistant at the Harvey A. Friedman Center for Aging at the Institute for Public Health

For many of us, our vehicles are essential to our daily lives. We use our cars to commute to our jobs, to run errands, to visit with family and friends, and to accomplish countless other activities throughout the week. When driving becomes such a habitual action, it’s easy to take it for granted.

Older adults continue to drive now more than ever before, accounting for about 26% of licensed drivers in the U.S.1 It is important to note that disease, not age, affects our ability to drive. The majority of older adults drive safely and are able to self-monitor their driving when necessary (e.g., limiting driving to daylight hours in response to visual impairment).

However, as we age, we may experience physical and mental changes that impact our ability to safely navigate busy streets and highways. For example, aging-related visual impairments can make it difficult to read street signs and mobility limitations may make it difficult to check blind spots. Older adult drivers are also much more susceptible to serious injury or death if they are involved in a car accident.2 Involvement in fatal crashes begins increasing among drivers between the ages of 70-74 and is highest among drivers ages 85+.

Given this increased risk for injury and mortality, responding to the driving and transportation challenges of older adults is a public health issue of great importance.

So, what is being done to help older drivers stay safe on the road? Several scholars at Washington University in St. Louis research older adult drivers at the levels of individual abilities, driving assessment, and policy. For example, Dr. David Carr and colleagues developed the Washington University Road Test (WURT) to assess the driving ability of older adults.3 This evaluation consists of a battery of physical and cognitive assessments, as well as an on-road driving assessment carried out by an occupational therapist. Dr. Carr and Dr. Peggy Barco have since used this evaluation as well as other clinical measures to test driving fitness in a variety of populations, such as post-stroke individuals, older adults with dementia, and people taking medications that may impair driving ability. Dr. Carr has also been involved in policy-focused research related to older adult drivers. In 2009, Dr. Carr and colleagues analyzed the impact of a confidential reporting system for professionals and family members to report driving fitness concerns. This policy was associated with an increase in screenings and a significant decrease in crash involvement among reported drivers.

Dr. Catherine Roe’s lab explores relationship between older adult’s cognition and maintenance of driving ability. Recent research from the Roe Lab has focused on development of older adult driver profiles using GPS devices and the association between pre-clinical markers of Alzheimer’s disease (AD) and driving risk. Dr. Roe’s research provides evidence for implementation of driving-related safety strategies through early identification pre-clinical cognitive decline.

Through targeting multiple channels of screening and intervention, Washington University scholars are supporting older adults in maintaining driving safety.

Since driving is associated with independence and identity, making the decision not to drive can be very difficult. It’s important to remember that transportation transitions are a process and each case is unique. It may be most appropriate to gradually reduce your driving and increase your utilization of public transit, ride sharing, or other transportation alternatives.

Here are a few tips for maximizing safety on the road:

Exercise regularly to improve your strength and flexibility, making it easier to operate your vehicle. Organizations such as OASIS, YMCA, and community centers offer a variety of fitness classes specifically tailored for older adults. Online registration & payment for OASIS exercise classes can be completed through their website. Silver Sneakers® exercise programs are specifically designed for older adults and offered at St. Louis region YMCA centers.

Consider a driving assessment. The Rehabilitation Institute of St. Louis (TRISTL) offers comprehensive driving evaluations that assess your physical and cognitive driving fitness. Further information can be found on the TRISTL website.

Determine the best conditions to facilitate safe driving. Do you find it more difficult to drive at night or in inclement weather? Should you avoid highway driving or rush hour traffic? Restricting driving to optimal conditions can maximize your driving performance. AARP offers a free self-evaluation of driving skills that provides recommendations tailored to your assessment results.

Explore transportation alternatives. If you or a loved one decides to reduce or cease driving, there are several alternatives to help you get around the community. MetroLink and MetroBus, volunteer driver services, and mobile application driving services are free or low-cost transportation options available to Metro St. Louis residents. The St. Louis Chapter of the Alzheimer’s Association released a report on free & low-cost transportation options available to older adults with and without disabilities. The report is accessible through the Alzheimer’s Association website.

To learn more about research at Washington University:

Driving Rehabilitation Laboratory – Dr. David B. Carr and  Dr. Annie C. Harmon

Driving and Community Mobility Laboratory – Dr. Peggy P. Barco

Roe Laboratory – Dr. Catherine M. Roe


  1. Federal Highway Administration, Department of Transportation (US). Highway Statistics 2015. Washington (DC): FHWA; September 2016. Retrieved March 24, 2017. Available from URL:
  2. National Highway Traffic and Safety Administration, Department of Transportation (US). Older Drivers 2014. Washington (DC): NHTSA; 2014. Retrieved March 24, 2017. Available from URL:
  3. Hunt LA, Murphy CF, Carr D, Duchek JM, Buckles V, Morris JC. Reliability of the Washington University Road Test: a performance-based assessment for drivers with dementia of the Alzheimer type. Archives of Neurology 1997; 54: 707–712.