Should We Let Old People Drive?

And how do we know when to pull the plug?

Jonathan Adrian, MD
5 min readFeb 10, 2020
Photo by Victor Xok

Yesterday, my grandfather celebrated his 81st birthday, which means he’s seen the full moon 972 times, and has spent over 3900 weekends. To put that into context, that’s enough time to finish the entire Friends series 5241 times. He’s also been on the road for 51 years, which is almost two-thirds of his entire lifetime.

My grandfather is a stout man, and standing at a measly 5 feet 5 inches, he looks like a slightly shorter version of Robert De Niro. For his age, he looks to be in exemplary shape. He’s had a lens replacement in both his eyes — which is only normal in his age range — and suffers no chronic conditions besides a well-controlled hypertension, which runs in the family, and a sporadic case of osteoarthritis in his spine from the years of standing and carrying heavy equipment during his time as an architect.

Just last week, he got into a fender-bender during one of his weekly morning commutes to our local church. Although nobody sustained injuries, and that there was only mild damage to both vehicles, it did cause a bit of stir within the family as to his safety on the roads. After thinking through this incident, my grandfather decided to take a break from driving.

One week later, we barely remember the accident ever happened, but this mishap rejuvenated interest in a writing prompt I had already thought about weeks before. Should we let old people stay on the roads? Do they pose a threat to the safety of the general public? If they do, then what’s the ideal age of roadway retirement?

It’s easy for controversial prompts like this to branch off into additional queries, but the idea behind this is very simple. A person’s driving abilities, as their abilities with physically demanding sports, will naturally decline as they rack up years because of the ancient concept of biological ageing.

As birthday photos pile up our Facebook albums, old presents line our office table shelves, and moments of conviviality gather in our repository of memories, our biological system takes an inescapable toll. Ageing occurs as a result of chronic DNA damage, waste protein buildup, and years and years of free-radical accumulation in our naturally imperfect biological system.

Evolutionary biologist Thomas Kirkwood believes that organisms age in order to balance the demands of maintaining their body, cells and reproducing. “Because an organism invests resources into reproduction, over time mutations and other cellular damage accumulate in the soma (cell body) because the body cannot repair all of it,” he adds.

As a result, we slowly lose our physiological abilities. Movement become less fluid as we age because of diminishing muscle mass and stiffening of joints. Our senses, particularly our sight and hearing become less sensitive, and that may impair detecting people, things, and movement outside their direct line of sight.

Glare from oncoming headlights or street lights can also be a problem, and its likely for night-time vision to be reduced in the elderly, a condition known as nyctalopia. Impairment in both our sensory and motoric departments may lead to a significant drop hand-eye coordination, which by pure logic sense is absolutely necessary for road safety.

If this isn’t properly regulated, we will have millions of physically incapable drivers roaming the streets every single day. Yes, you may argue that young drivers account for a higher accident count than older people, but the aetiology is completely separate, and it doesn’t change the fact that we have highly dangerous people behind the wheels that wander our streets — people who we are exposed to on a daily basis. The worst part is not knowing whether that person is in the car in front of you, or in the intersection as you pass a faintly lit traffic light.

The CDC highlights that in 2017, almost 8,000 adults aged 65 and older were killed in motor vehicle crashes, and more than 257,000 were treated in emergency departments for motor vehicle crash injuries.

While it’s unwise to immediately point our fingers to our driving senior citizen population — it could have been a drunk truck driver on the other end of the wheel for all we know — the undebatable fact is that these people have decreased physiological abilities, which simply increases the risk of an unwanted road incident.

This 2014 paper shows that human reaction times peak at age 24 and declines at a steady pace from then onwards. The human reaction time is a very powerful determinator of our driving competence as it clearly depicts our ability to react to obstacles on the road, such as a moose crossing the road or an unexpected sudden brake.

So if driving becomes less and less safe as we age, what is the recommended age of roadway retirement? The National Institute on Aging (NIA) suggests older people to regularly go through a checklist of questions to gauge their driving setbacks and self-introspect to see if their time on the roads may be up.

The checklist includes questions like “Do other drivers often honk at me?” and “Have family, friends, or my doctor said they’re worried about my driving?” to more serious prompts such as “Do I have trouble moving my foot between the gas and the brake pedals, or do I sometimes confuse the two?”

The NIA recommends that if you answered “yes” to any one of these questions, it may be wise to arrange a consultation with your doctor about driving and collect insight on potentially bidding farewell to your driving days.

Although this will take a hit on mobility, there are prevalent ride-sharing services and free or low-cost transportation systems that senior citizens that can capitalise on. Some countries even provide shuttle bus services that go around neighbourhoods in short and regular intervals to take the locals to nearby towns, where they can carry out their normal day-to-day without worrying about driving back home.

Finally, the NIA suggests regularly going over safe driving tips — which is useful not only for the elderly — before leaving home and while driving. Things like avoiding streets you’re unfamiliar with, not driving when you’re stressed or tired, ensuring seatbelts are worn at every outing and avoiding cell phone usage while navigating the roads.

As for my grandfather, I hope he’ll find something interesting to take his mind off from during his driving interlude, and hopefully soon, hang his car keys for good.



Jonathan Adrian, MD

Doctor, writer, photographer, and part-time social media strategist.