The following is quoted from the article:

Rose Cento knew her uncle, Guy Lange, 91, should stop driving. She had noticed a decline in his mental faculties, most shockingly when he accidentally set his pant leg on fire while pouring gasoline on flames in his living room fireplace.

"His mind was slipping," says Cento, 61. "And then one day it occurred to me: This man is still driving." She tried to convince him to give up his keys, but each time he lashed back in anger, "I can drive as well as anyone else!"

Indeed, Lange did drive as well as anyone else-until 4:20 p.m. on July 27, 1993, when he wound up heading east in the westbound lane of Interstate 70 near Marshall, MO. Jason Suroff, a 21-year-old senior at Indiana University, spotted Lange coming at him and veered off the road to avoid a collision. Unfortunately, he hit a soft shoulder, and his car rolled over and down an embankment. Suroff broke his neck and died instantly. Lange drove on unharmed and unaware of what he'd done. He was later charged with careless and imprudent driving and manslaughter and diagnosed with dementia.

This tragedy, however, doesn't end at the cemetery; it continues up the steps of statehouses across the nation and may someday come crashing through your windshield. "Our lives turned upside down that day," says Jason's father, Sheldon Suroff. "We've got to get high-risk drivers off the road." To that end, he founded Concerned Americans for Responsible Driving (CARD) in 1994. Missouri State Senator Irene Treppler introduced legislature in 1995 to help identify impaired drivers. Because automobile accident rates rise significantly for those over 75, the measure calls for drivers age 75-79 to take a driving and written test every three years, and drivers over 80 to be tested annually. But the bill was shot down in a hail of fire from angry seniors. "They complained and made threats. One said, 'I hope you burn in hell,'" recalls Treppler, who is 69 herself. This year she introduced new legislation that aims to identify only impaired drivers, without mentioning age.

The article outlines the lack of national standards that summarize means of identifying older drivers who have critical impairments, as discussed by Elaine Petrucelli, executive director of the Association for the Advancement of Automotive Medicine (AAAM).

The following physical changes as the result of aging can occur that can result in the deterioration of mental skills needed for driving: visual problems (including night and low-light vision, and degraded contrast sensitivity); the ability to easily move arms, legs, and head, diminished hearing abilities; slower reflexes; deteriorating useful field of view (which affects peripheral vision); heart disease (can reduce judgment and concentration); dementia, Alzheimer's, Parkinson's (often the most serious of dangers, because they can't judge whether they're capable of driving), plus the effect of prescription drugs.

According to the article, every state has some method to assess impaired older drivers-provided a doctor of family member reports the problem to the department of motor vehicles. But only Illinois, Indiana, and New Hampshire require a road test for older drivers beginning at age 75. And in only 11 states are doctors required to report specific serious disabilities.

Also affecting the situation is the shortage of enforcement resources. The article mentions a legally blind 80-year-old Pennsylvania woman who couldn't make out the large E on the vision chart, but remained on the road even after she was repeatedly called in to the state motor vehicle department. According to Jim McKnight, PhD, the president of the National Public Services Research Institute, it usually takes a police stop or a family member reporting to help, but this only picks up a small portion of problem drivers.

An 82 year old Massachusetts woman plowed her car into the back of a 35 year old man's car at a stoplight in 1991, killing him and leaving a 7-year-old girl fatherless. The elderly woman had a history of seizures, was blind in one eye, and had a record of four previous accidents. A grand jury investigation found no basis to charge the elderly woman with a crime.

Advocates for the elderly blame the media for creating an older-driver problem. According to Arlene Berger of the AARP, "stories in the news about isolated but sensational incidents involving older drivers have fueled the perception that older motorists are a menace. Whenever there's a big accident with an older driver at fault, a lot of agitated relatives of the victims come out of the woodwork and go into motion to get older drivers off the road."

The AARP is all for safety on the road, however, and pushes driver refresher courses, like its 55-Alive program. But, there is no evidence that refresher courses reduce fatal accidents among seniors. Reviewing road rules cannot restore physical and mental impairments, according to the article.

John Eberhard, PhD., senior research psychologist at the National Highway Traffic Safety Administration supports the AARP's standing, calling age-based screening discrimination. But, he adds a disclaimer: he isn't opposed IF researchers can make a strong cause-effect connection between the infirmities of old age and higher accident rates. Although at the time of the article, research on this was in progress, Eberhard said, "The probability of finding a highly effective screen to identify impaired older drivers is almost zero."

He dismisses the research of useful field of vision by Karlene Ball, PhD., professor of psychology at Western Kentucky University at Bowling Green, and says that computer-enhanced assessment is too expensive.

To many, the statistics seem pretty compelling. According to the article, McKnight (65), completed a study in April 1995-for the AARP-comparing the serious-injury and fatal accident rate in Illinois and Indiana with those in Michigan and Ohio. The accident rate for age 75+ drivers was six percent lower in Indiana and Illinois, where seniors are required to be tested. Illinois and Indiana also showed a 27 percent lower fatal accident rate among older drivers.

Advocates of testing say critics haven't even considered the possibility that good screeners would identify not just impaired drivers, but also those who are fit, thus removing the stigma from them. Researchers such as Matt Rizzo, M.D., professor of neurology at the University of Iowa, are working to develop assessments that truly measure driving-ability impairment so fit drivers can stay on the road.

The Iowa Driving Simulator, the nation's most sophisticated, places test subjects in an actual working car, with front and rear wide-angle video projection screens and vehicle motion. Drivers are put through a variety of road simulations on a virtual-reality terrain of everything from freeways to rural roads, along with virtual emergency situations.

As far as the age-based screening being discriminatory, Orlando Delogu, a law professor at the University of Maine School of Law, sites federal law forbidding anyone past 60 to be an airline pilot and the Massachusetts mandatory retirement for police officers at age 55. Also mentioned by other age-based advocates was the fact that AARP doesn't claim age discrimination with regard to medical screenings, such as breast-cancer screenings at age 50.

The issue of impaired driving, regulating, and testing is stalled because, as Petrucelli says, "this is a political hot potato."

Joseph Coughlin, Ph.D., is a senior policy analyst with EG&G Dynatrend at the Volpe National Transportation Systems Center, a federal transportation-research lab in Cambridge, MA. He and colleague Roger W. Cobb, Ph.D., professor of political science at Brown University, interviewed motor vehicle administrators and legislators in all 50 states and the District of Columbia. Every legislator was reluctant to move on laws that could be seen as age-discriminatory because of the fear of reprisals from senior interest groups.

Senior citizens do have legitimate concerns about how the loss of driving privileges would affect them. It is a sign of freedom, and a reminder of mortality when taken away. Withdrawal and depression are common reactions to a senior's loss of a license.

The practical issues come up, also. For seniors who live in areas without mass transit, getting the basic supplies and accomplishing the normal day-to-day tasks are a challenge.

The Independent Transportation Network (ITN) may have a solution. Based in Portland, Maine, its seven volunteers and four paid drivers pick up some 151 customers at their doors and take them, by car, wherever they want to go. The specially trained drivers are more attuned to seniors' needs than standard cab drivers are. ITN customers pay more than they would for a bus, but less than they would for a cab. ITN is also perfectly tailored to the era of government spending cuts, because the customer pays for the ride, not the taxpayers. Customers set up an account into which they can deposit money they would have spent on insurance, gas, maintenance, and registration. A local auto dealer can turn the older drivers' cars into cash for deposit into the ITN account. ITN also offers gift certificates.

The article summarizes that the solutions needed are credible age-based screening tests and senior-friendly transportation alternatives. To quote:

The missing element is legislators with the backbone to do what's necessary in the face of opposition from special-interest groups.