Drivers over 65 are more likely to get into crashes because of declining perception and motor skills, but the biggest risk is to themselves, not others on the highway, says a study based on nearly 4 million traffic accidents.

The study, released Wednesday by the AAA Foundation for Traffic Safety (search), also found that drivers 65 or older are nearly twice as likely to die in a crash as drivers between 55 and 64. Drivers over 85 were nearly four times as likely to die.

Often, older drivers are frail and can die from injuries that wouldn't be fatal to younger drivers, the report said.

As they grow older, some drivers are more likely to cause a crash because of a lapse in perception, such as failing to yield or running a red light. Fifty-nine percent of drivers 75 or older involved in crashes had such a lapse, the same percentage as 15-year-old drivers. For drivers 85 or older, perception lapses were cited in 67 percent of the accidents.

Old people also were more likely to get into crashes while turning to the left, when drivers often must make quick judgments, the study said. Drivers over 65 were 25 percent more likely to get in a crash than middle-age drivers; drivers over 85 were 50 percent more likely to get in a crash during a left turn.

The study, by the Texas Transportation Institute (search), analyzed Texas police records from 3.9 million crashes between 1975 and 1999. Those crashes caused 90,036 fatalities.

According to federal statistics, there were 19.1 million drivers 75 or older in 2001 -- about 10 percent of all drivers. Peter Kissinger, president of the AAA Foundation for Traffic Safety, said the nation could face a major public health crisis as that number grows.

Still, AAA stopped short of recommending new laws to govern elderly drivers. Twenty-two states already have such laws. Florida requires drivers age 80 or older to have their vision checked when they renew their licenses. New Hampshire and Illinois require road tests for those 75 and older.

"We all age at different rates," said Bella Dinh-Zarr, AAA's director of traffic safety. "As a country, we should really be thinking of ways to help older drivers. There are solutions to these problems and we need to think them out before just giving up our keys."

Lore Edidin, 81, of Falls Church, Va., said laws based on age are unfair. But she also said seniors should be realistic.

"I know my limitations. I don't drive at night very much and I don't drive on highways. I limit my driving to where I feel secure," said Edidin, who regularly drives short distances for her work as a counselor with a community center.

Barbara Harsha, executive director of the Governors Highway Safety Association (search), said most safety groups also oppose laws based solely on age because elderly people like Edidin are good at regulating themselves. Harsha prefers a system that would take licenses away from drivers when either their families or their doctors feel it's medically necessary.

"It's pretty hard to argue with approaching this from a medical impairment perspective," said Harsha.

She said she has asked Maryland's medical review board to consider revoking her 87-year-old father's license after he got into three crashes last year.

AAA says older motorists should consider taking specially designed driving courses. Thirty-five states now provide insurance discounts for drivers who take such courses.

Older drivers, with help from their physicians, also should assess their driving skills regularly, AAA said.

Dinh-Zarr said vehicles can be modified to help older drivers. Larger rear and side mirrors, larger and brighter dashboard displays and seat belts that are easier to lock would help, she said.

Elderly drivers wear their seat belts more often than any other age group but often complain that the belts are difficult to put on, Dinh-Zarr said. She also said better lighting, larger signs and protected left-turn lanes at intersections would help decrease accidents.