Old people have quiet accidents.

As a rule, there are no fiery crashes, no high-speed motorcycle chases, no drive-by shootings. Even their deaths, said attorney Stephen Teret, "tend not to make noise in the vital statistics.

"And one reason," said Teret, director of the Johns Hopkins University Injury Prevention Center, at a recent conference on senior citizen safety, "is that they are often not even recorded as injury deaths."

If an old person falls down a flight of stairs and breaks a hip or shatters a bone in a car accident, "he goes to a hospital, may be discharged to a nursing home and dies months later from pneumonia. His death is listed as a pneumonia death, without the vital statistics ever realizing that this is another injury death."

Even so, according to Michael C. Maher of the Association of Trial Lawyers of America, people over age 65 "have the highest rates of auto-injury-related hospitalization and death of any segment of the population except teenage drivers." In addition, he said, in the same kind of auto accident, "seniors are three times more likely to die than someone under 65."

In 1989, more than 6,000 people 65 and older died in automobile crashes. According to a brochure published by Johns Hopkins and the lawyers' group, most were drivers or passengers, while a fifth were pedestrians.

Older drivers tend to drive less often than other age groups in bad weather, at night, on major highways or in heavy traffic, so there is a drop among older people in accidents per 100 drivers. However when they do drive, they have more accidents per mile driven.

These crashes, according to Julian A. Waller, a professor of epidemiology at the University of Vermont, tend to involve intersections, right-of-way violations, running stop signals and making turns, especially left turns, which are more complicated. They tend to be low-speed accidents, but because the fragility of bone structure increases with age, old people are more likely to be injured.

As people age, he noted, there are changes in vision that affect driving, among them diminished night vision, reduced ability to deal with glare and sensitivity to contrast. There are also changes in problem-solving ability.

"Given enough time," says Waller, "the elderly do as well as younger people, but if you tell them to solve a problem quickly, the older individual will often get flustered."

Finally, there are subtle reductions in reaction time and reflexes that may begin even as early as the thirties.

Gene Cohen, deputy director of the National Institute on Aging, described a test now being used in its studies that focuses on divided attention, distractability and speed.

Called the "useful field-of-vision test," it describes a common situation at a left turn, for example. "You get to an intersection, and it measures to what extent you can pay attention to pedestrians on the sidewalk, traffic coming from three different directions and the car behind you honking," he said. NIA studies have shown, he said, that people who fail this test were over 15 times more likely to have had intersection accidents in the previous five years.

Changing demographics mean that the incidence of such accidents is likely to increase. The numbers of senior citizens are rising, and there are many more elderly drivers today than there were 30 or 40 years ago, Cohen noted.

In 1951, Cohen said, 37 percent of men and 19 percent of women over 70 still drove. By 1984, 86 percent of men and 63 percent of women older than 70 drove. By the year 2030, drivers over 65 will account for more than one third of all those on the road.

Cohen and others emphasized the diversity of the over-65 age group, "with their enormous differences between functional and chronological age." As Karen R. Tarrant, executive director of the Michigan office of Highway Safety and Planning, put it: "You can't just set some magic age and take away everybody's license beyond it."

Old people are the most law-abiding drivers on the road, she noted. They are, for example, the most likely to wear seat belts. "We can use that {concern} by giving them information about the problems they have with night driving, intersections and the like. We need creative solutions."

The key, Tarrant and others said, is to "keep the mature driver on the road as long as possible." People who flunk distractability tests might do fine at better-designed intersections, they suggested. However, Tarrant observed, highway engineers tend to plan exclusively "for the average male" driver, not the elderly.

Sam Yaksich, director of the American Automobile Association's Foundation for Traffic Safety, said that in general there is a "lack of awareness of the needs and problems of older drivers and the failure to appreciate the importance of driving to the mental and social welfare of this growing segment of our population."

Among the recommendations that would assist all drivers, particularly the elderly:

Protected left-turn intersections - left-turn lanes and lights with left-turn arrows.

Better contrast in road signs.

Better education about the effects of various medications on driving ability and their potential interaction with other drugs or with alcohol.

Better lighting and delineation of roadways and lanes.

More "user friendly" licensing bureaus providing better screening for older drivers in an atmosphere of "improving skills" rather than threatening loss of driving privileges.

Self-assessments to help older people decide themselves when it's time to stop driving. "Nagging families are the least effective way," said Yaksich.

For automobile manufacturers, the experts recommended:

Less use of tinted glass. Older people's eyes are already light-deprived.

Safety belts and airbags especially suited to the changing and increasingly fragile bone structure of the elderly.

Simpler and more uniform dashboards.

Better protected doors, where most crashes involving the elderly occur.

Yaksich noted that some Japanese auto manufacturers, already have consulted with Triple A's traffic safety foundation about features that ought to be included in a car designed for mature drivers. In a year or two, he predicted, it is likely that there will be a senior citizens' car on the market.

"I don't see any big push in marketing strategies for older people in this country," he said. "I guess the Japanese are going to be ahead of us again."

Meanwhile, older drivers are encouraged to avoid left turns, even if it means making three right turns.

They are urged to always wear their glasses; keep windshields, mirrors, headlights and tail lights clean; install a right side-view mirror and an extra-large rear-view mirror, avoid driving at dawn or dusk and to keep fit.

For safety tips for senior citizens on the road, send a stamped, self-addressed business-size envelope to Keep It Safe, P.O. Box 3717, Washington, D.C. 20007.