Associations Between Falls and Driving Outcomes in Older Adults: A LongROAD Study

This study examines the relationship between falls and subsequent motor vehicle crash involvement among older drivers.

March 2016

Suggested Citation

For media inquiries, contact:

Tamra Johnson
202-942-2079
TRJohnson@national.aaa.com

Authors

Kenneth A. Scott

Eli Rogers

Marian E. Betz

Lilian Hoffecker

Guohua Li

Carolyn DiGuiseppi

Abstract

Falls in older adults are associated with a significantly increased risk of subsequent motor vehicle crashes. Older adults who had fallen were 40% more likely to experience a subsequent motor vehicle crash than older adults who had not fallen. Additional studies are needed to clarify the relationships between falls, driving behaviors and driving safety among older adults.

Background

  • Driving is an important indicator of mobility and well-being for older adults
  • A fall is defined as an event in which a person comes to rest inadvertently on the ground or floor or other lower level
  • Prior work suggests that falls may increase the risk of subsequent motor vehicle crash (MVC) or other adverse driving outcomes
  • Falls have the ability to impact driving in three ways:
  1. Falls may cause physical injury, limiting an older driver’s ability to use the steering wheel, brake pedals, or otherwise perform essential driving maneuvers; e.g. a wrist fracture
  2. Falls may indirectly lead to reduced functional ability; e.g. increase in fear of falling leads to more limited physical activity, which may lead to physical and cognitive de-conditioning – “use it or lose it”
  3. Falls may heighten self-awareness of age-related physiological changes or precipitate a fear of injury; e.g. may lead to self-restricting driving behaviors like reduced mileage and day-driving only

Objective

  • To better understand the research literature on the associations of falls in older drivers with subsequent MVCs, crash-related injuries, and driving performance and behavior

Methods

  • A systematic literature review, including a narrative and a meta-analysis was conducted on previously published studies related to falls and ensuing driving behaviors
    • Quantitative data for drivers aged 55 and older
    • Cohort, case-cohort, case-control, and time-series designs
  • Fifteen studies met the inclusion criteria
  • This study is part of the AAA Foundation for Traffic Safety’s LongROAD study effort, a national, prospective cohort study designed to examine crashes, driving, and medical issues relevant to drivers 65 and older

Increased risk of MVC

  • A fall history significantly increased the risk of subsequent crashes
    • Older adults who had fallen were 40% more likely to experience a subsequent motor vehicle crash than older adults who had not fallen
    • Many included studies adjusted for age and other factors such as neuromuscular function, vision, or cognition, suggesting that falls independently adversely affect drivers’ functional abilities
  • Limited evidence suggests that falls may also be associated with MVC-related injuries, hospitalizations, and deaths

Inconclusive evidence

  • There was no evidence that falls were associated with:
    • Conditional driving avoidance
      • Avoidance of driving under certain conditions; e.g. at night, on highways, or alone
    • Driving difficulty
      • A self-reported measure, asking subjects whether they had difficulty driving under certain conditions, while performing certain tasks; e.g. turning left
    • Driving frequency, distance, or space
    • Driving cessation

Implications

  • Falls in older adults are associated with a significantly increased risk of subsequent MVCs
  • Safe mobility, both for walking and driving, is important for older adults’ well-being and health. These findings support the importance of fall prevention efforts
  • Fall prevention programs may prevent MVCs, either by reducing injuries that can negatively impact safe driving or mitigating unnecessary self-restriction of driving, which could result in deteriorating driving skills
  • SeniorDriving.AAA.com contains resources for senior drivers on strength and flexibility exercises – AAA.com/fitness

Suggested Citation

For media inquiries, contact:

Tamra Johnson
202-942-2079
TRJohnson@national.aaa.com

Authors

Kenneth A. Scott

Eli Rogers

Marian E. Betz

Lilian Hoffecker

Guohua Li

Carolyn DiGuiseppi