Background: Elderly pedestrians are among the most vulnerable groups in terms of traffic-related injuries. This study aimed to investigate traffic behavior and its determinants among elderly pedestrians in Iran.Methods: This cross-sectional study examined the traffic behavior of 600 elderly pedestrians in Zanjan, northwestern Iran. Pedestrian traffic behavior was evaluated in five domains (traffic violations, traffic distraction, adherence to traffic rules, aggressive behaviors, and positive behaviors) using the Pedestrian Behavior Questionnaire (PBQ). Participants’ socioeconomic status (SES) was assessed by an SES questionnaire, and cognitive function was assessed by the Abbreviated Mental Test score (AMTS). The participants were selected using the multistage random sampling method.Results: 50% of elders were man. 488 (81.3%) of them had 60-74 and 112 (18.7%) were 75 years old and above. More than 90% of elderly pedestrians showed unsafe traffic behavior. This included traffic violations and failure to adhere to traffic rules. Almost half the elders were aggressive and distracted when walking and crossing the street. Higher SES was associated with both higher cognitive status and safer traffic behavior. Higher SES, healthy cognitive function, male sex, walking more than 1 hour a day, higher levels of education, and being married were among the determinants of safe traffic behavior.Conclusion: The majority of the elders showed unsafe traffic behavior Elderly pedestrians with high SES and healthy cognitive function were more likely to exhibit safe behavior than those with low SES and cognitive dysfunction. . Interventions are needed to improve the traffic behavior of elderly pedestrians special with low SES.
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