Fragility versus excessive crash involvement as determinants of high death rates per vehicle-mile of travel among older drivers

Li, Guohua; Braver, Elisa R.; Chen, Lee-hwa

doi:10.1016/s0001-4575(01)00107-5

Cited by 400 publications

(243 citation statements)

References 25 publications

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“…A previous study by Newgard (2008) similarly found that young and old victims were more likely to be seriously injured, and that the risk for serious injury rose more steeply after the age of 50. The positive relationship between age and severity is traditionally associated with the greater fragility of elder victims (Li et al, 2003), whereby physical decline would be intensified from the age of fifty onwards.…”

Section: Coefficient Estimatesmentioning

confidence: 99%

Factors affecting hospital admission and recovery stay duration of in-patient motor victims in Spain

Santolino

Bolancé

Alcañiz

2012

Accident Analysis & Prevention

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Section: Coefficient Estimatesmentioning

confidence: 99%

Factors affecting hospital admission and recovery stay duration of in-patient motor victims in Spain

Santolino

Bolancé

Alcañiz

2012

Accident Analysis & Prevention

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“…As individuals grow older, they are more likely to experience a decline in cognitive function that can affect their ability to safely operate a motor vehicle, potentially putting themselves and others at risk. In fact, drivers over the age of 65 have a higher rate of motor vehicle collisions per mile driven than middle-aged drivers (Li et al, 2003) and when injured in a collision, they are more likely to die or sustain serious injury (Zhang et al, 2000, Bédard et al, 2002. Literature to date suggests that cognitive impairment in later life does not predict self-regulation or perceptions of driving abilities (Ball et al, 2006;Crizzle et al, 2013;Kowalski et al, 2011;Molnar & Eby, 2008), and hence the risk to road safety may be particularly concerning.…”

Section: Introductionmentioning

confidence: 99%

The relationship between cognitive performance, perceptions of driving comfort and abilities, and self-reported driving restrictions among healthy older drivers

Rapoport

Naglie

Weegar

et al. 2013

Accident Analysis & Prevention

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The objective of the present study was to examine the relationship between cognitive performance, driver perceptions and self-reported driving restrictions. A cross-sectional analysis was conducted on baseline data from Candrive II, a five-year prospective cohort study of 928 The baseline data indicates this cohort is largely a cognitively intact group. Univariate regression analysis showed that longer Trails A and B completion times were significantly, but only modestly associated with reduced driving frequency and perceived driving abilities and comfort, as well as a significant tendency to avoid more difficult driving situations (all p < .05). Most of these associations persisted after adjusting for age and sex, as well as indicators of health, vision, mood and physical functioning. Exceptions were Trails A and B completion times and situational driving frequency, as well as time to complete Trails B and current driving restrictions. After adjusting for the confounding factors, the total MoCA score was not associated with any of the driving measure scores while the number of errors on Trails A was significantly associated only with situational driving frequency and number of errors on Trails B was significantly associated only with situational driving avoidance. Prospective follow-up will permit examination of whether baseline cognition or changes in cognition are associated with changes in driver perceptions, actual driving restrictions and on-road driving outcomes (e.g., crashes, violations) over time.4

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“…This is more evident when an exposure measure (yearly distance driven, for example) is taken into account for calculating risk (Li et al, 2003; 2006). Due to greater vulnerability to injury (reductions in bone strength and fracture tolerance), these figures must be corrected by the so-called "frailty bias" (Li et al, 2003;.…”

Section: Introductionmentioning

confidence: 99%

“…Due to greater vulnerability to injury (reductions in bone strength and fracture tolerance), these figures must be corrected by the so-called "frailty bias" (Li et al, 2003;. Between 60 and 95% of the increase in death rate per distance travelled for those aged 60 and over can be accounted for by increases in fragility (Li et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Older drivers, medical condition, medical impairment and crash risk

Álvarez¹,

Fierro²

2008

Accident Analysis & Prevention

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New evidence has appeared to support the fact that the over-involvement of older drivers in traffic accidents disappears when the low mileage bias is taken into account. As a group, older drivers are as safe as or safer than other age groups, and only low mileage older drivers have a high crash rate. Furthermore, the role of the medical condition of older drivers in traffic accidents, as well as the fitness to drive evaluation, are objects of controversy. We examined all this with a cohort of 4316 drivers attending Medical Driving Test Centres for a mandatory fitness to drive evaluation. Our data shows that older drivers (≥75) have a lower crash rate. Medical conditions that impair fitness to drive, as a tendency, increased with advanced age and with lower mileage group. The multivariate analysis of variance showed that there is an effect (p < 0.0001) of age-range and mileage on the annual crash rate per million kilometres driven, while a medical restriction ("fit to drive with restriction") has no effect (p > 0.05). Our data suggests that health status is not associated with increased crash risk for the low mileage group, although further studies are needed.

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Fragility versus excessive crash involvement as determinants of high death rates per vehicle-mile of travel among older drivers

Cited by 400 publications

References 25 publications

Factors affecting hospital admission and recovery stay duration of in-patient motor victims in Spain

Factors affecting hospital admission and recovery stay duration of in-patient motor victims in Spain

The relationship between cognitive performance, perceptions of driving comfort and abilities, and self-reported driving restrictions among healthy older drivers

Older drivers, medical condition, medical impairment and crash risk

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