Trends in the crash involvement of older drivers in Australia

Cardiac disease and driver fatality

To determine the role of cardiac disease in driver fatalities, a retrospective review of autopsy files at Forensic Science SA in Adelaide, Australia, was undertaken over a 13-year-period January 2005-December 2017 for individuals aged ≥ 40 years who had died while driving a motor vehicle. The incidence of significant coronary artery atherosclerosis (CAA) and cardiomegaly was evaluated with comparisons between drivers and a control group of passengers. Autopsy examinations were performed on 303 drivers and 72 passengers who died of trauma and on 63 drivers who died of a cardiac event while driving. The average age for drivers dying of trauma was 58.5 years (range 40-93 years) with 48 (15.8%) having CAA and 31 (10.2%) having cardiomegaly. This was not statistically different to passengers (aged 63.3 years; range 40-93 years; 20.8% having CAA; 11 (15.2%) cardiomegaly; (p > 0.2). Drivers with significant cardiac disease did not, therefore, have increased rates of death in crashes, although a distinct subgroup of drivers consisted of those who had died from cardiac events and not trauma, while driving. The latter may be increasing in number given the aging population.

Road traffic fatalities in rural and remote Australia from 2006 to 2017: The need for targeted action

Objective

To explore rural motor vehicle collision (MVC) fatalities by trends over time, mode of transport, age, state, sex, and Aboriginal and Torres Strait Islander status.

Design

A retrospective total population‐based time series was conducted using the Australian Bureau of Statistics (ABS) death registration data.

Setting

All statistical local area (SLA) within Australia from 2006 to 2017.

Participants

Australian residents whose deaths were registered with the ABS between 01 January 2006 and 31 December 2017 where the underlying cause of death was related to unintentional transport accidents.

Main outcome measures

Fatality rates were determined using population data collected from the 2006, 2011 and 2016 census. Trends over time by rurality were analysed by financial year. Rates of transport deaths by vehicle type were determined by rurality. Risk ratios were calculated to compare demographic groups based on sex, Aboriginal and Torres Strait Islander status and age. A 3‐year scorecard was organised by state and rurality using 99.7% confidence intervals.

Results

Motor vehicle collision fatalities increase with increasing remoteness. Females, children from 0 to 14 years, pedestrians, and Aboriginal and Torres Strait Islander peoples are at a significantly higher risk of fatal MVCs than their respective metropolitan counterparts. The 3‐year scorecard indicates that road fatality rates in the NT, WA, and all rural and remote areas required immediate attention and targeted action.

Conclusions

There is a need for investment in MVC fatality prevention in rural Australia from inner regional to remote areas in order to meet the road safety targets established by the National Road Safety Strategy.

Risk factors of road accident severity and the development of a new system for prevention: New insights from China

Road accident fatalities and accident severity costs have become top priorities and concerns for Chinese policymakers. Understanding the principal factors that explain accident severity is considered to be the first step towards the adequate design of an accident prevention strategy. In this paper, we examine the contribution of various types of factors (vehicle, driver and others) in explaining accident severity in China. Unlike previous studies, the analysis gives a particular focus on fatal accidents. Using a large sample of 405,177 observations for 4-wheeled vehicles in the year 2017 and various statistical and econometrics approaches (e.g., OLS, quantile regression and extreme value theory), the results show that the factors explaining the severity of accidents differs significantly between normal and extreme severity accidents, e.g. across quantiles. Interestingly, we find that the gender factor is only significant for fatal accidents. In particular, the analysis shows that male drivers have an increased likelihood of extreme risk taking. On the basis of these empirical findings, a new ratemaking approach that aims to improve road safety and prevention is discussed and proposed.

Older Adults' Expectations about Mortality, Driving Life and Years Left without Driving

People are living and driving longer than ever before, with little preparation for transitioning to being non-drivers. We investigated driving expectations among drivers age 65 and older, including sociodemographic and driving context predictors. Cross-sectional data from 349 older drivers were explored to determine variation in how many years they expected to continue driving. General linear models examined predictors of both expectations. In this predominantly Black/African American sample, 76% of older drivers (mean age = 73 ± 5.7 years) expected a non-driving future, forecasting living an average of 5.75 ± 7.29 years after driving cessation. Regression models on years left of driving life and years left to live post-driving cessation predicted nearly half of the variance in older drivers' expectations with five significant predictors: income, current age, age expected to live to, self-limiting driving to nearby places and difficulty, visualizing being a non-driver. Many older drivers expect to stop driving before end of life.

Exploring the contribution of executive functions to on-road driving performance during aging: A latent variable analysis

With the aging of the population the issue of older drivers safety has gained importance in recent years. Age-related cognitive decline is frequently cited as the main cause of unsafe driving performance in older drivers.

OBJECTIVE

The present study investigated how executive functions (EFs), measured as latent variables, are related to on-road driving performance during aging.

METHOD

One hundred and twenty-six participants aged from twenty to eighty-two, completed a two hundred and forty-seven km on-road driving test and a set of executive tasks selected to tap three often postulated EFs: inhibition (inhibiting prepotent responses), updating (updating working memory representations), and shifting (shifting task sets).

RESULTS

Confirmatory factor analysis reproduces previous results obtained by Miyake et al. (2000), Miyake and Friedman (2012) of unity and diversity of EFs in an adult life span sample. Structural equation modeling suggested that on-road driving performance was related to inhibition. Furthermore, findings indicate that the age-related driving performance decline in normal aging may be mediated by the inhibition function.

CONCLUSIONS

The results highlight the importance of a proper method to assess executive functioning in a specific domain as well as emphasising the major role of those functions in driving performance while aging.

Comparison of traffic collision victims between older and younger drivers in South Korea: Epidemiologic characteristics, risk factors and types of collisions

Objective

This study aimed to show the epidemiological characteristics and the difference in the risk factors and types of collision between older and younger drivers in Korea.

Methods

We collected data from the Emergency Department-based Injury In-depth Surveillance retrieved by the Korea Centers for Disease Control and Prevention from 2011 to 2015. We included injured drivers aged ≥ 18 years who were registered in the database, who were limited to drivers of four-wheeled vehicles. The enrolled patients were divided according to age into older (≥ 65 years) and younger (< 65 years) drivers. The total number of enrolled drivers was 37,511; 2,361 (6.3%) of them were older drivers. The epidemiological characteristics (e.g., age, sex, fatality rate) of traffic collision victims for 5 years were determined, and the risk factors (e.g., seat belt use) and types of collision (single- vs. multi-vehicle) between the two groups were compared.

Results

The median age and interquartile range (IQR; 25^th and 75^th percentiles) of all drivers were 41.0 (IQR, 32.0–52.0), and 24,544 (65.4%) of them were men. The median age increased from 40.0 (IQR, 31.0–50.0) to 43.0 (IQR, 33.0–54.0) between 2010 and 2015 (P < 0.001). The proportion of older drivers increased from 5.0% to 8.4% annually during the study period (P < 0.001). Between 2010 and 2015, the fatality rate decreased from 3.1% to 1.2% (P = 0.287) for older drivers and from 0.9% to 0.5% (P = 0.009) for younger drivers. The proportion of single-vehicle collision (25.9% vs. 20.3%) was higher in older than in younger drivers (P < 0.001). Older drivers had a lower rate of seat-belt use than younger drivers (79.0% vs. 83.0%, P < 0.001).

Conclusions

The proportion of older drivers increased annually during the study period, and older drivers experienced more single-vehicle collision and used seat belt less frequently than younger drivers. A national policy support to reduce traffic collision in older drivers and public relation activities to enhance their seat belt use should be strengthened in the future.