The world population is ageing. Current projections show that in Europe, the ratio of the number of people aged over 65 to the population aged 15-64 is projected to double between 2010 and 2050 (Lanzieri, 2011). Not only is the population increasing, but it is also increasingly heterogeneous; diverse lifestyles, health, education, and expectations of retired life mean that people are maintaining high levels of mobility for longer. There are a number of key sensory, psychomotor and cognitive functions that decline with age, and research has found relationships between a number of skills considered important for driving safely and functional decline (For example, Janke, 1994 for a review; Horswill, Anstey, Hatherly & Wood, 2010; Selander, Lee, Johansson & Falkmer, 2011). Older drivers as a whole are generally safer than younger age groups as they are more experienced and tend to compensate for functional impairment. In fact, accident involvement is at its lowest rate for drivers aged 70-79, and only increases 20% for drivers aged 80 and over (Mitchell, 2013). This, however, may be due to increased risk resulting from the decrease in miles driven for the older old, also known as the ‘low mileage bias’. The ‘low mileage bias’ shows that independent of age, drivers who travel more kilometres tend to have lower crash rates (per km) than those driving fewer kilometres. As this effect is apparent for drivers of all ages, some authors have argued that crash rates based only on distance travelled may be invalid (Langford, Methorst, & HakamiesBlomqvist, 2006). Older drivers may be safer on the roads, but increased fragility with age means that they are more likely to die from injuries sustained in an accident than their younger counterparts. According to data from the Department for Transport, drivers aged 60-69 had an average of 18.8 KSI casualties per billion miles driven. This number significantly increases to 56.7 KSI casualties for drivers 70 and older (DfT, 2013a). Research has shown that older drivers tend to be overrepresented in intersection or right of way crashes; the proportion accidents that are right of way accidents increases with driver age when compared to other age groups (Clarke, Ward, Truman & Bartle, 2009; Clarke, Ward, Bartle & Truman, 2010). This may be due to higher order problems with hazard perception (Horswill, Anstey, Hatherly & Wood, 2010) or allocation of attention (Lopez-Ramon, Castro, Roca, Ledesma, & Lupiañez , 2011), or may be simply due to reduced neck flexibility and mobility (Reed, Kinnear & Weaver, 2012). Technology can be used to increase safety, ease and comfort for older drivers. Intelligent Transport Systems (ITS), including in-vehicle navigation systems (tools that use geographical information to give feedback and support to drivers) can provide older drivers with increased confidence, and potentially deter them from undertaking more risky behaviours such as reading notes while driving (Emmerson, Guo, Blythe, Namdeo & Edwards, 2013). Cognitive and physical training have also been explored as measures to improve older people’s driving skills. Cognitive training seems to show more promise as studies have attempted to relate the training back to the driving task and have involved large numbers of participants. On the other hand, evaluation of exercise programs tends to be based on other functional measures to show progress; therefore benefits to driving may only be indirect (Ross, Schmidt & Ball, 2012). Opinions on the effectiveness of educational interventions are relatively mixed, though this is likely to be due to the large diversity of educational interventions available (Ross et al., 2012). This said, there is some evidence that education, when used in parallel to other forms of intervention such as on-road training, may be effective in reducing risk (Bédard, Porter, Marshall, Isherwood, Riendeau, Weaver, Tuokko, Molnar & Miller-Polgar, 2008). As no single intervention is likely to reduce risk for all drivers, to a large extent safety depends on older drivers’ own awareness of their visual, motor and cognitive impairments, and on their ability to self-regulate their driving accordingly. A number of studies have demonstrated that older drivers tend to be sensitive to the effects of ageing on driving performance, and that they learn to adjust their driving patterns to limit their exposure to difficult or threatening situations (Lang, Parkes & Fernández-Medina, 2013, for a discussion on the topic). This short review is necessarily limited in scope, yet aims to identify some of the main issues surrounding older driver safety, including risks, age-related changes, and how this information has been used to develop interventions to help maintain safe mobility. Identifying what is an ‘older driver’, and how growing older affects driving is a complex task and requires further research to further understand the link between ageing and driving. A detailed description of the methodology used to produce this review is provided in the Methodology section of the Observatory website at http://www.roadsafetyobservatory.com/Introduction/Methods. This synthesis was compiled during November-December 2013. Note This review includes statistics from Reported Road Casualties Great Britain 201 2, which were the latest available data when the review was written. More recent statistics are available in Reported Road Casualties Great Britain 2013. Literature search Searches were carried out on the pre-defined sources identified in the link above, and included the Transport Research International Documentation (TRID) database, and Pub Med. Together these databases provide access to over 24 million records in transportation and medical research. Search terms used to identify relevant papers are included in the table below (Table I). Asterisks denominate the use of special characters to include all forms of the word (e.g. evaluate, evaluation, evaluated). Research articles, reviews, statistical reports and policy documents have been included in this review. The search yielded 655 results. Abstracts were evaluated on a set of pre-established, objective criteria before moving to a full text review. (Author/publisher)
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