Associations Between Falls and Driving Outcomes in Older Adults: A Systematic Review and Meta-Analysis: A LongROAD Study

Driving is an important indicator of mobility and well-being for older adults. Prior work suggests falls may increase the risk of subsequent motor vehicle crash (MVC) or other adverse driving outcomes. To inform efforts to enhance older adult health, mobility and well-being, the authors sought to systematically review the observational (that is, non-experimental) research literature characterizing relationships between falls in older adults and subsequent driving behaviors and outcomes, and to synthesize data across studies on the associations between falls and subsequent driving activity and performance and motor vehicle crashes (MVCs). Two authors independently extracted study and participant characteristics, exposures and outcomes and assessed risk of bias. Pooled risk estimates for MVCs and MVC-related injuries were calculated using random-effects models. Other results were synthesized narratively. From 3286 potentially eligible records, 15 studies met inclusion criteria; sample size ranged from 27 to 17,349 subjects. A fall history was associated with a significantly increased risk of subsequent MVC (summary risk estimate=1.40; 95%CI 1.20, 1.63; I²=28%), based on five studies. One cohort study found a significantly increased risk of MVC-related hospitalizations and deaths after a fall (adjusted hazard ratio=3.12; 95%CI: 1.71, 5.69). Falls were associated with a modestly elevated risk of crash-related injuries, but the pooled risk estimate from the two relevant studies was not statistically significant (1.34; 95%CI 0.94, 1.92; I²=0%). There was inconclusive evidence for an association of falls with driving cessation and no association of falls with conditional driving avoidance, driving difficulty and driving frequency, distance or space. It was concluded that falls in older adults are associated with a significantly increased risk of subsequent MVCs. Evidence also suggests that older adults might be at an increased risk of MVC-related injury after a fall. Rigorously designed studies are needed to clarify the relationships between falls, driving behaviors and driving safety among older adults.

Language

  • English

Media Info

  • Media Type: Digital/other
  • Features: Appendices; Figures; References; Tables;
  • Pagination: 48p

Subject/Index Terms

Filing Info

  • Accession Number: 01596681
  • Record Type: Publication
  • Files: TRIS
  • Created Date: Apr 8 2016 10:09AM