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Associations between Falls and Driving Outcomes in Older Adults: Systematic Review and Meta-Analysis
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12 2017
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Source: J Am Geriatr Soc. 65(12):2596-2602
[PDF-334.06 KB]
Details:
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Alternative Title:J Am Geriatr Soc
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Description:Background/Objectives
Driving is an important indicator of mobility and well-being for older adults. Prior work suggests falls are associated with an increased risk of adverse driving outcomes. We examined associations between falls and subsequent motor vehicle crashes (MVCs), crash-related injuries, driving performance and driving behavior.
Design
Systematic review and meta-analysis.
Participants
Observational studies including adult drivers aged 55 and older or with mean age of at least 65.
Measurements
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.
Results
From 3286 potentially eligible records, 15 studies (N=27 to 17,349 subjects) met inclusion criteria. Risk of bias was low to moderate, except for cross-sectional studies (n=3) which all had a high potential for bias. 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%, N=5 studies). One study found a significantly increased risk of MVC-related hospitalizations and deaths after a fall (hazard ratio=3.12; 95%CI: 1.71, 5.69). Evidence was inconclusive regarding an association of falls with driving cessation and showed no association with driving performance or behavior.
Conclusion
Falls in older adults appear to be a risk marker for subsequent MVCs and MVC-related injury. Given the nature of the evidence, which is limited to observational studies, the identified associations may also result at least partly from confounding or bias. Further research is needed to clarify the mechanisms linking falls to increased crash risk and develop effective interventions to ensure driving safety in older adults with a history of falls.
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Pubmed ID:28873218
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Pubmed Central ID:PMC5729077
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