Driving gets more dangerous with age, but older adults may be more vulnerable while walking on the sidewalk than behind the wheel, a new paper says.
Researchers who reviewed data on road accident deaths in the UK found that pedestrians over 70 years old were five times more likely to die from being hit by a car each time they went out than those age 21 to 29.
But elderly drivers were no more likely to die on the road than those in their twenties.
"The focus is usually on older drivers as a danger to themselves and other drivers," said Jonathan Rolison, who led the study at the University of Plymouth in the UK.
But, he added, "the real issue isn't really safeguarding older drivers, it's making the road environment safer for pedestrians."
There has been a shift in recent years in both the UK and the U.S. toward more demanding license renewal processes for older adults.
As eyesight and cognitive abilities decrease with age, older adults are often assumed to be more dangerous on the road than younger drivers.
But previous research suggests that's not necessarily the case. In one U.S. study, researchers found male drivers were less of a risk to other road users at 70 years old than they were at 40.
For the new study, Rolison and his colleagues reviewed UK police records on all fatal road accidents reported between 1989 and 2009.
Older is ideal?
They found the risk of dying behind the wheel was similar for older adult drivers and young people every time they got in the car: 13 in 100 million driving trips ended in fatality among those under 29, compared to 14 in 100 million trips for people over 70.
The elderly still accounted for fewer driver deaths overall. In 2009, when 1138 people died behind the wheel, one in 10 was over age 70, while younger drivers accounted for one in four of those deaths.
The pattern held for passengers, too, with no difference in fatalities per trip for old and young passengers.
For both drivers and passengers, risks were highest at both ends of the age spectrum and dipped among middle-aged people.
But when the researchers looked at figures for pedestrians, they found the risk of being killed when travelling on foot was five times higher for older people than for the young. Among older adults, 23 trips in every 100 million were fatal.
Older adults accounted for 37% of all pedestrian deaths in 2009, according to results published online in the Journal of the American Geriatrics Society.
For Rolison, the findings suggest that the increasing restrictions on older drivers are misplaced.
"Assessing whether older adults can drive is important, but the problem is it leads to policies which are becoming tighter and tighter and distract us from older adults at risk as pedestrians," he said.
According to Rolison, "older adults in a way are the ideal drivers, as they control their exposure to risk. If it's a rainy day, the older adults will stay at home, whereas people in middle age groups still have to go to work or drop kids off at school."
But elderly people are likely to be discouraged by the license screening process, Rolison said, and that could have important implications for their mobility and well-being.
Time to focus
Dr David Carr, an expert in older driver assessment at Washington University in St. Louis, Missouri, agreed that more attention should be given to keeping older people safe as passengers and pedestrians, rather than restricting them as drivers.
"One of the big major points is that older drivers represent a small proportion of driver fatalities. They're not going out there and causing major problems," Dr Carr, who wasn't involved in the new research, he added.
But with baby boomers ageing, "now is the time to focus on making pathways and transportation areas more safe," he added.
Crossing the road is particularly risky for older adults who can't judge speed and distance very well, said Rolison. They're safer if they are accompanied by a younger person.
Because older adults are often frail, they are also more likely to die of their injuries if they're involved in an accident, he explained.
Introducing traffic islands and giving old people more time to get across the road at pedestrian crossings might actually save more lives than tightening license restrictions, said Rolison.
"You shouldn't assume that your granddad should avoid getting behind the wheel, because he won't necessarily be safer walking down the street," said Rolison.
(Reuters Health, August 2012)