Stevens JA, Hasbrouck L, Durant TM, Dellinger AM, Batabyal PK, Crosby AE, Valluru BR, Kresnow M, Guerrero JL. Surveillance for Injuries and Violence Among Older Adults. In: CDC Surveillance Summaries, December 17, 1999. MMWR 1999;48(No. SS-8):27-50.

In a recent issue of the Morbidity and Mortality Weekly Report, researchers from CDC’s National Center for Injury Prevention and Control summarized 1990-1997 surveillance data from the National Highway Traffic Safety Administration on motor vehicle-related injuries and fatalities among older adults. Results of the study showed that between 1990 and 1997, there was a 14% increase in the number of motor vehicle traffic-related fatalities and a 19% increase in the number of motor vehicle traffic-related nonfatal injuries, among older adults – defined as adults 65 years and older. During the 8-year study period, traffic crashes accounted for approximately 55,000 deaths and 1,869,308 nonfatal injuries among older adults. In 1996, older adults represented 13% of the U.S. population and accounted for 17% of all motor vehicle-related deaths.

While rates of motor vehicle-related death and nonfatal injury among older adults varied by state, there were some consistencies. In most states, the fatality rates for men were twice those for women. And in all states, motor vehicle-related fatalities were higher among adults 75 years and older, as compared with adults between 65 and 74 years of age.

Among older adult drivers only, the number of motor vehicle-related fatalities increased 30% and the number of nonfatal injuries increased 21% between 1990 and 1997. A review of licensing information between 1990 and 1995 led researchers to suggest that the increasing fatalities and injuries among drivers may be due in part to an increased number of older drivers. The number of fatalities and nonfatal injuries among older adult pedestrians, however, declined during these same years (23% and 24%, respectively).

Possible reasons for older adults’ increased risk for motor vehicle-related injury include visual deterioration and declines in cognitive and motor skills. Also, physical frailty increases susceptibility to injury in a crash. Thus, a crash that results in nonfatal injuries to a younger person might result in the death of an older adult driver or passenger.

To effectively address the problem, multifaceted interventions should be specifically tailored to the risks and needs of older adults. Interventions could focus on improving the design of motor vehicles, changing the environment to improve traffic and pedestrian safety, and changing the behavior of older drivers, passengers and pedestrians. For example, increasing the size and illumination of instrument panels and road signs would improve their nighttime readability. Environmental alterations, such as the installation of median islands on wide roadways, might help older pedestrians. A screening and testing program that assesses drivers’ functional and cognitive abilities could help older adults assess their own abilities and make decisions about their driving behavior. The efficacy of these and other interventions should be evaluated to determine the most effective way to prevent motor vehicle-related injuries among older adults.