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- Title
Associations Between Falls and Driving Outcomes in Older Adults: Systematic Review and Meta-Analysis.
- Authors
Scott, Kenneth A.; Rogers, Eli; Betz, Marian E.; Hoffecker, Lilian; Li, Guohua; DiGuiseppi, Carolyn
- Abstract
Objectives To examine associations between falls and subsequent motor vehicle crashes ( MVCs), crash-related injuries, driving performance, and driving behavior. Design Systematic review and metaanalysis. Participants Observational studies including drivers aged 55 and older or with a mean age of 65 and older. 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 3,286 potentially eligible records, 15 studies (N = 27-17,349 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 greater risk of subsequent MVC (summary risk estimate = 1.40, 95% confidence interval ( CI) = 1.20-1.63; I2 = 28%, N = 5 studies). One study found a significantly greater 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 between falls and driving cessation and showed no association between falls and 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 crash risk and to develop effective interventions to ensure driving safety in older adults with a history of falls.
- Subjects
PREVENTION of falls in old age; TRAFFIC accidents; OLDER automobile drivers; HUMAN behavior research; TRAFFIC accident victims; HOSPITAL care of older people; AUTOMOBILE driving; DRIVING cessation; WOUNDS &; injuries; SYSTEMATIC reviews; META-analysis; TRAFFIC accident risk factors; CONFIDENCE intervals; ACCIDENTAL falls; HOSPITAL care; MORTALITY; MATHEMATICAL variables; RESEARCH bias; DESCRIPTIVE statistics
- Publication
Journal of the American Geriatrics Society, 2017, Vol 65, Issue 12, p2596
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/jgs.15047