Crash characteristics and injury outcomes for older passenger car occupants

For some time now, it has been recognised that a major shift is occurring in the population age distributions of most motorised countries resulting in a growing number of older persons with an increasing need for mobility. It is expected that the mobility of older persons will become even more reliant on the motor vehicle as European countries in particular undergo transitions towards decentralisation and suburbanisation and because of the well-established longevity factor. This study compares injury outcomes in passenger car crashes for belted occupants of different ages. The study considers drivers and front seat passengers. National accident data in the UK show that whilst older car occupants are less likely to be involved in a car accident than younger occupants, in the event of a crash, older occupants are more likely to be killed or to sustain serious injury. This, in conjunction with the increasing numbers of older licence holder and car users implies that the protection of the inherently frail elderly should become a priority for the future. Analysis of the UK in-depth accident data revealed that the older car occupants were significantly more prone to serious chest injury than their younger counterparts and that these injuries were predominantly due to forces exerted by the restraint system, particularly in frontal impacts. Since by the year 2030 one in four persons will be aged over 65 in most Organisation for Economic Cooperation and Development (OECD) countries, the results suggest a need for intervention through vehicle design including in-vehicle crashworthiness systems that take into account the reduced tolerance to impact that occurs with ageing

An overview of requirements for the crash protection of older drivers

For some time now, it has been recognised that a major shift is occurring in the population age distributions of most motorised countries resulting in a growing number of older persons with an increasing need for mobility. It is expected that the mobility of older persons will become even more reliant on the motor vehicle as European countries in particular undergo transitions towards decentralisation and suburbanisation and because of the well-established longevity factor. As a group, older drivers do not currently represent a major road safety problem in most Western societies when compared with other age groups such as the young. However, they are involved in significantly more serious injury and casualty crashes per head of population. Furthermore, as older drivers are likely to become a more significant problem in the years ahead, it is now necessary to examine some vehicle design factors that affect the safety of the older driver in a crash

Association between mortality and HbA1c, stratified by age group.

<p>Figures are odds ratios (95% confidence intervals).</p>a<p>6.5% to 9.0% as reference category;</p>b<p>adjusted for comorbidity, lipid lowering medication, smoking, BMI and diabetes drug utilisation.</p

Flow chart showing the data extraction from the General Practice Research Database (GPRD).

<p>Flow chart showing the data extraction from the General Practice Research Database (GPRD).</p

Rate of recording of different groups of CHD codes in adults aged 30 to 100 years in GPRD.

<p>Figures are age-standardised recording rates per 1000 using the European Population as standard.</p

Incidence of new CHD diagnoses in adults aged 30 to 100 years in GPRD.

a<p>test for linear trend.</p><p>Figures are age-standardised incidence rates per 1000 using the European Population as standard.</p

Association between mortality and HbA1c.

<p>Figures are odds ratios (OR), 95% confidence intervals (CI).</p>a<p>adjusted for comorbidity, lipid lowering medication, smoking, BMI and diabetes drug utilisation.</p>b<p>6.5% to 9.0% as reference category.</p>c<p>‘no change’ as reference category.</p

Participant characteristics for cases and controls.

<p>Values are frequency (percent) unless otherwise stated.</p>a<p>figures are medians (interquartile range).</p>b<p>No glucose lowering drugs were prescribed for these diabetes patients and most these patients were possible referred to dietary and exercise support.</p

Mean values and change in HbA1c in the last 365 days prior to the index date in cases and controls.

<p>Values are number (percent) unless otherwise stated.</p

Incidence of first stroke by study year and type of codes used for case selection.

<p>Figures are rates per 1,000 years standardised by age and sex to the European standard population.</p