Elderly driver safety in Switzerland current reality and future perspectives
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1 Elderly driver safety in Switzerland current reality and future perspectives FERSI-Congress, 27th & 28th of November, Bergisch-Gladbach Uwe Ewert, PhD MPH Andrea Uhr, MSc in Psychology
2 Number of elderly drivers will increase Number of elderly will increase by more than 50% until 2035 Percentage in the total population will increase from 18 to 26% years years years 65 and older Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
3 Number of elderly drivers will increase Licence possession rates will increase 100% 90% 80% 70% 60% 50% 40% 30% Men Women 20% 10% 0% Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
4 Number of elderly drivers will increase Kilometers driven are and will be increasing to to to and older Kilometers driven per day by those who do drive (Census by FOS) Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
5 Percent killed by age of car driver Percent fatalities in crashes of car drivers aged 25 to 64 Percent fatalities in crashes of car drivers under age 25 Percent fatalities in crashes of car drivers aged 65 and older 0 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
6 Fatalities in older car drivers crashes Ø Killed Total number of road fatalities 309 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
7 Fatalities in older car drivers crashes Ø Killed Total number of road fatalities 309 Elderly car driver involved in crash 47 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
8 Fatalities in older car drivers crashes Ø Killed Total number of road fatalities 309 Elderly car driver involved in crash 47 Elderly car driver at-fault 37 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
9 Fatalities in older car drivers crashes Ø Killed Total number of road fatalities 309 Elderly car driver involved in crash 47 Elderly car driver at-fault 37 Killed: elderly at-fault car driver 21 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
10 Fatalities in older car drivers crashes Ø Killed Total number of road fatalities 309 Elderly car driver involved in crash 47 Elderly car driver at-fault 37 Killed: elderly at-fault car driver 21 Killed: other person 15 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
11 Fatalities in older car drivers crashes Ø Killed Total number of road fatalities 309 Elderly car driver involved in crash 47 Elderly car driver at-fault 37 Killed: elderly at-fault car driver 21 Killed: other person 15 Elderly car drivers cause about 12% of all fatalities. 7 percentage points are the elderly at-fault drivers themselves 5 percentage points are other victims Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
12 Current reality in Switzerland Mandatory medical examination system beginning at age 70 Repeated every two years Conducted by family practitioner Check whether medical minimum criteria are fulfilled Criteria only roughly defined (except for vision) Physician makes a recommendation (fit to drive, fit to drive with constraints, unfit to drive) Form is returned to road office Road office decides Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
13 Medical screening in Europe Siren, A. et al. (2013). Driver Licensing Legislation. CONSOL, Work Package 5.1. Final Report. Accessed at Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
14 Fatality rate of car occupants per mio inhabitants (indexed for age 25 to 64) Countries with age-based medical screening Countries without agebased medical screening 50 0 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
15 Fatality rate of pedestrians per mio inhabitants (indexed to age 25 to 64) with age-based medical screening without age-based medical screening 50 0 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
16 Future perspectives: medical examination Medical examination should be focussed better on medical conditions with increased crash risk and substantial prevalence Better education of physicians for the use of screening tests like the Mini Mental State Examination (MMSE) Focus of the medical examination should be on treatment, rehabilitation and auxiliary measures (like transport equipment modifications) More frequent issuing of limited licences (travel time, region) instead of licence withdrawal Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
17 Future perspectives: self assessment Medical examination serves the identification of medical problems What about normal age-related physical and cognitive changes? Self-assessment instruments raise awareness of own abilities and possible problems provide feedback and advice support self-regulation (up to voluntary driving cessation) facilitate discussion with family members Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
18 Future perspectives: self-assessment Open questions: Development and validation of self-assessment instruments (Lang, Parkes & Fernández Medina, 2013) Predictive validity of self-assessment to self-regulation and road safety? Dissemination? Beginning age? Periodicity? Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
19 Future perspectives: medication Psychoactive medications should get a closer look Dischinger et al. (2011) showed an exponential growth in crash risk Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
20 Future perspectives: frailty fatally injured Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
21 Future perspectives: frailty severely injured fatally injured Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
22 Future perspectives: frailty slightly injured severely injured fatally injured 0.0 Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
23 Future perspectives: frailty slightly injured severely injured fatally injured 0.0 Counteract frailty with cars with good crash test ratings and appropriate test dummies Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
24 Future perspectives: ADAS Advanced Driver Assistance System (ADAS) may be helpful for the elderly, especially in urban areas Brake Assistance, Forward Collision Warning, Parking Assistance, Lane Departure Warning... Acceptance among the elderly is higher than among the younger Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
25 Conclusions The number and proportion of elderly drivers will increase ~10% of fatally injured and 6% of seriously injured persons were involved in crashes caused by older drivers Medical screening has to be carefully designed and conducted to increase road safety Self-assessments can complement the medical examination Psychoactive medication should be supervised better Active and passive safety systems will help the elderly driver Active driving should be sustained as long as possible Elderly driver in Switzerland, Ewert & Uhr 27/28th of November
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