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Introduction: The ability to remain safe behind the wheels can become arduous with aging, yet important for sustaining local travel needs. This review aimed to explore safe mobility issues involving older adults and gain a broad understanding of older drivers' self-regulatory driving practices and motivators behind such behavioral changes, including strategies adopted to reduce or cease driving while maintaining safe mobility., Methods: A systematic literature search was performed on 11 online databases for quantitative studies describing self-regulation of driving amongst older adults aged 60 years and above from database inception until December 2018. Data were described narratively and, where possible, data were pooled using random-effects meta-analysis., Results: Of the 1556 studies identified, 54 studies met the inclusion criteria and 46 studies were included in the meta-analyses. All included studies examined car drivers only. Older adults who were single or female were found to be at higher odds of driving cessation. Physical fitness, mental health, social influence, and support systems received by older adults were important driving forces influencing mobility and adjustments made in their travel patterns., Conclusions: Driving self-regulation amongst older adults is a multifaceted decision, impacting mobility and mental health. Therefore, future interventions and support systems should not only create opportunities for retaining mobility for those who have ceased driving, but also promote better psychological and social well-being for regulators and for those who are transitioning from driving to non-driving status. Practical applications: (a) Engage and educate older adults about self-regulation, including strategies that can be adopted and non-car mobility options available. (b) Expand the research focus to explore potential interactions of factors facilitating or hindering the transition process to develop a more comprehensive framework of self-regulation. (c) Encourage ongoing research to formulate, monitor, and evaluate the effectiveness of policies and interventions implemented. (d) Expand the research horizon to explore and understand the perspectives of older adults from developing countries., (Copyright © 2019 Elsevier Ltd and National Safety Council. All rights reserved.)

Objective: The objective of this study was to address the uptake of safer vehicles and in-vehicle technologies among older adults through a better understanding of extent and use of safer vehicles and awareness/acceptance of new vehicle technologies. Methods: Data were collected from a sample of 501 active older drivers (those who drove at least once a week) through telephone surveys. Results: The sample included experienced and active drivers aged between 65 and 92 years (median 73 years). Though two-thirds indicated that safety was a priority in their vehicle choice, other factors such as reliability and vehicle make were more important. There was low awareness of driver assist safety features, particularly among the oldest drivers. Only one-quarter of drivers were receptive to paying extra for safety features, and there was no interest in paying more for driverless vehicles. Conclusions: The findings showed an overall low awareness and acceptance of in-vehicle safety features; however, where there was some awareness, there was greater interest in purchasing vehicles with safety features. More effort should be undertaken to develop and prioritize a set of recommendations to increase use of safe vehicles by older drivers.

Objectives: With the increasing popularity of cycling generally and availability of new bicycle child carriers, there is an emerging interest in the safety of child bicycle passengers and riders. However, very little is known about the nature and extent of injuries to child bicycle riders and passengers. The aim of this study was to enhance our understanding of child safety in bike transportation and to identify injury patterns and outcomes., Method: Analyses of Victorian hospital data (emergency department presentations and hospital admissions) were undertaken to describe and compare injury outcomes among children aged 0-3 years, 4-6 years, and 7-10 years on bicycles. Data over the 15-year period, July 1, 1999, to June 30, 2014, were examined., Results: A total of 17,859 emergency department presentations and 4,794 hospitalizations were reported for child cyclists under the age of 10 years. The rate of emergency department presentations and hospital admissions per 100,000 population decreased by 1.5% (-2.8 to -0.2%) and 5.0% (-6.5 to -3.4%), respectively. For emergency department presentations, the most commonly injured body parts included the head (34.9%), elbows and forearms (14.6%), and wrist and hands (16.3%). For hospital admissions, the head was again the most commonly injured body region (36.5%), followed by the elbow and forearm (26.7%) and shoulder and upper arm (9.1%). Comparisons of injured body regions between age groups revealed that children aged 3 and under were significantly more likely to sustain injuries to the head that required hospital admissions compared to older age groups. In contrast, older children, between the ages of 7 and 10 years, were significantly more likely to sustain injuries to either the arms, wrists, or hands. Further analysis of the nature of injury revealed that children aged 3 and under had a significantly higher number of open wound injuries compared to older children., Conclusion: This article provides an exploratory and broad overview of the magnitude and severity of injuries among child bike riders and passengers and highlights that younger children are more likely to sustain head injuries compared to older children. This is likely the result of very young children being passengers on bicycles who are constrained in a seat or trailer with little protection or opportunity to mitigate injuries., Highlights: • Analyses of injury data to understand the nature and extent of injuries to children on bikes as passengers and riders. • Child cyclist injuries as a significant safety issue within Victoria, Australia. • Young children aged 0-3 years experienced significantly more head injuries compared to older children.

Objectives: While there is much emphasis on managing the safety of older road users, there is limited understanding and recognition of the significance of mobility and transportation needs, mobility changes in later life, and the impact of reduced mobility on quality of life. Moreover, there is little information about the measures that can be taken to increase or at least maintain mobility in older age., Method: A systematic literature review was undertaken to address the issues associated with the transportation and mobility needs of older road users. Articles and publications were selected for relevance and research strength and strategies and measures aimed to manage the safe mobility of older road users were reviewed., Results and Discussion: The review provides clear evidence that, for older adults who cease driving, quality of life is reduced and that there are a number of adverse consequences of poor mobility. The misconceptions regarding the risks that older drivers pose on the road and how their safe mobility should be managed are discussed, particularly the implications of current licensing procedures on mobility. Evidence is also presented showing there are subgroups of older adults who are more likely to suffer more pronounced mobility consequences including women and financially disadvantaged groups. Moreover, "best-practice" strategies for maintaining at least some level of mobility for older adults are highlighted in four broad categories: safer road users, safer vehicles, safer roads and infrastructure, and provision of new and innovative alternative transport options that are specifically tailored to older adults., Conclusions: Provision of safe travel options that allow easy access to services and amenities is a vital factor in maintaining mobility amongst older road users. An understanding that continued mobility means access to a private vehicle, either as a driver (for as long as possible as it is safe to drive) or as a passenger, and easy and practical access to other forms of transport is essential in the management of health, well-being, and the safe mobility of older road users.

Using data from i) a simulated road-crossing task, ii) a battery of functional performance assessments, and iii) a survey of parents, some factors that may predict poor road-crossing skill were identified. Children aged between 6 and 10 years made road-crossing decisions in a simulated road environment in which time gap and speed of approaching vehicles were manipulated. Functional performance was examined using a range of tools designed to assess cognitive, perceptual, attentional and executive functioning. Parents also provided information on physical activity, exposure to traffic and road safety education. The results suggest that children predominantly made decisions based on distance gap and that younger children (6-7 year olds) were 12 times more likely than older children (8-10 year olds) to make critically incorrect (or unsafe) crossing decisions. Factors found to be associated with incorrect crossing decisions included lower perceptual, attentional, cognitive and executive performance, and independent travel. There were no gender differences associated with incorrect crossing decisions. This study has used a novel and safe way to identify 'at risk' groups of children and the findings have been used to develop and evaluate a practical educational and training program aimed at improving essential skills and strategies to cross roads safely amongst 'at risk' children.

Access to adequate and appropriate transport options enables older people to continue as thriving community participants, to reach services and to maintain social connections. While transport needs are diverse, and tend to change over time, there is little information on current and future transport patterns, and the awareness, acceptance and adoption of new technologies. A national online survey was administered to current drivers in Australia. A sample of 705 drivers provided information on available travel modes and use of these modes, awareness of in-vehicle technologies and future use of vehicle technologies. The findings revealed high use of private vehicles, walking and taxis but little use of other travel modes (bicycles, motorcycles, rideshare, community services and public transport). Age, gender and residential location influenced the availability and use/potential use of some transport options. Overall awareness of in-vehicle technologies was generally low and particularly so amongst older and female participants. There was some appetite to use emerging technologies in the future. The findings inform the development of effective strategies and initiatives aligned with healthy ageing and wellbeing targets, increased sustainability, resilience and connectedness, creation of healthier travel choices and healthier environments to promote acceptance and use of a range of transport options and uptake of safer vehicles equipped with in-vehicle technologies to ultimately enhance safe and sustainable mobility of older road users. [ABSTRACT FROM AUTHOR]

• Combining GPS and video footage data offers unique and objective data to examine in-depth and real-time insight into route choice decisions at critical points during trips. • In addition to previously identified factors, additional dynamic traffic conditions (high traffic density, public transport, congestion, and traffic signal phasing) can impact route choice decisions. • Cyclists may be sensitive to features of the transport network at the micro level and continually negotiate their route. These influences may sometimes override broad factors and lead a cyclist to choose a less safe option. • These findings have implications for route planning strategies and technologies that may improve cyclists' awareness of the importance of route choice, especially in terms of safety. The choices cyclists make on which roads to travel on can have a significant impact on their safety. This paper aims to improve our understanding of the broad and subtle influences in route choice amongst cyclists, and describe the strengths and limitations of using naturalistic observational data for this purpose. Naturalistic cycling observational data (GPS and video footage) were accessed from a sample of 97 cyclists riding in their natural setting on urban roads in Melbourne, Australia. Using GIS software, GPS traces were utilised in combination with video footage to map and define routes taken by the participants over two weeks (or up to 6 h) of cycling. The findings showed that most cyclists travelled on two to three routes and that safety and the environment were important factors. The findings also revealed route variations within the same origin-destination pair, and found that subtle real-time traffic and operational conditions can may influence route choice, with the potential for cyclists to choose less safe routes. These findings have implications for route planning strategies and technologies that may improve cyclists' awareness of the importance of route choice, especially in terms of safety, and inform development of potential resources and technologies that can provide real-time information on specific routes. [ABSTRACT FROM AUTHOR]

Objective: This study set out to provide pretrial data for use in evaluating the benefits of lower speed limits in a local residential area in Melbourne.Methods: An online survey was conducted to assess community views among residents to the proposed trial on a number of relevant issues, along with speed measurements at more than 70 road sites in the region.Findings: The findings showed a degree of support for reducing the speed in local streets in the trial region, even though most respondents thought the current speed limit (40 km/h, 25 mph) was about right. Most agreed that reducing the speed limit in the region was good for safety and would make the area more pleasant. The average travel speed was 28.3 km/h (17.7 mph) and the 85th percentile speed was 35.0 km/h (21.9 mph) from onsite speed measurement (42% of the individual speeds recorded at the test sites were over 30 km/h or 18.75 mph).Conclusions: These findings give support to the expectation that lower speed limits on local streets may be possible with good community support. [ABSTRACT FROM AUTHOR]

Abstract: For many older adults in most of the Western world, continued mobility (with associated health, well-being, independence and quality of life) means access to a private vehicle, either as a driver or as a passenger. However older driver serious injury and fatality rates per distance travelled are higher than middle-aged drivers, and crash and injury rates are likely to increase in the coming decades as a result of the ageing population, increased car ownership and overall travel amongst older people. Evidence suggests that contributory factors to this high risk are (for most) frailty, (for some) the high proportion of driving in urban areas, and (for a few) reduced fitness to drive as a result of medical conditions and associated functional limitations. Australasia has recently adopted the ‘Safe System’ approach which aims to manage vehicles, the road infrastructure, speeds, and the interactions between these components, to ensure that when crashes do occur, crash energies will remain at levels that minimize the probability of death and serious injury. A system which aspires to achieving Safe System objectives cannot ignore the challenges that older road users pose – and will pose – to the transport system. This paper discusses the so-called ‘older driver problem’, presents crash data and evidence of the impacts of driving location and reduced fitness to drive on crash risk, and recommends countermeasures within the ‘Safe System’ context, with particular reference to urban road design and operation. [ABSTRACT FROM AUTHOR]

Abstract: This paper describes an investigation of safety, mobility and travel patterns in a sample of older women drivers and former drivers aged 60 years and over. Participants provided information on general health and functional abilities, travel and driving patterns, driving experiences and confidence, difficulty with and avoidance of driving situations, self-assessment of driving ability, crash and infringement history, the process and experiences leading up to stopping driving, and satisfaction with current mobility. The sample was a fairly active group, travelling frequently and substantial distances, and generally satisfied with their level of mobility. Current drivers were strongly interested in keeping driving for as long as possible, expressed strong concerns about the prospect of stopping driving and reported little evidence of self-regulation. In contrast, former drivers were less negative about driving cessation and mostly reported successful retirement from driving with few negative mobility consequences. Further, a number of relationships between crash involvement and driving experience, confidence of being a safe driver, and problems in driving situations were found. These findings have added to our understanding of the issues concerning the safety and mobility of older women. Implications for the promotion of safe driving practices are discussed. [Copyright &y& Elsevier]

The article examines differences in attitudes toward driving cessation, life satisfaction, and mobility between current and former drivers by conducting surveys of adults 60 years and older in three Australian jurisdiction. It also highlights some of the factors that are linked with a more acceptable transition to nondriving and those that have a more favorable mobility outcome. The implications of these findings are also cited.

Abstract: Older drivers are currently over-represented in severe injury crashes at intersections due in part to increases in frailty and functional disabilities that occur with age. Moreover, this rate is expected to increase as older people drive more and the population ages. Road design plays a major role in road safety and is likely to contribute to the driving difficulties of the elderly because of the general lack of consideration of the needs of older road users. Intersections, in particular, stand out as a major problem for older road users. This paper reviews age-related performance deficits that affect driving and describes a crash ‘black-spot’ site analysis that examined the relationship between intersection design features (believed to influence the safety of older drivers) and the older driver crash experience in Australasia. A number of intersection design problems for older drivers were identified and recommendations for changes in road design features and traffic management practices that have the potential to reduce crash and injury risk for older drivers at intersections are made. [Copyright &y& Elsevier]

Abstract: The over-representation of intoxicated pedestrians in serious injury and fatal crashes compared to non-intoxicated pedestrians may be due, in part, to the effects of alcohol on the ability to select gaps in the traffic for safe road-crossing. An experiment is described that tests the effectiveness of an experimental approach to elicit road-crossing responses among groups of intoxicated (BAC=between 0.05% and 0.10%, mean=0.07%) and sober adults (BAC=0.00%). Some subtle effects of alcohol on road-crossing decisions were found, particularly at higher BAC levels of 0.07–0.10%. Highly intoxicated participants showed some lack of awareness of impairment, a tendency to engage in risky road-crossings, and difficulty integrating speed and distance information in a timely manner, necessary to select safe gaps in the traffic. These results are discussed in terms of the effect of alcohol impairment on perceptual and cognitive capacities and the ability to compensate for impairment. Importantly, this study has established a methodology on which further research can be conducted to examine the road-crossing behaviour of those with high levels of BAC and other forms of impairment. [Copyright &y& Elsevier]

Abstract: The over-representation of older pedestrians in serious injury and fatal crashes compared to younger adults may be due, in part, to age-related diminished ability to select gaps in oncoming traffic for safe road-crossing. Two experiments are described that examine age differences in gap selection decisions in a simulated road-crossing environment. Three groups of participants were tested, younger (30–45 years), young–old (60–69 years) and old–old (>75 years). The results showed that, for all age groups, gap selection was primarily based on vehicle distance and less so on time-of-arrival. Despite the apparent ability to process the distance and speed of oncoming traffic when given enough time to do so, many of the old–old adults appeared to select insufficiently large gaps. These results are discussed in terms of age-related physical, perceptual and cognitive limitations and the ability to compensate for these limitations. Practical implications for road safety countermeasures are also highlighted, particularly the provision of safe road environments and development of behavioural and training packages. [Copyright &y& Elsevier]

• A pioneering study exploring self-regulatory practices amongst motorcycle riders. • Motorcycle riders were found to be at risk of crash involvement and riding cessation. • Behavioural and psychological factors were important contributors to self-regulation. • Interventions should be customised to cater for populations with mixed travel modes. The ability to drive longer and safely are crucial for many older adults. There is a growing evidence on self-regulatory practices amongst older drivers in developed countries, but limited studies are conducted in developing countries. This study aimed to explore self-regulatory practices amongst older Malaysian car drivers and motorcycle riders. A cross-sectional study was conducted amongst older adults aged 60 years and above residing in two states located in the west coast of Peninsular Malaysia using a self-administered questionnaire. Stepwise regressions were performed to identify for key factors associated with driving/riding self-regulation and crash involvement. Multilevel modelling was conducted to examine the clustering effect of respondents recruited from the two states. Six-hundred and thirty-seven respondents completed the questionnaire, with over three-quarters of them still driving/riding at the time of data collection. Physical fitness, behavioural and psychological changes experienced with advancing age were important motivators towards self-regulation. Motorcycle riders were found to be at a higher risk of crash involvement, and they were more prone to cease riding compared to car drivers. Self-regulatory practices amongst older car drivers and motorcycle riders were found to be different. As such, there is a need to customise evidenced-based approaches to cater for specific age groups and road users, particularly in a developing country like Malaysia, where motorcycle is often considered as an affordable mode of transport and is largely involved in road traffic crashes. [ABSTRACT FROM AUTHOR]

Objectives: Engaging in active transport modes (especially walking) is a healthy and environmentally friendly alternative to driving and may be particularly beneficial for older adults. However, older adults are a vulnerable group: they are at higher risk of injury compared with younger adults, mainly due to frailty and may be at increased risk of collision due to the effects of age on sensory, cognitive, and motor abilities. Moreover, our population is aging, and there is a trend for the current cohort of older adults to maintain mobility later in life compared with previous cohorts. Though these trends have serious implications for transport policy and safety, little is known about the contributing factors and injury outcomes of pedestrian collision. Further, previous research generally considers the older population as a homogeneous group and rarely considers the increased risks associated with continued ageing. Method: Collision characteristics and injury outcomes for 2 subgroups of older pedestrians (65-74 years and 75+ years) were examined by extracting data from the state police-reported crash dataset and hospital admission/emergency department presentation data over the 10-year period between 2003 and 2012. Variables identified for analysis included pedestrian characteristics (age, gender, activity, etc.), crash location and type, injury characteristics and severity, and duration of hospital stay. A spatial analysis of crash locations was also undertaken to identify collision clusters and the contribution of environmental features on collision and injury risk. Results: Adults over 65 years were involved in 21% of all pedestrian collisions. A high fatality rate was found among older adults, particularly for those aged 75 years and older: this group had 3.2 deaths per 100,000 population, compared to a rate of 1.3 for 65- to 74-year-olds and 0.7 for adults below 65 years of age. Older pedestrian injuries were most likely to occur while crossing the carriageway; they were also more likely to be injured in parking lots, at driveway intersections, and on sidewalks compared to younger cohorts. Spatial analyses revealed older pedestrian crash clusters on arterial roads in urban shopping precincts. Significantly higher rates of hospital admissions were found for pedestrians over the age of 75 years and for abdominal, head, and neck injuries; conversely, older adults were underrepresented in emergency department presentations (mainly lower and upper extremity injuries), suggesting an increased severity associated with older pedestrian injuries. Average length of hospital stay also increased with increasing age. Conclusion: This analysis revealed age differences in collision risk and injury outcomes among older adults and that aggregate analysis of older pedestrians can distort the significance of risk factors associated with older pedestrian injuries. These findings have implications that extend to the development of engineering, behavioral, and enforcement countermeasures to address the problems faced by the oldest pedestrians and reduce collision risk and improve injury outcomes. [ABSTRACT FROM AUTHOR]

Highlights: [•] The study examined the effects of functional declines on older pedestrians safety. [•] Older-old made more decisions that would have led to collisions with approaching cars. [•] Several functional performance measures were predictors of these dangerous choices. [•] That is, walking speed, time-to-arrival estimates, UFOV thresholds and attention shifting. [•] The findings have implications in terms of speed limits, road design, and training. [Copyright &y& Elsevier]