The Elderly and Mobility: a Review of the Literature

The ability to travel is associated with freedom, activity and choice and driving offers an important mobility option for most elderly. Driving cessation is linked to an increase in depressive symptoms and a decline in out-of-home activity levels and community mobility. Further, for at least some people, the same health conditions and functional impairments that cause a change in driving patterns will also limit access to other transport options (walking, cycling, public transport), thereby further contributing to restricted community mobility and its consequences. Driving status thus plays a critical role in the complex interactions between ageing, physical and psychological health, community mobility and use of health services. A good understanding of these relationships is required in order to enable older people to maintain economic and social participation and quality of life. This report provides a comprehensive review of international literature to assess the current state of knowledge with regard to the complex relationships between changing driving and travel patterns, ageing, health status, and reduced mobility and the impact of poor mobility on quality of life. The findings from the literature review were used to compile a set of 'best-practice' recommendations to effectively manage the safe mobility of elderly road users. It is recommended that a coordinated approach that encompasses innovative strategies and initiatives to manage the mobility of older road users be adopted. Such an approach should include measures that focus on safer road users (appropriate management of 'at-risk' older drivers through appropriate licensing procedures and development of targeted educational and training programs), safer vehicles (improved crashworthiness of vehicles, raising of awareness amongst older drivers of the benefits of occupant protection, and development of ITS technologies), safer roads (creating a safer and more forgiving road environment to match the characteristics and needs of older road users), and improvements to alternative transport options (provision of accessible, affordable, safe and coordinated transport options that are tailored to the needs of older adults and promotion and awareness of alternative transport options amongst older drivers and their families/caregivers). Options for further research are also highlighted. Poor mobility places a substantial burden on the individual, families, community and society and there is a real need for policy makers, local governments and communities to consider the transportation needs of the elderly to support ongoing mobility.