Review of safety and mobility issues among older pedestrians
Introduction
A common desire among older adults is to stay where they are as they age, while remaining mobile in their familiar environment (Lord and Luxembourg, 2006). The ability to stay connected to community services and to maintain social interactions is considered today to be crucial to well-being and successful aging (for a review, see Yen and Anderson, 2012). Beyond the need for mobility, walking is known to be the most common physical activity of older adults (McPhillips et al., 1989) and to have positive effects on health, cognition, and well-being (see e.g., Fox et al., 2007; for a review, see Kramer and Erickson, 2007). However, walking may be dangerous because it exposes the walker to accident risks and falling.
Within the last few decades, research has mostly focused on the safety of older drivers. The study of older pedestrians is more recent and more limited, even though a large portion of pedestrian accidents involve an older adult. For example, in Italy, Greece and France, more than half of all pedestrians killed on the road are over 65 years of age, whereas this age group represents a much smaller part (17–20%) of the population (ONISR, 2006, SafetyNet, 2009). The same pattern of over-implication of older adults in pedestrian casualties and injuries has also been observed in non-European countries such as New Zealand (Keall, 1995).
Being hit while crossing a street is not the only safety risk encountered by pedestrians: the risk of falls also increases dramatically with aging. About one third of adults age 65 or older have experienced a fall within the past year (for a review, see Lord et al., 2001). More than half of all falls in independent older community-dwelling people occur outside the home (Fothergill et al., 1995, Lord et al., 2001). Although the data are scarce, a study conducted on the US population reported that 77.5% of pedestrian’s nonfatal injuries were linked to a fall; accidents while crossing the street (15%) and overexertion (5.8%) were the other main causes (Naumann et al., 2011; see also Abou-Raya and ElMeguid, 2009).
The aim of the present paper was to comprehensively portray older pedestrians’ safety difficulties in carrying out three main tasks involved in travel on foot, i.e. walking and obstacle negotiation, navigation, and street crossing. To provide a more general understanding of these difficulties, we also report the underlying functional changes that occur with aging (sensorial, cognitive, and physical) and their consequences on pedestrian safety and mobility. Identifying risky situations and their main causes is a preliminary step toward developing efficient actions aiming at improving the safety and mobility of older pedestrians. Some of these programs are presented at the end of the paper.
Section snippets
Walking and obstacle negotiation
Directly linked to the risk of falling, walking and obstacle negotiation are two major components of pedestrian mobility that change during aging.
Wayfinding
Wayfinding is another important pedestrian activity. It can be divided into preparing for the journey (i.e., planning) and navigating while walking (i.e., moving and orientation).
Street crossing
Crossing a street is a complex task that requires several actions (Bailey et al., 1992). First, pedestrians have to select an adequate crossing place, approach the curb, and look for oncoming vehicles and/or traffic lights. If there is no traffic light, pedestrians then have to select an adequate moment to cross by judging the available gaps in the flow of traffic. From there, they have to adapt their start-up time and crossing time to the amount of time available for crossing, by calibrating
Functional changes affecting older pedestrians’ safety
Many components of pedestrian activity are affected by the normal aging process and may therefore have a negative impact on older pedestrians’ safety and mobility. These overall functional changes pertain to sensory, cognitive, and physical abilities, as well as self-perception.
Recommendations for improving safety and mobility
The studies reviewed above have shed light on the main causes of older adult pedestrian’s high rate of involvement in fatalities and injuries. Some of these factors are linked to the road user him/herself (i.e., declines in sensory, cognitive, and physical abilities, and incorrect estimation of one’s own capabilities). Risk factors linked to the road environment play an important role too (e.g., complexity of road infrastructures, vehicle speed). However, despite this accumulated knowledge,
Conclusion
Walking is the cheapest, easiest, and most sustainable way to get around. Every trip begins and ends by walking, which is the common link in the multimodal travel chain. While walking is the most common transportation mode used by older people, it is also a particularly risky activity for this population. Although population aging and urbanization, and in particular the development of “global age-friendly cities” (WHO, 2007), have been identified as two of the most important challenges of the
Acknowledgements
The work was funded by DG Move, through the SAMERU project (agreement number MOVE/SUB/2010/D3/300-1/SI2.565668-SAMERU), aimed at investigating the safety and mobility of elderly road users. The authors would like to thank Vivian Waltz for the English editing.
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