Why Are Older Adults More at Risk as Pedestrians? A Systematic Review

OBJECTIVE

To explore factors that could explain why older adults are more at risk at the roadside.

BACKGROUND

The physical and psychological health benefits of walking have been well-established, leading to the widespread promotion of walking amongst older adults. However, walking can result in an increased risk of injury as a pedestrian at the roadside, which is a greater risk for older adults who are overrepresented in pedestrian casualty figures.

METHOD

Relevant databases were searched up to January 2020. All peer-reviewed journals that presented data on healthy older adults and some aspect of road crossing or roadside behavior were included. A total of 142 papers were assessed and 60 met the inclusion criteria.

RESULTS

Identified papers could be grouped into three areas: crossing at a designated crossing place; crossing with no designated crossing place; perceptions or behaviors.

CONCLUSION

Multiple individual (attitudes, perceived behavioral control, walking time, time-to-arrival judgments, waiting endurance, cognitive ability), task (vehicle size, vehicle speed, traffic volume), and environmental (road layout, time of day, weather) constraints influence road crossing in older adulthood.

APPLICATION

Accessibility of designated crossing areas needs to be addressed by ensuring sufficient time to cross and nonrestrictive waiting times. Signalized crossings need to be simplified and visibility increased. Where there is no designated crossing place, a reduction in speed limit alongside the provision of pedestrian islands to provide "pause" places are needed. Educational-based programs may also help ensure safety of older adults where there is no designated crossing place.

Effects of secondary tasks on auditory detection and crossing thresholds in relation to approaching vehicle noises

Research suggests an association between distracting environmental sound stimuli and poorer performance in detecting and localizing approaching vehicles using auditory cues. However, no studies have investigated the distractive potential posed by intrapersonal distractors in the context of pedestrian auditory perception. We examined the effects of holding naturalistic vocal and texting cell phone conversations on participants' auditory detection of approaching vehicles and crossing thresholds in a non-visual simulated setting. Ninety-nine adults were randomly assigned to conditions of vocal conversation, texting conversation, or a control group and completed an auditory vehicle detection task. Participants in the vocal cell phone conversation group detected vehicles at significantly shorter distances than participants in the control group. The concurrence of a secondary task did not affect the distances at which participants deemed vehicles noise too close for them to safely cross (i.e., crossing thresholds). Implications for future research and injury prevention are discussed.