What affects the safety of older people in road transportation? A narrative review
DOI:
https://doi.org/10.61089/aot2026.3psn2x08Keywords:
older road user, road safety, ageing population, crash risk, mobilityAbstract
This narrative review examines the factors affecting the safety of road users aged 65 years and older, with particular attention to drivers, pedestrians, and cyclists. Its purpose is to integrate evidence that has usually been discussed separately for individual road-user groups and to identify both group-specific risks and cross-cutting prevention priorities. Publications were selected through iterative, relevance-based searches of the Web of Science database using combinations of terms relating to older road users, crashes, health, functional limitations, behaviour, infrastructure, technology, and regulation. The final narrative synthesis comprised 141 analysed publications and documents. The scientific literature covered 1995-2024; three additional official statistical and institutional sources provided contextual data, while a later legal document was consulted to verify the current regulatory framework. The synthesis shows that age-related deterioration in visual, cognitive, and motor functions affects the ability to perceive hazards, process complex traffic situations, maintain balance, and react in time. Older drivers are particularly vulnerable at intersections, where failure to yield and difficulties in rapid situational assessment are recurrent crash factors. Chronic disease, visual impairment, polypharmacy, and mental workload can further reduce driving fitness. Older pedestrians face elevated injury and fatality risk because of slower walking speed, impaired estimation of vehicle speed and distance, unsafe crossing choices, greater physical frailty, and emerging conflicts with e-scooters in pedestrian space. Among older cyclists, loss of balance during mounting, stopping, low-speed manoeuvres, or encounters with kerbs is a major crash mechanism, and head and lower-extremity injuries are especially important. The review indicates that no single intervention is sufficient. The most promising approach combines age-friendly infrastructure, vehicle and bicycle technologies, targeted education and practical training, medical and cognitive assessment, proportionate licensing procedures, and viable alternatives to private-car use. Safety measures should reduce crash and injury risk without unnecessarily limiting mobility, independence, and social participation. The review's added value lies in analysing the three principal older road-user groups within one road-safety framework and in linking individual limitations with environmental, technological, and regulatory responses. The findings can guide coordinated infrastructure, policy, screening, and mobility-support measures.
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