A Comparison of Health Outcomes in Older versus Younger Adults following a Road Traffic Crash Injury: A Cohort Study

Abstract

BackgroundGiven the aging demographics of most developed countries, understanding the public health impact of mild/moderate road traffic crash injuries in older adults is important. We aimed to determine whether health outcomes (pain severity and quality of life measures) over 24 months differ significantly between older (65+) and younger adults (18–64).MethodsProspective cohort study of 364, 284 and 252 participants with mild/moderate injury following a vehicle collision at baseline, 12 and 24 months, respectively. A telephone-administered questionnaire obtained information on socio-economic, pre- and post-injury psychological and heath characteristics.ResultsAt baseline, there were 55 (15.1%) and 309 (84.9%) participants aged ≥65 and 18–64 years, respectively. At 12- and 24-month follow-up, older compared to younger participants who had sustained a mild/moderate musculoskeletal injury had lower physical functioning (3.9-units lower Short Form-12 Physical Composite Score, multivariable-adjusted p = 0.03 at both examinations). After multivariable adjustment, older (n = 45) versus younger (n = 207) participants had lower self-perceived health status (8.1-units lower European Quality of Life-5 Dimensions Visual Acuity Scale scores at 24 months, p = 0.03), 24 months later.ConclusionsOlder compared to younger participants who sustained a mild/moderate injury following a road-traffic crash demonstrated poorer physical functioning and general health at 24 months.

Functioning and health-related quality of life following injury in older people: a systematic review

“…There were six studies on hip fracture,28–31 32 four studies on traumatic brain injury (TBI)),33 34 35 36 one study on wrist fracture,37 one study on any type of injury38 and one study on mild-to-moderate musculoskeletal injury following a road crash 39…”

“…Of the 13 studies, 10 only included participants aged ≥65 years, the other 3 studies included people aged <65 years33 36 39 (table 2). …”

“…A variety of outcome measures were used (table 1): six studies used the FIM,28 29 31 33 32 36 three studies used the EQ-5D,28 30 39 four studies used SF-12,37 39 35 32 two studies used the SF-36,31 38 three studies used the GOS-E34 35 36 and one study used the WHOQOL-BREF 40. Of the 15 studies, 6 studies (46%) used more than one outcome measure (table 2).…”

“…Overall, seven studies examined the effect of age on outcomes: four studies reported results stratified by age group33 37 38 34 and three studies reported results for adults aged <65 vs ≥65 years33 39 36 (table 2). …”

“…There was heterogeneity in the timing and overall length of follow-up, the latter ranging from discharge to 24 months postinjury39 (with the exception of one study with no fixed follow-up times and mean follow-up of 2.8 years (range 1.5–4.5 years)38). Furthermore, some studies included deaths in their follow-up rates.…”