Drug Use and the Risk of Motor Vehicle Collision in Adults 65 Years of Age and Older

Abstract

The population of adults 65 years of age and older is growing at an exponential rate in the United States. The current generation of older adults is more mobile and driving much later in life compared to previous cohorts. While the current generation of older adults is living longer, they are not necessarily healthier. Older adults consume roughly 30% of all written prescriptions, are the largest consumers of over-the-counter medications, and report a higher prevalence of lifetime licit and illicit drug use compared to previous generations. There is concern that many older adults will drive while taking drugs-either illicit or licit-that will interfere with their ability to safely operate a motor vehicle. Licit and illicit drug use is largely understudied in this population of drivers, particularly in the United States. Methods: This study employed a systematic review to discern which individual licit drugs were associated with increased risk/odds of motor vehicle collision, a cross-sectional analysis of a national traffic fatality database to discern which types of licit and/or illicit drugs and combinations were most prevalent among fatally injured senior drivers compared to middle-aged drivers, and a case-crossover study using electronic medical records to assess the risk that individual licit drugs pose to drivers 65 years of age and older in West Virginia who were admitted to medical treatment following a motor vehicle collision. Results: Among the 53 specific medications investigated by the 27 studies included in the systematic review, 15 medications (28.3%) were associated with an increased risk of motor vehicle collision. The medications that were associated with an increased risk of collision were: