Functioning and Disability
jihui jeon, MD
resident
seoul national university hospital
seoul, Seoul-t'ukpyolsi, Republic of Korea
Ja-ho Leigh, PhD
Professor
National Traffic Injury Rehabilitation Research Institute
Yangpyeong, Kyonggi-do, Republic of Korea
Traffic accidents involving older drivers are increasing in Korea. Age-related declines in cognitive function, visual perception, and attention contribute to driving risk. This study aimed to (1) identify traffic accident risk factors among older drivers and (2) determine whether certain subgroups have accident rates comparable to those of younger drivers.
Design:
This population-based study used data from the Korea Road Traffic Authority. Korean drivers aged ≥75 are mandated to undergo a driving aptitude test every three years, which assesses cognition, attention, visuospatial perception, and coordination relevant to driving. Individuals tested in 2019 were included, and their records were cross-referenced with police-reported accidents through August 2021. The dataset included age, sex, region, test performance grade, and post-test accident records. National accident rates for all licensed drivers were also collected. Cox regression identified risk factors, and logistic regression predicted accident probability. The accident rate of drivers aged 60–69 served as a standardized reference.
Results:
A total of 100,825 older drivers were included. The 2019–2021 accident rate was 7.1 per 100 drivers. Females (HR = 0.63) and metropolitan residents (HR = 0.83) had significantly lower accident risk, whereas low scores on cognitive screening (MMSE < 24) had higher risk (HR = 1.13). After adjustment, high performance drivers had lower accident risk than those with moderate performance. Among high performance drivers aged 75–84, accident risk did not increase with age. Notably, all drivers under 85 with moderate-to-high performance had lower accident risk than the estimated 6.8% rate of drivers aged 60–69.
Conclusion:
Cognitive function emerged as a stronger determinant of accident risk than age among older drivers. High-performance older drivers showed consistently low risk across ages and even lower rates than drivers in their 60s, identifying a “relatively safe older driver group.” Moderate performance drivers had accident risk comparable to drivers in their 60s.
