Traffic Inj Prev. 2026 Mar 11:1-8. doi: 10.1080/15389588.2026.2628080. Online ahead of print.
ABSTRACT
OBJECTIVES: The circumstances of fatal crashes among older drivers have been attributed to a few typical triggers, most commonly erroneous maneuver and acute disease. Whether these triggers are one-off events or can be linked to existing potentially driver-impairing (PDI) conditions and medications remains to be determined. This study investigates this question more closely.
METHOD: Drivers aged 50 and older who died on the road between 2010 and 2019 as a result of an erroneous maneuver or an acute disease were identified in the Swedish In-Depth Registry of Road Fatalities (n = 332 and n = 193, respectively). Their history of PDI conditions and medications prior to the fatal crash was then traced in the National Patient Register (hospitalization and specialized outpatient care in the past 12 months) and the National Prescribed Drug Register (past three months).
RESULTS: For both triggers, more than half of the drivers had no documented PDI condition in the past 12 months (51.3% and 55.7%, respectively) and when they did, cardiovascular condition was by far the most common one (20.2% and 32.6%), significantly more prevalent than at population level in both instances. By contrast, over 75% were on PDI medication in the past three months, with cardiovascular ones being the most prevalent (53.6% and 68.9%), followed by three groups acting on either blood and blood-forming organs (20.2% and 29.0%), the nervous system (31.0% and 21.2%), and the alimentary tract and metabolism (21.4% and 22.3%).
CONCLUSION: An underlying driver-impairing condition can be detected in remarkably many instances of fatal crashes typical for older drivers; those triggered by either an erroneous maneuver or an acute disease. The latter is more readily discernible in the medications they are prescribed than in their relatively recent hospital care history. In both scenarios, a current cardiovascular condition features prominently, either as a past-year treated condition or an ongoing targeted pharmaceutical treatment. A few additional ones are also detectable which prevalence and rank are trigger specific. These findings underscore the importance of individualized medication reviews and, where appropriate, deprescribing, alongside the responsibilities of both drivers and health care providers.
PMID:41811302 | DOI:10.1080/15389588.2026.2628080