Why Might Older People Get Injured More Easily After A Car Accident? (And What Is Post-Traumatic Arthritis?)

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Why Might Older People Get Injured More Easily After A Car Accident? (And What Is Post-Traumatic Arthritis?)

It is a fact that in the modern world, life expectancy is higher than ever. And as we live longer, on average, it is not uncommon to see elderly drivers on the road each time we drive a car. Many older people try to have an active life style and driving a car is a significant part of it.  In fact, a few years ago there were almost 42 million drivers older than 65 years of age in the USA alone, which is twice as much as it was in 1999.1

Unfortunately, around 290,000 elderly people were treated in the ER after car accidents in 2016, though this is not that big of a number considering the total number of elderly drivers.2

Many will think that elderly people are the worst possible drivers, but the studies show that actually they are less involved in car accidents than other age groups. It is believed that this is related to the fact that they avoid possibly dangerous situations. Recent studies show that there is no distinct age relationship with regard to involvement in car accidents.3

However, even if they are less involved in car accidents, the consequences of these accidents are more devastating than in case of younger individuals.4

The human body constantly changes as we age. Every tissue in the human body suffers from age-related changes. Some of them might have an impact on the ability to drive safely in traffic. Most middle-aged and elderly people suffer from arthritic changes in different body joints. The muscles are weaker and joints are stiffer which can have a negative effect on their ability to turn the steering wheel and press the brake or clutch. Another consideration is medications, which can have side effects that can influence their ability to drive vehicles or to react on time to prevent accidents.5,6

In the case of motor vehicle injuries among the elderly, almost every third individual had an injury of the head or neck. This was followed by injuries to the lower extremities and upper extremities.5

Head injuries in car accidents are usually caused by direct blows to the head. The severity of injury depends on the amount of force applied to the head. In elderly people, blood vessels in the brain have lost their elasticity and are more fragile, so even a smaller amount of force can cause their rupture and bleeding. This can lead to serious consequences or even death.7,8

Spine injuries are very common in car accidents. Whiplash and spine sprains or strains are quite common in younger people. But in the elderly, the spine is not as elastic as it was before, so it can’t resist forces applied to it in case of car accidents. Increased tension during hyperflexion or extension can cause more severe injuries than in younger individuals. Ligaments, muscles, and joint capsules are more fragile, so a smaller force is required for them to tear.8,9

Osteoporosis is a significant risk factor for fractures. It is a disease which affects human bones, and its main characteristic is reduced bone mineralization which leads to loss of bone strength. Osteoporosis can occur in younger adults in specific situations, like prolonged immobilization of a body part for example. But in older people it is almost a regular issue and it is very common, affecting over 75 million people in the USA, Europe, and Japan.10

Women are more frequently affected by osteoporosis. Every third facture in women older than 50 years of age is caused by osteoporosis, and in men every fifth fracture is caused by osteoporosis.11

In the case of car accidents, a significant force can be applied to different parts of bodies. A healthy, young individual might suffer that amount of force and not sustain any serious injury. However, in the case of elderly people, their bodies and bones are more fragile and susceptible to injuries, especially fractures.5

Fractures of different parts of upper or lower extremities in elderly people are frequent in car accidents. They are usually caused by a minor trauma, but a high-energy trauma can cause very severe injuries to the extremities.

If a fracture is non-displaced, it usually heals well even in the elderly. However, if the fracture is comminuted or if it affects the joint, it tends to be more severe.

What Is Post-Traumatic Arthritis?

Generally speaking, joints connect two different bones and allow us movement and other sophisticated functions. Most joints are covered by cartilage which is very smooth, and for it to retain normal function it is essential that it stays that way. When we get older, the cartilage changes with us too. It becomes more fragile and thin, and cracks occur which can’t heal. These are some characteristics of osteoarthritis. If a fracture occurs in the joint, the cartilage will be damaged. If bone fragments located in the joint remain dislocated, they will heal that way. Even 2 mm of dislocation in joints is considered severe. With repetitive use over a course of months or years, this step in the joint will cause increased force applied to other parts of the joint which will lead to faster cartilage damage and arthritis. This is called post-traumatic arthritis.

The best way to prevent post-traumatic arthritis is to perform a good fracture reduction at the joint line so there is no significant step.

In conclusion, older people are at higher risk of injuries in car accidents due to chronic changes within their bodies. And in case of joint injuries, they have a higher chance of developing post-traumatic arthritis.

  1. Federal Highway Administration, Department of Transportation (US). Highway Statistics 2016. Washington (DC): FHWA; September 2018. Available at: https://www.fhwa.dot.gov/policyinformation/statistics/2016/
  2. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta, GA: CDC; 2017. Available at: https://www.cdc.gov/injury/wisqars/index.html
  3. “Seniors Vs. Young Drivers: Who Causes More Accidents?.” FreeAdvice. N. p., 2019. Web. 1 Dec. 2019.
  4. Preusser D, et al. Fatal crash risk for older drivers at intersections. Accident Analysis and Prevention 1998;30:151-159.
  5. Azami-Aghdash, Saber, Mir Hossein Aghaei, and Homayoun Sadeghi-Bazarghani. “Epidemiology Of Road Traffic Injuries Among Elderly People; A Systematic Review And Meta-Analysis.” Bulletin of Emergency and Trauma 6.4 (2018): 279-291. Web. 1 Dec. 2019.
  6. “Facts & Research – AAA Senior Driving.” Seniordriving.aaa.com. N. p., 2019. Web. 1 Dec. 2019.
  7. “Car Accident TBI.” Traumatic Brain Injury. N. p., 2019. Web. 1 Dec. 2019.
  8. “Trauma In Older Adults: An Overview Of Injury Patterns And Management.” Reliasmedia.com. N. p., 2012. Web. 1 Dec. 2019.
  9. Ikpeze, Tochukwu C., and Addisu Mesfin. “Spinal Cord Injury In The Geriatric Population: Risk Factors, Treatment Options, And Long-Term Management.” Geriatric Orthopaedic Surgery & Rehabilitation 8.2 (2017): 115-118. Web. 1 Dec. 2019.
  10. EFFO and NOF (1997) Who are candidates for prevention and treatment for osteoporosis? Osteoporos Int 7:1.
  11. Melton LJ, 3rd, Atkinson EJ, O’Connor MK, et al. (1998) Bone density and fracture risk in men. J Bone Miner Res 13:1915.