Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study

J Am Geriatr Soc. 2011 Sep;59(9):1575-80. doi: 10.1111/j.1532-5415.2011.03561.x. Epub 2011 Aug 24.


Objectives: To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.

Design: Retrospective population-based case-crossover study.

Setting: A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.

Participants: Six hundred sixteen individuals aged 60 and older who were hospitalized as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.

Measurements: Hospitalization after a motor vehicle crash.

Results: Greater risk for a hospitalization crash was found for older drivers prescribed benzodiazepines (odds ratio (OR)=5.3, 95% confidence interval (CI)=3.6-7.8, P<.001), antidepressants (OR=1.8, 95% CI=1.0-3.3, P=.04), and opioid analgesics (OR=1.5, 95% CI=1.0-2.3, P=.05). Crash risk was significantly greater in men prescribed a benzodiazepine (OR=6.2, 95% CI=3.2-12.2, P<.001) or an antidepressant (OR=2.7, 95% CI=1.1-6.9, P=.03). Women prescribed benzodiazepines (OR=4.9, 95% CI=3.1-7.8, P<.001) or opioid analgesics (OR=1.8, 95% CI=1.1-3.0, P=.03) also had a significantly greater crash risk. Subgroup analyses further suggested that drivers with (OR=4.0, 95% CI=2.9-8.1, P<.001) and without (OR=6.0, 95% CI=3.8-9.5, P<.001) a chronic condition who were prescribed benzodiazepines were at greater crash risk. Drivers with a chronic condition taking antidepressants (OR=3.4, 95% CI=1.3-8.5, P=.01) also had a greater crash risk.

Conclusion: Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / adverse effects
  • Antidepressive Agents
  • Automobile Driving*
  • Benzodiazepines / adverse effects
  • Chronic Disease / epidemiology
  • Cross-Over Studies
  • Databases, Factual
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Psychotropic Drugs / adverse effects*
  • Retrospective Studies
  • Risk Factors
  • Western Australia / epidemiology


  • Analgesics, Opioid
  • Antidepressive Agents
  • Psychotropic Drugs
  • Benzodiazepines