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Most cyclists hospitalized for injuries are over age 45, study finds

REUTERS/Brian Snyder
Secretary of State John Kerry broke his right femur in a cycling accident in Scionzier, France, in May.

As the popularity of bicycling has increased, so has the number of people showing up in hospital emergency rooms with serious cycling-related injuries.

In fact, the rate of hospital admissions for cycling injuries — especially injuries to the head and torso — more than doubled during a recent 15-year period, according to research published this week in the Journal of the American Medical Association (JAMA).

That finding is not, perhaps, surprising. More people on bikes means more possibilities for accidents — and more trips to the hospital.

What is surprising, however, is that older cyclists — people over the age of 45 — appear to be behind most of the increase in injuries.

ER data

For the study, researchers analyzed data collected from about 100 hospital emergency rooms across the country between 1998 and 2013. They found that cycling-related injuries for which people sought ER care rose 28 percent within that time period.

Digging deeper into the data, the researchers also discovered that injured cyclists were getting proportionally older — significantly so. From 1998 to 2013, the proportion of the cycling-related injuries involving people older than 45 rose 81 percent, from 23 percent to 42 percent.

As for the number of riders hospitalized for cycling-related injuries, it climbed even more sharply — a stunning 120 percent.  And the proportion of these hospitalized riders in the over-45 age group shot up 66 percent, from 39 percent to 64 percent.

That means that 4 of 10 cyclists showing up in ERs with cycling-related injuries and 6 of 10 who are hospitalized for those injuries are middle-aged or older.

Most of the cyclists getting injured are men, the data also revealed. The proportion of women arriving in an ER with cycling-related injuries stayed at around 35 percent throughout the 15-year period of the study.

The role of age

Age is probably a major factor in why so many older riders are hospitalized, according to the study’s authors.

“If you take typical 25-year-olds and 60-year olds, if they have a similar crash, it’s more likely the older person will have more severe injuries,” explained Dr. Benjamin Breyer, the study’s senior author and a urologist at the University of California, San Francisco, in a statement released with the study. 

The researchers also found an increase in street accidents (ones involving crashes with motor vehicles) — a finding that highlights the need for better cycling infrastructure as well as safer riding practices, they say.

Some Minnesota numbers

Here in Minnesota, bicycling appears to be getting safer even as the number of riders increases. Injuries in the state — at least those caused by a collision with a motor vehicle — actually decreased 8 percent in 2014 from the previous year, according to the Department of Public Safety.

In 2014, 755 cyclists were injured in such crashes compared to 822 in 2013. Bicycle fatalities dropped as well, from six to five.

Almost half of the street crashes in 2014 involved cyclists less than 25 years of age, and all five cyclists who died were under the age of 40.

Among the 277 Minnesota cyclists who experienced severe or moderate injuries in collisions with motor vehicles in 2014, 28 percent (78) were aged 45 or older.

You’ll find an abstract for the JAMA study on the journal’s website, but the full study is behind a paywall. 

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Comments (7)

  1. Submitted by Noel Martinson on 09/04/2015 - 12:19 pm.

    Change in underlying Cycling demographics

    It would be helpful to understand how the cycling population has changed over the last fifteen years. If there was a significant surge in older male riders over that period it may help explain some of the increases here. Hard to understand the outcomes without also understanding the changes in population.

  2. Submitted by Ray Schoch on 09/04/2015 - 03:06 pm.

    As if knees weren’t enough

    Thank you, JAMA, for providing me with another reason not to take up cycling at age 71.

    I hadn’t ridden a bike since I was about 13, but I test-rode several bicycles a couple summers ago in a serious search for one I’d find comfortable enough to ride back-and-forth to the grandkids’ place for babysitting duty. At 5 miles each way, with about 30% on paved bike path, I thought it would provide beneficial exercise, as well as get me where I needed to go with minimal environmental impact. Instead of comfort, however, I discovered that my knees simply won’t tolerate the type of motion required to pedal a bike. It’s one of those old-age things that surgery could probably fix, but I’m not dedicated enough to the idea of taking up cycling late in life to want the surgery. I’m even less interested in the prospect of serious injury or hospitalization.

    I’ll continue to drive, thank you.

  3. Submitted by Paul Udstrand on 09/04/2015 - 04:09 pm.

    Rider Profile

    This doesn’t surprise me. What I’d really like to know is how long these middle age riders have been riding? I’d also like to know how much they rode when they were younger. I suspect that a significant percentage of them recently returned to riding after years of little or no riding.

    The male-female difference also doesn’t surprise me, this demographic of rider can be quite agressive in my experience.

  4. Submitted by Steven Bailey on 09/04/2015 - 04:44 pm.

    Older people just seek medical help more.

    Young males are not the same species as older males (no matter how much older males disagree). When you are young you can basically be run over by a bus and shake it off to make happy hour. Older people in general have much better health insurance than young people do and they use it. I would bet injury rates are much more similar than this study shows.

  5. Submitted by Beth Daniels on 09/09/2015 - 11:31 am.

    How to confound and confuse with statistics

    I honestly can’t tell what the study is purporting to say. More information is needed. How much percentage increase has there been in the number of cyclists? Number of male cyclists 20-45 years old? Number of female cyclists 20-45 years old? Number of male cyclists 46-70 years old? Number of female cyclists 46-70 years old? Number of male cyclists over 70 years old? Number of female cyclists over 70 years old? Once we have that data, then tell us the number of cycling-related emergency-room visits for each age and gender demographic and the number of cycling-related hospital stays for each age and gender demographic. And the percentage in each age and gender demographic who wear adequate helmets. Then maybe we can begin to untangle this hodge-podge of statistics, at least a little bit. Here’s one data point: I am a 60-year-old female cyclist. I have been biking since I was 6 years old (well, since age 3, if you count the tricycle years) and have always had a bike. I have never had a bicycle accident requiring medical treatment of any kind, thank goodness! I also get my bike tuned up periodically, make sure to ride within my capabilities, and ride during daylight hours. Always have, always will. Helmets did not exist when I was a kid and I must confess I was a late adopter. But somewhere around age 45, I decided that I did not want to risk spending the rest of my life brain-damaged if I could help it and I have been wearing good helmets ever since.

  6. Submitted by Todd Piltingsrud on 09/08/2015 - 08:06 am.

    45 year cutoff

    I guess I have just under a year before I have to give up cycling. And I should’ve given up happy hour a long time ago. Thanks for the heads up. 🙂

  7. Submitted by Eric Ferguson on 09/08/2015 - 03:52 pm.

    Where do they ride?

    I’m wondering if older riders are commuting to work on therefore riding routes that have no bicycle infrastructure, but are where they have to go to get to work. Or maybe younger riders move where bicycling is more facilitated by infrastructure, while older riders can’t move or are more settled where they are, and therefore ride more on streets mixing with car traffic. I thought of that because I happened to buy near a bike path, but if the bike friendly infrastructure went away, I wouldn’t be likely to leave the house I’ve been paying on for all these years without another compelling reason, whereas if I were a renter or moved recently, I would think about moving to a more bike-friendly neighborhood.

    I think the prior comment about older riders being more likely to seek medical help is a good one. When I was in a serious bike accident, I was the last person to realize how badly I was hurt, and that’s not a mistake I’ll make again. Now I know the injured person is the worst judge of their need for help.

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