Abstract This study aims to assess motorcycle riding-related functional abilities among older adults and identify high-risk road locations in rural communities of Ubon Ratchathani Province, Thailand, to prevent accidents involving older motorcycle riders. The study administered a driving competency test to 202 older adults, modeled after the Thai driving license test, and required participants to complete a questionnaire. Fifty network partners participated in a focus group to identify potential risks and develop solutions. The data was evaluated using frequency and percentage distribution, while image display and content analysis were employed to interpret opinions about locations that pose risks for motorcycle accidents. The results indicated that 81.2% of older adults require improved driving functional abilities. The failed tests were the brake pedal reaction and wide vision tests, with failure rates of 61.4% and 60.9%, respectively. Additionally, 72.3% of older adults do not possess a driver's license, 50.0% hold a lifetime motorcycle license, 41.6% of motorcycles driven by older adults are either uninsured or have expired under the Motor Vehicle Accident Victims Protection Act, and 64.9% of older adults do not wear helmets while driving. The focus group activity identified seven main high-risk points on the roadway. Each of the seven high-risk zones is in villages where the older adults comprise more than 10 percent of the population. The recommendations include the improvement of road condition and the establishment of automated driving transportation services within the operational structure of local government or similar bodies to enhance individual and public safety.

Keywords: Aging, Risk, Safety, Management

Funding: The authors are grateful for the research funding provided by the Ubon Ratchathani University, Thailand.

Citation:  Boonkhao, L., Rattanachaikunsopon, P., Tuphila, P., Chanthason, O., Labcom, C., Chakhamrun, N., Tancharoen, J., Thongdamrongtham, S., Chaikhan, S., Kaewsuk, W., and Hernmek, U. 2026.  Motorcycle riding-related functional abilities among older adults and recommendations for mitigating risk-related problems on rural community roads in Ubon. Natural and Life Sciences Communications. 25(4): e2026093.

Graphical Abstract:

INTRODUCTION

There were approximately 1.19 million fatalities due to road traffic incidents in 2021, equating to a rate of 15 deaths per 100,000 individuals. Ninety-two percent of these fatalities occurred in middle- and low-income countries. In Thailand, vehicular accidents impose a significant human and economic burden. In 2022, traffic injuries claimed 17,000 lives and left 15,000 people with disabilities, resulting in economic losses of approximately US$12.5 million (World Health Organization, 2023). Over the past few decades, the majority of motor vehicle fatalities in Thailand have occurred on two-lane roads. The 2024 road safety data from the Thai RSC Accident Information Center classifies total fatalities by vehicle type. Motorcycles accounted for 83 percent of fatalities, while other vehicles made up 17 percent. The age groups exhibiting the highest death rates were 36–60 years at 37.56 percent, 25–35 years at 21.83 percent, and 60 years and above at 18.73 percent, respectively (Thai RSC, 2024).

Globally, one in six individuals is expected to be 60 years or older by 2030. Projections indicate a threefold increase in the population aged 80 years or older from 2020 to 2050, reaching 426 million (World Health Organization, 2024). Older adults will face common health risks associated with aging (Wong et al., 2023). In Thailand, over one-third of rural older adults report lower happiness, linked to poor health, low income, and limited social participation (Mungkhunthod et al., 2025). These vulnerabilities heighten accident risks, underscoring the need to integrate road safety with elderly well-being initiatives.

The likelihood of accidents will increase as long as older adults continue to ride motorcycles (Chen et al., 2017). As of 2023, the minimum driving age globally is 16 years (World Population Review, 2024), while in Thailand, the minimum age for operating motorcycles with engines of 110 cc or smaller remains 15 years (Royal Thai Police, 1976). After this age, applicants must apply and pass a driving test. Numerous countries have established a minimum driving age, varying from 14 to 18; however, not all impose a maximum age limit (CGTN, 2020).

The study by Boonkhao et al. (2023) found that reflex tests and depth perception tests affected the competency of motorcycle riders among older adults living in semi-urban areas with scores of 72.46% and 69.57%, respectively (Boonkhao et al., 2023). Several patterns of accident risk are associated with motorcycle operation in Ubon Ratchathani Province, Thailand. Evidently, rural regions' side roads and village lanes are characterized by their rugged trajectory and suboptimal curvature. Motorcycle accidents remain a risk, and relevant agencies or partners are lacking to effectively address the issue.

Pho Yai Subdistrict in Warin Chamrap District, Ubon Ratchathani Province, is regarded as a rural locality where the community predominantly resides the villages. Additionally, sub-routes, which are divided by dwellings, constitute the types of roads and routes found within the villages. This is especially true if an older adult is a motorcycle rider. Unavoidably, there will be an increased risk due to other factors associated with physical disabilities in older adults. According to an initial survey, road incidents occasionally cause older adults to sustain injuries that lead to incapacitation. Furthermore, there has never been a thorough investigation into motorcycling functional abilities among older adults living in rural areas. Therefore, the research team aims to assess motorcycle riding-related functional abilities, including reaction time, peripheral vision, and color vision among older adults and identify high-risk road locations in rural communities of Ubon Ratchathani Province, Thailand by engaging the support of relevant communities and network partners and to acquire suitable guidelines and create them as a guide for handling future motorcycle accident issues in rural areas.

MATERIALS AND METHODS

Study design and setting

A cross-sectional study was conducted from June 2024 to November 2024 on older adults aged 60 years or older residing in Pho Yai Subdistrict, Ubon Ratchathani Province, Northeastern Thailand. Two hundred and two older adults were evaluated using a questionnaire and functional tests that assessed three physical screening indicators associated with safe motorcycle riding rather than comprehensive motorcycle riding performance: 1) the reflex test, 2) the peripheral vision test, and 3) the color blindness test (Legislative Institute Repository of Thailand, 2012). Additionally, the focus group with 50 partnerships was held to identify risk areas and provide detailed information, incorporating protocols for rectification and prevention. The factors were analyzed using descriptive statistics, and the participants’ opinions regarding high-risk locations and surroundings were examined. Image displays and content analysis were used to present the findings from brainstorming sessions on problems, risks, and solutions.

Sampling size and sampling method

The study population was comprised of older adults residing in Pho Yai Subdistrict, Ubon Ratchathani Province, Thailand, along with their associated households. This subdistrict consists of a total of 13 villages, and 490 older adults who ride motorcycles. A sample size formula for proportions was employed to calculate the sample size.

The formula is defined with the following parameters: n represents the sample size, N is the total population size of 490 persons, Zα/2 is the coefficient under the standard normal curve at the 95% confidence level, which equals 1.96, p is the estimated proportion of older adults with motorcycle riding competence (0.85, obtained from literature reviews (Boonkhao et al., 2023), and e is the precision of the estimate, set at 0.04. The calculated sample size for the study was 189 older adults, an additional 7% was added to compensate for possible non-response, resulting in a final sample size of 202 participants. Simple random sampling was employed to gather data from these participants across 13 communities. Participants’ information was verified in accordance with the inclusion criteria before data collection.  Then data were collected from the older adults, and a driving performance test administered to assess their driving competence. The focus group process for identifying risk points and solutions involved 50 network partners, including community leaders, caregivers, elderly representatives, representatives from the subdistrict administrative organization, representatives from the subdistrict health promotion hospital, and the research team.

Participant selection criteria

The inclusion criteria encompassed: (1) male and female older adults aged 60 years and above; (2) who are motorcycle riders in Pho Yai Subdistrict; (3) possess the ability to communicate and comprehend; (4) are willing to participate in an interview and eager to contribute to data collection for research purposes. Participants were excluded based on the following criteria: (1) inability to understand and/or respond to the questions or complete the physical riding-related functional abilities test; (2) older adults with acute illness or unstable medical conditions that prevented them from completing the physical assessments or questionnaire at the time of data collection were excluded from the study; (3) refusal to participate in the study. The dropout criteria applied to participants who wish to withdraw from the study at any point during their involvement.

Questionnaire

The researcher created the questionnaire for this study to gather general characteristics of older adults in Part 1. The questionnaire included closed-ended questions about gender, age, education level, occupation, underlying congenital diseases, average daily motorcycle driving distance, motorcycle driving experience, motorcycle ownership, motorcycle accident experience in the past 2 years, possession of a motorcycle driver’s license, the validity of the driver’s license, and whether the motorcycles driven were insured under the Motorcycle Accident Victims Protection Act. The three tests that comprised the older adult motorcycle driving competence test are: 1) the reflex test, 2) the peripheral vision test, and 3) the color blindness test. The assessment of the older adults' riding-related functional abilities was categorized into two sections: 1) pass (showing that the older adults successfully completed all three assessments, and their driving performance was rated as “good”) and 2) fail (showing that the older adult failed at least one test, resulting in their driving performance being categorized as “need to be improved”). The focus group inquiries consisted of open-ended questions, allowing network partners to identify risk areas and provide detailed information. These discussions incorporated protocols for rectification and prevention. 

Questionnaire validity test

The validity of the questionnaire content was reviewed by three experts, resulting in an item-objective congruence index ranging from 0.67 to 1.00.

Data collection

A questionnaire regarding the characteristics and conditions of older adults was administered, and undergraduate students in Environmental Health Science, trained in data collection methods, assessed the functional abilities of older adults in riding. For participants with reading and writing difficulties, trained interviewers read the questions aloud and recorded their responses. A face-to-face interview was conducted to gather information on the occurrence of older adults. Undergraduate students in Environmental Health Science, trained in using measurement tools, assessed how well the older adults performed when driving motorcycles following the standard tests of the Department of Land Transport (Legislative Institute Repository of Thailand, 2012). These tests included: 1) The reflex test: This test evaluated the ability to control the pedal brake three times. If the participants could successfully hit the brake pedal within 0.75 seconds when the red light appeared two out of the three times, they would pass the test. 2) The peripheral vision test: The participants must be able to correctly identify the colored lights at 75 degrees on the left and the right two out of three times on each side. 3)The color blindness test: The participants needed to identify the green, red, and yellow lights flashing from the test box or from the color blindness test plate approved by the Department of Land Transport, which was placed 2.50-3.50 meters away from them. They had to tell each of the three colors three times (9 in total). They would pass the test if they could correctly tell the colors six times out of nine. The focus group exercise was conducted to generate ideas for assessing risk factors and establishing mitigation strategies with 50 network partners.

Study variables

The primary outcome of the study was physical riding competency among older adults. The questionnaire collected general characteristics of older adults, such as gender, age, education level, occupation, underlying congenital diseases, average daily motorcycle driving distance, motorcycle driving experience, motorcycle ownership, motorcycle accident (In this study, a motorcycle accident was defined as any self-reported event involving a motorcycle that resulted in a fall, collision, loss of vehicle control, or injury during the previous two years, regardless of injury severity or whether medical treatment was required.), possession of a motorcycle driver's license, validity of the license, and insurance coverage for motorcycles driven under the Motorcycle Accident Victims Protection Act. The older adult motorcycle riding-related functional abilities test comprised three tests: 1) the reflex test, 2) the peripheral vision test, and 3) the color blindness test.

Statistical analysis

Data analysis was conducted using SPSS v.29.0 software (IBM, New York, USA). Quantitative data were evaluated using the mean and standard deviation, whereas qualitative analysis was conducted using descriptive statistics, such as frequency and percentage distribution. Opinions about locations and surroundings that pose the risk of motorcycle accidents were analyzed. Image displays and content analysis were used to present the findings from brainstorming sessions on problems, risks, and solutions.

Ethics statement

Ethical clearance was obtained from the Ethical Committee for Human Research, Ubon Ratchathani University, Mueang Si Khai, Thailand (code UBU-REC-96/2567, May 24, 2024), in adherence to the Declaration of Helsinki.

RESULTS

Characteristics of the included participants

In Pho Yai Subdistrict, Ubon Ratchathani Province, the majority of older adults who rode motorcycles were men, with an average age of 66.25 years (S.D.=5.32). Among the survey respondents, 84.7% were farmers, 76.8% had congenital conditions, and 55.4% had only completed primary school. Heart disease and migraines were the most common conditions among older adults in Pho Yai Subdistrict, Ubon Ratchathani Province. Among all the participants, 46.4% had heart disease and 31.3% experienced migraine. Additionally, 42.1% had driven a motorcycle 1–4 kilometers per day, while 30.7% reported driving motorcycle 5–10 kilometers daily. Most motorcycle riders had more than 10 years of experience, with 86.1% owning the motorcycle they used. A total of 93.1% had experienced an accident while riding a motorcycle, and 91.1% had encountered an accident. Additionally, 72.3% of older adults did not possess a driver's license, while 50.0% held a lifetime motorcycle license. Furthermore, 41.6% of motorcycles driven by older adults were uninsured or had expired coverage under the Motor Vehicle Accident Victims Protection Act, and 64.9% did not wear helmets while driving (Table 1).

Table 1. Characteristics of older adults in Phoyai subdistrict, Ubon Ratchathani province. (n=202).

Note: Max: Maximum; Min: Minimum; S.D.: Standard Deviation.

Older adult functional abilities

An assessment of the functional abilities for motorcycle riding among older adults in Pho Yai Subdistrict revealed that 81.2% require improved functional abilities (Table 2). The driving-mandated color vision test achieved the highest pass rate, with 92.6% of the participants passing. The most common failed test was the wide vision test, with a failure rate of 39.1%, followed by the brake pedal reaction test, which had a failure rate of 38.6% (Table 3).

Table 2. Motorcycle riding-related functional abilities level among older adults in Phoyai subdistrict, Ubon Ratchathani province (n=202).

Table 3. Motorcycle riding-related functional abilities among older adults in Phoyai subdistrict, Ubon Ratchathani province (n=202).

The focus group activity identifying high-risk points on the roadway

The focus group activity identified high-risk roadway points that could lead to accidents. The Pho Yai Subdistrict community identified seven main risk points (Figure 1). The primary risk factors included: inadequate traffic signals, poorly maintained roads with potholes, vehicular congestion narrowing the roadway, and drivers frequently neglecting to reduce speed at junctions. Pho Yai Subdistrict consists of 13 villages with a total population of 5,962 individuals, averaging 459 inhabitants per village. A significant portion of the population resides in Villages 1, 5, and 6, where the population exceeds 150% of the district's average. Older adults comprise 1,283 individuals, or 21.52% of the total population of Pho Yai Subdistrict. The average number of older adults per village is 97. As a result, Pho Yai Subdistrict is categorized as a fully aged society. All villages have joined the older adult society, with 9 out of 13 villages exhibiting a proportion of older exceeding 20% of the subdistrict's population (Figure 2). Furthermore, in the data synthesis across all seven risk areas, the identified risk locations exhibit a greater proportion of the village population compared to the typical village population. Six out of seven risk areas are situated in villages 1, 2, 4, 5, and 8, where the population proportion exceeds 125% (high and extremely high levels), in comparison with the average population of each village. Each of the seven high-risk zones is located in the villages where the proportion of older adults exceeds 10 percent.  These villages fall into two categories: an aged society and a fully aged society (Foundation of Thai Gerontology Research and Development Institute, 2017) (Figure 3). We have established recommendations to resolve these issues, including improving the road to ensure it is in appropriate condition and removing trees that impede visibility. Proposals also recommend installing convex mirrors at intersections to enable vehicles on the route to monitor approaching traffic before crossing and redesigning the roadway to promote reduced speeds among drivers. To address
long-term risk concerns, network partners have suggested organizing safe driving training courses for the community, advising local government agencies and village caregivers to supervise and regulate unsafe areas, rectifying risk factors, and developing prototype models of effective solutions.

Figure 1. Seven main risk areas in Pho Yai Subdistrict, Ubon Ratchathani Province.

Figure 2. Classification of the number of residents in the area of Pho Yai Subdistrict, Ubon Ratchathani Province.

Figure 3. Number of older adult residents exceeding 10 percent of the population in each village of Pho Yai Subdistrict, Ubon Ratchathani Province.

DISCUSSION

The majority of older adults possess motorcycle riding-related functional abilities that require improvement. The driving performance issues observed in the older adults pertain to brake pedal reaction time and peripheral vision. As individuals age, there is a decline in the activity of the nervous system and brain (Ferrucci et al.,2016; Amarya et al., 2018; Alrosan et al., 2024). There is a relationship between the brain and muscles, including decreased muscle strength (Manini et al., 2013). This signifies the transformation in the physiology of the older adults. It may increase the susceptibility of the older adult to driving accidents (Ayuso et al., 2020; Jeong et al., 2023). The braking response is an evaluation of a driver's reaction when a green light transitions to red. It is crucial to engage the brakes promptly to guarantee safety; the inability of older adults to pass this test indicates a likelihood of failing to apply the brakes swiftly when encountering an obstacle while driving (Summala, 2000). Moreover, older adults failed the comprehensive vision assessment (60.9%). The wide vision exam evaluates the driver's ability to perceive their environment. Limited vision in older adults may impact decision-making in various driving situations. This is in line with previous studies, which show that older drivers have significantly inferior outcomes in various facets of visual function and challenges with driving simulator performance (Ortiz-Peregrina et al., 2020; Wood, 2022). Moreover, older persons demonstrate a restricted comprehension of adherence to regulations, such as using helmets when riding, possessing a driver's license, and procuring accident insurance under the Motorcycle Accident Victims Protection Act. Older adults may experience a higher severity of accidents when they occur. This study, in line with previous research, indicated that over 80% of motorcycle riders in rural Chiang Mai, Thailand, do not wear helmets while riding (Panumasvivat et al., 2024). The findings of this study extend beyond documenting deficits by emphasizing the potential benefits of structured interventions to mitigate age-related risks. Similar to the E75 Exercise Program for Strong and Active Elderly (E75EPSAE), which significantly improved muscle strength, cardiovascular fitness, and flexibility among older adults in Chiang Mai, this research highlights the value of targeted assessment and training. By identifying specific deficits such as delayed braking response and restricted peripheral vision, tailored programs combining physical exercise, visual training, and road safety education could be developed to enhance both driving competence and overall health. Such approaches not only reduce the risk of accidents but also promote active and healthy aging, strengthen confidence in mobility, and contribute to maintaining independence in daily life (Paknapa et al., 2025). The combined insights support a multidimensional strategy: promoting physical fitness through community-based exercise interventions, enhancing regulatory compliance and safety behaviors, and designing public health initiatives that address both physiological decline and risky road use practices. In doing so, this study provides a dual benefit—advancing knowledge about the risks older adults face in motorcycle driving while also offering evidence-informed pathways to improve safety, health, and quality of life for Thailand’s rapidly aging population.

The focus group activity identified key risk points and proposed corrective solutions. It was found that the seven main risk areas in the communities were primarily caused by blind spots obstructing vehicle visibility at intersections, trees blocking sightlines, a lack of safety signage, degraded road conditions, narrow roadways, and drivers failing to reduce speed at intersections. This condition could affect driving abilities, increasing the risk of accidents (Rosey et al., 2009; Chao et al., 2013) among older adults who drive in the communities. Additionally, all villages in Pho Yai Subdistrict have participated in the older adult society, with 9 out of 13 villages demonstrating a percentage of aged adults over 20% of the subdistrict’s total population. Six of the seven risk areas have a population proportion exceeding 125% of the average population in each village. All seven high-risk zones are situated in communities where the percentage of older adults exceeds 10%. This could be a contributing factor to the significant traffic in the community. This increases the area's susceptibility to accidents associated with the route (Malin et al., 2019; Olma et al., 2022). Furthermore, it is evident that communities in risky areas are experiencing a rising population of older adults, transitioning into an aged society and potentially becoming part of a completely aged society. If these groups continue to use unsafe routes, the likelihood of accidents will increase (Pembuain et al., 2019; Basu and Saha, 2022).

In response to the immediate issue at critical locations within the communities, network partners have suggested enhancing road conditions, removing trees that impede vision, and addressing dead spots when space for improvement is limited. Proposals include installing convex mirrors at crossings to allow vehicles to view oncoming traffic before crossing and modifying the pathway to encourage drivers to slow down. In order to address long-term risk issues, network partners have proposed organizing safe driving training courses for the community, recommending that local government agencies and village caregivers oversee and maintain order in risky areas, implement corrections to risk points, and establish prototype models of concrete solutions. Therefore, this approach could potentially be implemented by other rural communities.

The assessment focused only on selected physical functions related to motorcycle riding and did not include actual riding performance, hazard perception, or practical riding skills. Therefore, the findings should be interpreted as indicators of riding-related functional abilities rather than overall motorcycle riding competence.

Since this study was designed as a descriptive study to assess riding-related functional abilities among older adults, inferential analyses were not performed. Future studies should employ analytical study designs and multivariable statistical analyses to identify independent factors associated with poor riding-related functional abilities and to quantify their effects on motorcycle safety among older adults.

CONCLUSION

Our findings have clear implications for regulators tasked with road safety policies, particularly regarding the need for specific driver licensing requirements and training for older adults. The safety management for older adult drivers necessitates understanding their mental and physical conditions, particularly for older adults residing in rural communities. We recommended evaluating and upgrading the driving capabilities of older drivers, with multi-modal approaches considered the most effective. Furthermore, the recommendation was to improve road conditions and establish automated transportation services within the operational structure of local government or similar bodies to enhance individual and public safety.

ACKNOWLEDGEMENTS

This research was a collaboration between Ubon Ratchathani University and Pho Yai Health Promoting Hospital. The authors would like to express their gratitude to the older adults in the Pho Yai Subdistrict and the College of Medicine and Public Health at Ubon Ratchathani University for funding this study.

The authors would like to acknowledge the assistance of the Editor and Reviewers in the preparation of the article for publication.

AUTHOR CONTRIBUTIONS

Laksanee Boonkhao: Conceptualization (Lead), Methodology (Lead), Software (Equal), Validation (Equal), Investigation (Lead), Resources (Lead), Data Curation (Equal), Writing - Original Draft (Lead), Writing - Review & Editing (Lead), Visualization (Lead), Supervision (Lead), Project administration (Lead); Pongsak Rattanachaikunsopon: Investigation (Equal), Writing - Original Draft (Equal), Writing - Review & Editing (Equal), Visualization (Equal), Supervision (Lead); Papatsorn Tuphila and Orathai Chanthason: Methodology (Equal), Software (Lead), Validation (Equal), Formal Analysis (Lead), Resources (Equal), Data Curation (Equal), Writing - Review & Editing (Equal); Chiraporn Labcom, Nittaya Chakhamrun, Jittar Tancharoen, Somjate Thongdamrongtham, and Sitthichai Chaikhan: Conceptualization (Equal), Methodology (Equal), Investigation (Equal), Resources (Equal), Validation (Equal), Writing - Review & Editing (Equal); Wannee Kaewsuk and Ueamporn Hernmek: Supervision (Supporting), Investigation (Supporting), Writing - Review & Editing (Equal).

CONFLICT OF INTEREST

The authors declare that they have no conflicts of interest.

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