The Relationship Between Self-Rated Memory and Driving Behaviors Among Community-Living Older Adults: Evidence from the Health and Retirement Study

Background and Purpose: Adults aged 65 years and older make up over 15% of all current drivers, and this proportion is projected to increase over the next few decades. One of the major social concerns related to older drivers is at-risk drivers with cognitive impairment. Previous studies have reported that older adults with cognitive impairment such as Alzheimer’s Diseases are more likely to stop driving compared to those without cognitive impairment. However, little is known about whether “self-perceived memory problem” is associated with driving cessation (i.e. giving up car keys) or self-regulatory driving such as limiting driving to nearby places. This study aimed to examine the relationship between self-rated memory and driving behaviors among community-living older adults, using a nationally representative sample of older adults.

Methods: Data were obtained from the 2010 Health and Retirement Study (N=9,850; average age=75.3 years; 58.5% women; 16.3% non-White). Older adults were asked to rate their own memory; their responses (prevalence) were excellent (3.7%), very good (20.3%), good (44.1%), fair (25.9%), or poor (5.9%). Driving behaviors were assessed with three items: (a) Are you able to drive? (b) Have you driven a car in the past month? and (c) Do you limit your driving to nearby places, or do you also drive on longer trips? Participants were grouped into four by their driving status: active drivers without self-regulation (50.6%), active drivers with self-regulation (27.3%), former drivers (21.0%), and never drivers (1.1%). Cognitive function was assessed with modified Telephone Interview of Cognitive Status (TICS). We used multinomial logistic regression to determine whether fair/poor self-rated memory was significantly associated with the likelihood of being active drivers without self-regulation, active drivers with self-regulation, or former drivers.

Findings: The results showed that older adults with fair/poor self-rated memory were more likely to limit their driving to nearby places than those with excellent/very good/good self-rated memory, after adjusting for sociodemographic and health characteristics including TICS (OR = 1.37, 95%CI = 1.22—1.54; reference group = active drivers without self-regulation). However, fair/poor self-rated memory was not significantly associated with driving cessation (OR = 1.11, 95%CI = 0.96—1.29; reference group = active drivers without self-regulation).

Conclusions and Implications: The findings of this study imply that self-rated memory problem might help older adults limit their driving, but not necessarily stop them from driving. Social workers working with older adults should be aware that older drivers with fair/poor self-rated memory tend to have limited mobility and to provide them with alternative transportation, so older adults can access community resources as well as fully participate in community activities. It is also important for gerontological social workers to help older adults and their family members make a timely decision to stop driving and navigate alternative transportation when elderly clients show symptoms of cognitive impairment.