What Makes Older Drivers Stop Driving?

PURPOSE: In American culture, individuals' mobility is primarily based on traveling in private vehicles. Given that, driving cessation among older adults means the loss of mobility, resulting in dependence on others. Previous studies showed that driving cessation could have negative effects on psychological wellbeing among the elderly (e.g., Regland, Satariano & MacLeod, 2005). Thus, knowing the causes of driving cessation is very important in geriatric social work. The purpose of this study is to examine the risk factors of driving cessation among older adults.

METHODS: A discrete-time multivariate hazard model was used to examine the effects of age, gender, medical conditions (cardiovascular disease, eye disease, orthopedic problems and diabetes), functional, cognitive and vision impairments on driving cessation. The greatest benefit of using this model is to enable us to estimate the impacts of time dependent covariates such as vision impairment and subjective health on the risk of driving cessation given that driving cessation tends to be decided by recent changes in health among older adults. Data were obtained from a longitudinal study of adaptation to aging. The study population consists of generally healthy community-living old-old persons (67-97 years old) residing in three Florida retirement communities. Annual in-home interviews were conducted over a four-year period (1997–2000). We restricted our sample to those who were driving at baseline (N = 196). Respondents had a mean age of 83.1 at baseline, and 60.7% of older drivers were female.

RESULTS: 35 older drivers among 196 ceased driving during the four-year observation period. The results showed older age was significantly associated with driving cessation, supporting previous studies. After controlling socio-demographic factors such as age and gender, functional impairment and vision impairment were statistically significant risk factors for driving cessation. Functional impairment was measured with a summary score of self-reported difficulty with ADL and IADL (range 0-44), and higher levels of functional impairment were significantly associated with higher risk of driving cessation (OR = 1.26, p < .001). Most notably, vision impairment was the strongest risk factor for driving cessation (OR = 2.36, p < .001) after controlling all other constant as well as time varying explanatory variables. Regarding medical conditions, the results showed that they were not significantly associated with driving cessation although more than half of older drivers reported having eye diseases (54.6%) and orthopedic problems (61.2%) at baseline.

IMPLICATIONS: Geriatric social workers need to understand that the key risk factors for driving cessation are vision impairment, functional impairment and older age. If elderly clients show increased vision or functional impairment, geriatric social workers need to assess clients' decision making capacities around safe driving. The findings of this study could also contribute to developing and improving safe driving and driving retirement programs in the community.