Associations of Frailty Status with Low-Mileage Driving and Driving Cessation in a Cohort of Older Drivers

Abstract

The US older adult population is projected to considerably increase in the future, and continued driving mobility is important for health aspects in populations with fewer transportation alternatives. This study evaluated whether frailty is associated with low-mileage driving (<1865 miles per year) and driving cessation among older adults. Baseline demographics and health data were collected for 2990 older drivers via in-person assessments and questionnaires, with 2964 reporting baseline frailty data. Multivariable log-binomial regression models were used to evaluate the association between baseline frailty status and low-mileage driving. Multivariable Cox proportional hazards regression were used to evaluate the association between baseline frailty status and driving cessation. For every unit increase in frailty, the estimated adjusted risk of driving fewer than 1865 miles/year increased by 138% (adjusted risk ratio: 2.38, 95% CI: 1.63-3.46). Relative to older drivers who were not frail, the adjusted hazard ratios of driving cessation were 4.15 (95% CI: 1.89-9.10) for those classified as prefrail and 6.08 (95% CI: 1.36-27.26) for those classified as frail. Frailty is positively associated with low-mileage driving status and driving cessation in a dose-response fashion. Public health interventions that reduce frailty, such as physical activity, may help older drivers maintain safe and independent mobility.

Driving cessation and physical frailty in community‐dwelling older adults: A longitudinal study

“…We performed a multiple logistic regression analysis to clarify whether driving cessation was the cause of further physical frailty. As a previous study has reported that baseline frailty status was associated with driving cessation, 30 future research should use designs that can help clarify the causal relationship. However, despite its limitations, this study provided a comprehensive assessment within a large prospective sample of community-dwelling older adults in Japan.…”

Age-Related Diseases and Driving Safety

“…Non-opioids can also impair psychomotor skills relevant to driving. For example, indomethacin and phenylbutazone (but not acetylsalicylic acid) affected eye-hand coordination and divided attention up to 150 min after their administration [194]. Some authors found a significantly increased accident rate after taking non-steroidal antiinflammatory drugs (e.g., [52]).…”

“…Frailty is a syndrome following a decline in function and resilience across numerous physiological systems [ 195 ]. It is defined as “a clinical state in which there is an increase in an individual’s vulnerability for developing increased dependency and/or mortality when exposed to a stressor” [ 196 ].…”

“…Crowe and colleagues [ 195 ] studied the association between frailty status and low mileage driving and driving cessation respectively in almost 3000 subjects. They outlined that for every unit increase in frailty, the estimated risk of driving fewer than 1865 miles/year increased by 138%.…”

The Influence of Hearing Impairment on Driving Avoidance Among a Large Cohort of Older Drivers

“…Factors associated with driving reduction and avoidance include the presence of health conditions, increased frailty, cognitive impairment, concern about crashing, lack of driving comfort, lifestyle changes, and perceptual (especially visual) declines (Crowe et al, 2020;Devlin & McGillivray, 2014;Dickerson et al, 2007;Kandasamy et al, 2018;Molnar et al, 2013;Ragland et al, 2004). The influence of vision problems on driving reduction/avoidance has been studied extensively.…”