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

Abstract

Physical frailty is a critical health problem that can increase the risk of adverse health outcomes in older adults. Driving cessation has been associated with negative outcomes such as disability. However, the relationship between physical frailty and driving cessation remains unclear. Thus, this study aimed to examine whether driving cessation is associated with physical frailty transition in community-dwelling older adults.Methods: This prospective cohort study was performed in a community setting in Japan. Participants were 2934 older Japanese adults, classified into two groups according to their driving status: a driving group (drivers at baseline who continued driving at a 4-year follow-up) and a driving cessation group (drivers at baseline who ceased driving by 4-year follow-up). We examined the association between physical frailty transition and driving cessation over a 4-year period, using logistic regression analysis before and after imputation.Results: In total, 3.9% of community-dwelling older adults had ceased driving by the 4-year follow-up. Rates for physical frailty transition in the driving and driving cessation groups were 4.6% and 17.1%, respectively (P < 0.001). In fully adjusted logistic regression analysis, when compared with driving, driving cessation independently affected physical frailty transition. The results were similar after multiple imputations.Conclusions: Our findings indicated driving cessation was an independent risk factor associated with physical frailty transition in older adults. As physical frailty in older adults can contribute to negative health outcomes, including increased disability and mortality, preventing frailty has important public health implications.

Frailty and poor physical functioning as risk factors for driving cessation

“…Ishii et al evaluated driving cessation as the exposure and physical frailty transition as the outcome in a cohort of 2,934 older Japanese adults (9). They reported that driving cessation was a risk factor for frailty, as indicated by a 4.6% versus 17.1% difference in the rates for frailty transition (9). Our study is the first to evaluate time-varying frailty as the exposure and driving cessation as the outcome longitudinally.…”

“…Baseline frailty in this cohort has previously been found to be associated with the rate of DC at 1 year HR of 4.2 (95% CI: 1.9-9.1) for pre-frail and HR of 6.1 (95% CI: 1.4-27.3) for frail participants (8). Ishii et al evaluated driving cessation as the exposure and physical frailty transition as the outcome in a cohort of 2,934 older Japanese adults (9). They reported that driving cessation was a risk factor for frailty, as indicated by a 4.6% versus 17.1% difference in the rates for frailty transition (9).…”

Effect of driving training on car crashes and driving skills in older people: A systematic review and meta‐analysis

“…3 For example, previous studies have reported that driving cessation could lead to frailty, disability, and even mortality. [4][5][6] However, the rate of fatal accidents caused by older drivers is considerably higher (8.9 fatal accidents per 100 000 in license holders ≥75 years) than that caused by younger drivers (< 75 years: 3.8). 1 Moreover, the proportion of fatal accidents anticipate potentially dangerous traffic events, and Ball et al 8 indicated that cognitive training that targeted speed-of-processing and reasoning (up to 10 sessions) reduced the rate of at-fault motor vehicle collisions by approximately 50% over a 6-year follow-up period.…”

“…Not only is driving a car essential for transportation but it also allows older adults to maintain their life‐space mobility, 2 and it can impact their health 3 . For example, previous studies have reported that driving cessation could lead to frailty, disability, and even mortality 4–6 . However, the rate of fatal accidents caused by older drivers is considerably higher (8.9 fatal accidents per 100 000 in license holders ≥75 years) than that caused by younger drivers (< 75 years: 3.8) 1 .…”

Reliability and Validity of the Japanese Version of the Assessment of Readiness for Mobility Transition (ARMT-J) for Japanese Elderly

“…Furthermore, older adults’ cessation of driving is related to their physical frailty [ 15 ] and affects their level of social isolation [ 16 ], life satisfaction or time spent outside [ 17 ], inactivity and lack of interest [ 18 ], networking with friends [ 19 ], paid work, and volunteer activities [ 20 ]. Some studies have also shown that the factors influencing driving cessation in the elderly depend on personal experience and environment, such as hospitalization [ 21 ], area of residence [ 22 , 23 ], relationship with a partner [ 24 ], and financial situation [ 25 ].…”