To Continue, Modify or Relinquish Driving: Findings from a Longitudinal Study of Healthy Ageing

Abstract

Background: The number and proportion of drivers among people entering later life continues to rise. More information on patterns of driving for older adults is required to improve service provision and traffic planning. Objectives: To map the changes in driving status for a sample of drivers aged 65 years or older over the period 1994–2000, and to identify factors associated with older people continuing, modifying or relinquishing their status as drivers. Methods: The 752 participants were drawn from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) program, a longitudinal study of people aged 65 years and older living in the community. Participants were interviewed or contacted for follow-up in 1994, 1996, 1998 and 2000 on a range of topics including their health, functional independence and driving status. Results: Although the number of recent drivers was smaller as participants died or were admitted to nursing homes over the 6-year data collection period, relatively few participants relinquished driving while remaining in the community. Many drivers reported modifying their driving habits over time, including decisions to restrict their driving to their local area during daylight only. Relationships were explored between driving status and the key variables of age, gender, marital status, instrumental activities of daily living (IADL) independence and self-rated measures of income, health, eyesight and hearing. Multivariate analyses indicated that drivers were more likely to modify their driving habits if they were older, dependent in IADL, and rated their eyesight as poor. Similar factors predicted relinquishing driving, but in addition, women were three times more likely to relinquish driving than men (even when health and disability were taken into account) and people who rated their incomes as ‘comfortable’ were more likely to relinquish driving than those with lower incomes. Conclusions: This study confirmed previous evidence that older drivers self-regulate by modifying their driving behavior as they age. However, since few drivers voluntarily relinquish driving, further research is required to identify ways of supporting older drivers to continue to drive safely.

Effect of Cognitive Status on Self-Regulatory Driving Behavior in Older Adults

“…11 Reported self-regulatory behavior increases with age and becomes even more pronounced with declining health status, suggesting that elderly drivers are in fact attempting to compensate for perceived functional impairments. [16][17][18][19][20] Consistent with this notion, several survey studies have reported increased driving restriction among older drivers that is at least partly in response to the presence of cognitive or functional impairment. 9,12,[20][21][22][23][24] In a 5-year longitudinal study in which older drivers were interviewed yearly about driving habits, drivers categorized as at-risk on the basis of reduced Useful Field of View performance were found to limit their driving mobility over time at a faster rate than those categorized as not-at-risk drivers.…”

Does Automatic Transmission Improve Driving Behavior in Older Drivers?

“…Several studies have reported that older drivers selfregulate their driving in certain driving situations, for example by driving slower or by reducing the time and distance driven [3,5] . Moreover, older drivers seem to compensate for distractions by driving slower in complex traffic environments [34] .…”

“…The car enables mobility and access to essential services and social activities [2][3][4] . Consequently, most older drivers continue to drive as they age [5] . However, the complex interaction between sensory, cognitive and perceptual-motor processes required for safe driving are vulnerable due to the inherent changes that come with age [6] .…”

Retrospective cohort study of accident outcomes for individuals who have successfully undergone driver assessment following stroke

“…This may be due to the adoption of compensatory strategies similar to those used by elderly drivers, although there is no direct evidence of this in stroke patients (De Raedt & Ponjaert-Kristoffersen, 2000;Fisk et al, 1997;George, Clark & Crotty, 2006;Unsworth, Wells, Browning, Thomas & Kendig, 2008). Older drivers who learn and use compensatory strategies such as avoiding peak hour traffic, driving in daylight and driving only in familiar areas, can reduce their accident level to that of, or lower than, technically better drivers (De Raedt & Ponjaert-Kristoffersen, 2000).…”