Driving Habits of Older Adults- A Population Based Study

Abstract

Introduction Driving is a key and complex instrumental activity of daily living that requires integration of multiple domains including cognitive, motor, visual and sensory functions in order to perform adequately. Older drivers comprise 19 percent of licensed drivers in the US and 70-80 % of drivers over 75 were considered at fault in two vehicle crashes .Although there are many studies in the literature reporting on driving habits and difficulties in samples of older adults in clinical settings, there are relatively few reports from population-based samples. Here we describe the driving history, social habits and self-reported driving difficulties of older adults in a large population based survey. Methods Our study cohort comprised1982 individuals aged 65+ years. Participants were assessed on their ability to perform Instrumental activities of daily living, cognitive functions, self-reported health, social supports, physical limitations, depressive symptoms and driving status. We built multivariate logistic regression models to identify factors associated with (a) never having driven, (b) driving cessation, and (c) self-reported driving difficulties Results In multivariable models, “never drivers” were more likely than “ever drivers” to be older, female, less educated and to leave home less frequently. Those who had ceased driving, i.e. former drivers, were significantly older, more likely to be women, to have lower test performance in the cognitive domain of attention, have more IADL difficulties, leave home less frequently and have visual field deficits than current drivers. Current drivers who reported difficulties while driving were more likely than those without difficulties to have test performance that was lower in attention but higher in memory, were more likely to report depressive symptoms and to have both vision and hearing loss. Conclusions In this population-based study of older adults in a small-town, post-industrial, economically disadvantaged region of southwestern Pennsylvania, we identified factors associated with never having driven a motor vehicle, with having given up driving, and with current drivers’ self-reported difficulties while driving. There were some similarities and some differences among the three groups of factors. In the fully adjusted models, both never-drivers and former drivers were significantly more likely to be female, older, and to leave home less frequently. Both former drivers and current drivers with difficulties were more likely to have lower cognitive test performance, with former drivers testing worse on attention, and current drivers with difficulties testing worse on attention but better on memory, compared to their respective reference groups. In addition, never-drivers had lesser education, former drivers were more likely to report difficulty with IADLs, and current drivers with difficulties were more likely to report depressive symptoms. Our findings can help health care providers identify their patients whose driving histories and abilities warrant more careful attention. The snapshot we have provided of driving-related issues in a low-SES community may be useful to planners and policy makers in addressing the transportation and safety needs of older adults. Funding The work reported here was supported in part by grant # R01AG023651 from the National Institute on Aging, NIH, US DHHS.