Moon Choi

Depression and frailty in later life: a synthetic review

Many of the symptoms, consequences, and risk factors for frailty are shared with late‐life depression. However, thus far, few studies have addressed the conceptual and empirical interrelationships between these conditions. This review synthesizes existing studies that examined depression and frailty among older adults and provides suggestions for future research.

The Impact of Transportation Support on Driving Cessation Among Community-Dwelling Older Adults

OBJECTIVES This study longitudinally examines the impact of transportation support on driving cessation among community-dwelling older adults residing in retirement communities. METHOD Data came from 3 waves of the Florida Retirement Study (1990-1992), a population-based cohort study. Analysis was limited to participants who drove at baseline and were reinterviewed in 1992 (N = 636). Transportation support from a spouse, family members, friends/neighbors, agencies/organizations (e.g., church), or hired assistants was included. Discrete-time multivariate hazard models were estimated to examine the impact of transportation support on driving cessation while controlling for demographic and health characteristics. RESULTS Participants were more likely to stop driving if they had received at least some transportation support from friends/neighbors (Hazard Ratio = 2.49, p = .001) as compared with those with little or no support. Transportation support from organizations/agencies or hired assistants was also significantly associated with the likelihood of driving cessation, but only a small number of participants reported to have received such support. Receiving some or more transportation support from a spouse or family members did not have a statistically significant relationship with driving cessation. DISCUSSION The findings suggest that available nonkin transportation support, particularly support from peer friends, plays an important role in driving cessation for older adults living in retirement communities.

Gender and racial disparities in driving cessation among older adults

Objectives: To longitudinally examine gender and racial disparities in driving cessation among older adults. Methods: Data came from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study (N = 1,789). Logistic generalized estimating equations (GEE) were used to identify predictors of driving cessation; stratified analysis and interaction terms were used to determine whether factors differed by gender and race. Results: Two hundred and five (11.5%) participants stopped driving over the study period. Education was associated with increased risk of cessation for men (adjusted odds ratio [AOR] =1.40, 95% confidence interval [CI] =1.10 to 1.78), but decreased risk for women (AOR = 0.90, 95% CI = 0.82-0.98). Being married was associated with lower risk of cessation for men (AOR = 0.18, 95% CI = 0.06-0.56) but was unrelated to cessation for women (AOR = 1.00, 95% CI = 0.56-1.80). Results were consistent with the hypothesis that racial disparities in cessation widen with increasing age. Discussion: Factors predictive of driving cessation vary by gender. Racial disparities in cessation are wider at older ages. Transportation policies and programs should account for social determinants and aim to address social disparities in driving mobility among older adults.

Trajectories of cognitive decline by driving mobility: evidence from the Health and Retirement Study

The recent emphasis of the importance of “aging in place” has highlighted the role of transportation in health promotion over the life course. Driving cessation in later life is associated with numerous poor health outcomes including limitations in social and physical functioning and increased risk of mortality. However, little is known about the relationship between driving cessation and change in cognitive functioning in late life. This study examined the association between driving mobility and trajectories of cognitive functioning among older adults.

Suicide risk in long‐term care facilities: a systematic review

Suicide risk is highest in later life; however, little is known about the risk of suicide among older adults in long‐term care facilities (e.g., nursing homes and assisted living facilities). The goal of this paper is to review and synthesize the descriptive and analytic epidemiology of suicide in long‐term care settings over the past 25 years.

Examining the aging process through the stress-coping framework: Application to driving cessation in later life

The aging process is marked by a series of transitions that influence multiple domains of well-being. One important transition for older adults is the process of driving cessation. Numerous studies have examined risk factors for driving cessation among older adults to identify at-risk older drivers for road safety. Recent research has focused on the consequences of driving cessation in later life for health and well-being. However, these reports have been largely empirical and are not drawn from a defined conceptual framework. Establishing a theoretical model of ‘how driving cessation interacts with other processes and domains of aging’ will promote synthesis of seemingly disparate findings and also link the empirical research on cessation to the broader field of gerontology. This article describes a conceptual model for articulating and examining the components of the driving cessation process based on the stress-coping paradigm. This model situates driving cessation within the context of exogenous stressors, individual vulnerabilities and coping strategies, and environmental hazards and buffers over the lifespan. This model could assist in guiding intervention strategies aimed at reducing premature driving cessation in older drivers with ameliorable impairments while assisting at-risk older drivers to reduce or stop driving in a less stressful way.

Aging Without Driving Evidence From the Health and Retirement Study, 1993 to 2008

This study characterized older adults who do not drive (former and never drivers) and examined how this group of elders has changed over the past 15 years. Sample included community-living adults aged 70 to 85 who do not drive from the 1993 Asset and Health Dynamics Among the Oldest Old Study (N = 1,979) and 2008 Health and Retirement Study (N = 1,119). Chi-square and t tests were used to assess differences between never and former drivers and between cohorts. Logistic regression was used to examine the predictors of having never driven. The driving status among older adults has improved over the past 15 years as the proportion of never drivers declined from 11% to 2%. However, nondriving has become more concentrated among ethnic minority women, and the gaps in education and net worth between former and never drivers widened over the 15 years.

The pathway to grandparenting stress: trauma, relational conflict, and emotional well-being

Objectives: This paper examines the mediating effect of child–grandparent conflict on the relationship between child trauma exposure and grandparenting stress. Methods: Data was collected from a sample of custodial grandparents who participated in kinship care or relative caregiving programs (n = 251). Grandparenting stress was measured with Parenting Stress Scale (Berry & Jones, 1995) modified for grandparents. A series of regression models and structural equation models (SEM) were used to test the relationship between the number of different types of child trauma exposures and grandparenting stress, and to examine the mediating effect of child–grandparent conflicts on the relationship. Results: Almost three-fourths (72%) of children had experienced at least one type of traumatic exposure. The SEM model shows that childs trauma exposure indirectly affected grandparenting stress, mediated by child–grandparenting conflicts though no direct path between the childs trauma exposure variable and grandparenting stress was found. A higher level of child–grandparent conflicts was also associated with a lower level of emotional well-being among custodial grandparents. Conclusion: Based on these findings, recommendations are made about how to tailor a trauma-informed approach to the needs of custodial grandparents.

Voluntary and Involuntary Driving Cessation in Later Life

This study explores the decision-making process of driving cessation in later life, with a focus on voluntariness. The sample included 83 former drivers from the Baltimore Epidemiologic Catchment Area Study. A majority of participants (83%) reportedly stopped driving by their own decision. However, many voluntary driving retirees reported external factors such as financial difficulty, anxiety about driving, or lack of access to a car as main reasons for driving cessation. These findings imply that distinction between voluntary and involuntary driving cessation is ambiguous and that factors beyond health status, including financial strain, play a role in the transition to non-driving.

Self-regulatory driving behaviors: gender and transportation support effects

This study examined the relationship between transportation support and self-regulatory driving behaviors of 566 community-dwelling older adults living in retirement communities, with a focus on gender differences. The results of logistic regression analysis showed that older women were more likely to avoid driving at night or on the highway than their male counterparts. Transportation support from peer friends was found to increase the likelihood of self-regulatory driving behaviors. The findings of this study imply that transportation policy and driving safety programs for older adults need to be developed, considering available transportation alternatives and gender differences in driving behaviors.