Older Adult Driving Patterns: Driving Resumption Among Former Drivers

摘要

Background: Many older adults stop driving due to age- and health-related functional declines. Driving cessation has been associated with decreased social support and increased risk of depression, cognitive decline, entry into long-term care and mortality. A small subset of former drivers resume driving, perhaps due to unmet transportation needs, although driving resumption has not been studied to date.;Objectives: 1) Provide evidence of the extent of driving resumption; 2) highlight how driving status definitions affect results; 3) identify predictors of driving resumption; and 4) quantify mortality risk based on driving status of continued driver, resumed driver, and former driver. Data source: National Health and Aging Trends Study (2011-2015) public-use data files; sample limited to those who were community-dwelling self-respondents in Round 1 (n=6,680).;Methods: Cross-sectional and longitudinal analysis using simple and multilevel logistic regression on driving resumption, and life table and discrete time logistic regression survival analyses.;Results: Driving resumption ranged from 1.4% to 38.7% and was highest among recently stopped drivers. When resumption was based on driving in the past month versus the past year, the number of resumed drivers differed by more than 20%. Predictors of resumption included age, car ownership, overnight hospitalization, immediate word recall score, and use of taxi or public transportation. Stroke was negatively associated with resumption. Mortality risk was similar between continued and resumed drivers but worse among former drivers (adjusted OR 2.42; 95% CI 1.54, 3.82).;Implications for public health: As the first study to explore driving resumption, the stage is set for additional studies to examine methodology related to driving behavior change and to further understanding of why some individuals resume driving and the potential consequences of resumption. Because resumption was associated with use of public transportation, mobility transition counseling should be expanded to include follow-up in the year or two after driving cessation to limit driving resumption.