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Consequences of Driving Cessation

Decreased Out-of-Home Activity Levels

^a Clinical Epidemiology Unit, VA Connecticut Healthcare System, West Haven, Connecticut
^b Departments of Medicine, Yale University School of Medicine, New Haven, Connecticut
^c Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut
^d Rush Institute for Healthy Aging, Rush–Presbyterian–St. Luke's Medical Center, Chicago, Illinois
^e Department of Epidemiology and Center on Aging and Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland
^f Department of Health and Social Behavior and the Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts

Richard A. Marottoli, Geriatrics and Extended Care, 240, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516 E-mail: marottol{at}ynhh.com.

Objectives. Increasing age, socioeconomic factors, and declining function and health have been linked to driving cessation, but little is known about the consequences of stopping driving. This study was designed to test the hypothesis that driving cessation leads to a decline in out-of-home activity levels.

Methods. In 1989 a survey of driving practices was administered to surviving noninstitutionalized members of the New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE) cohort. Of 1,316 respondents, 502 were active drivers as of 1988, 92 had stopped driving between 1982 and 1987, and 722 never drove or stopped before 1982. Information on sociodemographic and health-related variables came from in-home EPESE interviews in 1982, 1985, and 1988, and from yearly phone interviews. Activity was measured at all three in-home interviews, and an activity measure was created based on self-reported participation in nine out-of-home activities. A repeated measures random-effects model was used to test the effect of driving cessation on activity while controlling for potential confounders.

Results. Driving cessation was strongly associated with decreased out-of-home activity levels (coefficient–1.081, standard error 0.264, p < .001) after adjustment for sociodemographic and health-related factors.

Discussion. The potential consequences of driving limitations or cessation should be taken into account when advising older drivers and developing alternative transportation strategies to help maintain their mobility.

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