Driving Cessation and Health Outcomes in Older Adults

Abstract

Objectives: To determine what effect driving cessation may have on subsequent health and well-being in older adults.

Design: Systematic review of the evidence in the research literature on the consequences of driving cessation in older adults.

Setting: Community.

Participants: Drivers aged 55 and older.

Measurements: Studies pertinent to the health consequences of driving cessation were identified through a comprehensive search of bibliographic databases. Studies that presented quantitative data for drivers aged 55 and older; used a cross-sectional, cohort, or case-control design; and had a comparison group of current drivers were included in the review.

Results: Sixteen studies met the inclusion criteria. Driving cessation was reported to be associated with declines in general health and physical, social, and cognitive function and with greater risks of admission to long-term care facilities and mortality. A meta-analysis based on pooled data from five studies examining the association between driving cessation and depression revealed that driving cessation almost doubled the risk of depressive symptoms in older adults (summary odds ratio = 1.91, 95% confidence interval = 1.61-2.27).

Conclusion: Driving cessation in older adults appears to contribute to a variety of health problems, particularly depression. These adverse health consequences should be considered in making the decision to cease driving. Intervention programs ensuring mobility and social functions may be needed to mitigate the potential adverse effects of driving cessation on health and well-being in older adults.

Keywords: driving cessation; health outcomes; motor vehicle; older adults.

Figure 1

Flow diagram of identification, review, and selection of articles included in the systematic review of health outcomes after driving cessation in older drivers. Adapted from Mohar et al. 200925.

Figure 2

Forest plot, summary odds ratios (ORs), and 95% confidence intervals (CIs) of depressive symptoms associated with driving cessation. The size of each square is proportional to the relative weight that each study contributed to the summary OR. The diamond indicates the summary OR. Horizontal bars indicate the 95% CIs. Heterogeneity: Q statistic: 3.266, df = 4, P = .51, I ² = 0.000.