Ten Years Down the Road: Predictors of Driving Cessation

Edwards, J. D.; Bart, E.; O'Connor, M. L.; Cissell, G. · 2009 · OpenAlex-citations

DOI: 10.1093/geront/gnp127

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Summary

This study investigates the predictors of driving cessation among older adults over a 10-year period, addressing a gap in prior research that was largely limited to five-year follow-ups. As the population of licensed drivers aged 65 and older grows, maintaining driving mobility is critical for independence, health, and quality of life. Driving cessation is associated with negative outcomes, including social isolation, depression, and increased mortality. The authors utilized data from the Maryland Older Drivers Project to determine whether demographic, physical, and cognitive factors could predict the likelihood of stopping driving in a modern cohort. The study employed a prospective cohort design with 1,248 participants aged 55 and older who had recently renewed their driver’s licenses at Maryland Motor Vehicle Administration sites. Participants underwent baseline assessments of physical and cognitive abilities, with a second in-person evaluation conducted approximately five years later. Driving status was monitored annually via telephone interviews until cessation, death, or loss to follow-up. Physical measures included rapid walk time, arm reach, head-neck rotation, and self-reported mobility difficulties. Cognitive assessments included the Motor-Free Visual Perception Test, delayed recall, the Trail Making Test, and the Useful Field of View (UFOV) Test, specifically Subtest 2, which measures cognitive speed of processing. Cox proportional hazard models were used to analyze the risk of driving cessation based on these predictors. Over the 10-year period, 149 participants ceased driving. Initial models identified age, days driven per week, rapid walk time, and several cognitive measures as significant predictors. However, the final multivariate model revealed only three significant predictors of driving cessation: older age at baseline (hazard ratio [HR] = 1.12, p < .001), fewer days driven per week (HR = 0.83, p = .05), and slower cognitive speed of processing as measured by the UFOV test (HR = 1.76, p < .01). Physical performance measures, such as rapid walk time, and other cognitive tests did not remain significant in the final model when controlling for these factors. Gender was not a significant predictor, suggesting that historical gender differences in driving cessation may be diminishing in modern cohorts. The findings underscore the critical role of cognitive speed of processing in maintaining driving mobility among older adults. The study suggests that brief cognitive assessments, such as UFOV Subtest 2, can be administered in motor vehicle administration settings to identify drivers at increased risk of cessation. Since cognitive speed of processing deficits can be remediated through training interventions, identifying at-risk individuals offers a pathway to prolong safe driving and preserve independence. The results imply that screening for cognitive processing speed could help target interventions to prevent premature driving cessation and its associated negative health and social consequences.

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Topics

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• cognitive capacity variation
• cognitive impairment
• mci dementia driving
• older drivers
• cognitive aging