Frailty and poor physical functioning as risk factors for driving cessation
DOI: 10.3389/fpubh.2024.1298539
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Summary
This study investigates the impact of frailty and physical performance on driving cessation (DC) among older adults, addressing the need to identify modifiable risk factors that influence mobility and independence. While previous research established links between physical disability and DC, this study uniquely evaluates time-varying frailty and physical functioning longitudinally to determine their predictive value for stopping driving. The authors hypothesized that higher levels of frailty and poorer physical performance would significantly increase the likelihood of DC. The research utilized data from the AAA Longitudinal Research on Aging Drivers (LongROAD) cohort, a multisite prospective study of 2,990 active drivers aged 65–79 years recruited between 2015 and 2017. Participants were required to have valid licenses, no significant cognitive impairment, and drive vehicles from 1996 or newer. Physical performance was assessed using the Expanded Short Physical Performance Battery (SPPB), categorizing scores as poor (0–7), fair (8–10), or good (11–12). Frailty was measured using the Fried Frailty Phenotype, classifying participants as not frail, pre-frail, or frail; pre-frail and frail categories were combined for analysis. Driving cessation was defined as no driving activity for at least 30 days, verified via GPS monitoring and self-report. Cox proportional hazard models with time-varying covariates were employed to analyze the association between these physical metrics and time to DC, adjusting for age, sex, education, marital status, vision, and cognition. Over a five-year follow-up period, 73 participants (2.4%) ceased driving. The results demonstrated a strong protective effect of better physical performance. Compared to those with poor SPPB scores, individuals with fair scores had an adjusted hazard ratio (HR) of 0.31 for DC, while those with good scores had an HR of 0.09. Stratified analyses revealed significant sex differences in SPPB associations; for instance, men with good SPPB scores had an HR of 0.19 compared to those with poor scores, whereas women with good scores showed an even stronger protective effect (HR < 0.001). Regarding frailty, sex was not an effect modifier. Participants categorized as pre-frail or frail had a substantially higher risk of DC, with an adjusted HR of 6.1 (95% CI 2.7–13.8) compared to those who were not frail. The findings confirm that frailty and poor physical functioning are major, modifiable risk factors for driving cessation. The study suggests that maintaining physical activity and addressing frailty through targeted interventions, such as exercise and nutrition, may help older adults extend their driving life expectancy. This highlights the potential for clinical interventions to delay DC, thereby preserving mobility and independence in the aging population. The authors note limitations regarding the sample’s demographic composition, which was predominantly non-Hispanic white and highly educated, potentially limiting generalizability.
Key finding
Frailty and poor physical functioning are significant risk factors for driving cessation, with pre-frail or frail individuals having a 6.1 times higher adjusted hazard of stopping driving compared to non-frail individuals.
Methodology
naturalistic
Sample size: 2986
Provenance
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|---|---|---|---|---|---|---|
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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.
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