Impact of driving cessation on health-related quality of life trajectories
DOI: 10.1186/s12955-024-02231-4
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Summary
This study investigates the trajectories of health-related quality of life (HRQoL) among older adults before and after driving cessation (DC). While DC is traditionally associated with declines in social, physical, and mental health, recent evidence suggests outcomes may be heterogeneous, with some individuals experiencing improvements. The authors hypothesized that HRQoL might remain stable or improve for specific subgroups, including urban drivers, volunteers, and those who access alternative transportation. The research utilized data from the AAA Longitudinal Research on Aging Drivers (LongROAD) study, a prospective cohort of 2,990 drivers aged 65–79 recruited between 2015 and 2017. The study followed participants for five years, with data collection ending in October 2022. Driving cessation was defined as permanent stopping of driving, identified through self-report, notification to the study team, or objective vehicle data. The analysis focused on 61 participants who ceased driving during the follow-up period and had data both before and after DC. HRQoL was measured using the PROMIS-29 Adult Profile, assessing eight domains: depression, anxiety, ability to participate in social roles and activities, physical function, fatigue, pain interference, sleep disturbance, and pain intensity. Individual growth models, a type of linear mixed model, were employed to estimate adjusted trajectories (controlling for age, gender, and education) for 2,989 participants, examining changes immediately after DC and trends over time since cessation. The results indicated that most HRQoL domains worsened immediately after DC. Specifically, depression, anxiety, physical function, fatigue, pain interference, and pain intensity all showed significant immediate declines, with no subsequent change in the slope of decline compared to the pre-DC period. Sleep disturbance remained unchanged. In contrast, the ability to participate in social roles and activities declined immediately after DC but subsequently improved with a steep positive slope. Subgroup analyses revealed that volunteers experienced less improvement in social roles and activities compared to non-volunteers, contradicting the hypothesis. Participants accessing alternative transportation experienced a large immediate increase in fatigue, also contradicting the hypothesis. Urban residents exhibited worse function and more symptoms post-DC than rural residents, except for social roles and activities, which declined steeply for rural residents, supporting the hypothesis that rural drivers face greater social isolation risks. The study concludes that while driving cessation generally leads to immediate declines in physical and mental health markers, participation in social roles and activities can improve over time, particularly with the use of alternative transportation. The findings highlight a critical disparity for rural older adults, who experience steep declines in social engagement after stopping driving. The authors recommend educating older adults that utilizing alternative transportation may cause initial fatigue and emphasize the need to increase access to alternative transport options in rural areas to maintain social roles and activities.
Key finding
While most health domains worsened immediately after driving cessation, the ability to participate in social roles and activities improved over time, particularly for those utilizing alternative transportation, whereas rural residents experienced steep declines in social participation.
Methodology
naturalistic
Sample size: 2990
Provenance
The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via author_sweep_intake on 2026-05-27 (2 acquisition events logged).
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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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