Predicting driving cessation over 5 years in older adults: Psychological well-being and cognitive competence are stronger predictors than physical health

OBJECTIVES: To examine psychological, medical, and sensorimotor risk factors that predict driving cessation in older adults. DESIGN: Prospective cohort study including five waves of data collected in 1992, 1993, 1994, 1995, and 1997. SETTING: The Australian Longitudinal Study of Aging. PARTICIPANTS: One thousand four hundred sixty-six men and women aged 70 and older drawn from the electoral roll and including 753 drivers at baseline. MEASUREMENTS: Interviews, including assessments of self-rated health (indicating general well-being); medical conditions; driving status; and clinical assessments of vision, hearing, cognitive function, and grip strength, were conducted in 1992 (baseline) and 1994. Information on current driving status was obtained at baseline and four subsequent waves (1993, 1994, 1995, and 1997). Drivers and nondrivers were compared at baseline. Risk factors for driving cessation were identified using logistic regression. RESULTS: Drivers were younger and more likely to be male and had better self-rated health, vision, hearing, and cognitive performance than nondrivers at baseline. Seventeen percent of drivers in the study had vision of 6/18 or worse, and 7.3% were classified as possibly cognitively impaired. In those identified as drivers at baseline, subsequent cessation was associated with increasing age, low grip strength, poorer cognitive performance, and poorer self-rated health. CONCLUSION: Self-rated health and cognitive function were more important than medical conditions or sensory function for predicting driving cessation.