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 Giving up the car keys was linked to an almost doubled risk of
depression, the analysis found, a connection the researchers believe
might be at least partly due to the social isolation or lack of
independence that can ensue when elderly people can no longer get
around by car.
“The decision to stop driving is not trivial but has significant
implications for the patient’s health, well-being and life
expectancy,” said senior study author Dr. Guohua Li of the Mailman
School of Public Health at Columbia University in New York City.
There are 39.5 million adults aged 65 and older in the U.S., and
most have driver’s licenses, Li and colleagues report in the Journal
of the American Geriatrics Society.
Because driving requires good vision and reflexes as well as decent
physical and mental health, getting behind the wheel may become
unsafe for some older individuals, the authors note.
For their new research, they reviewed 16 previously published
studies examining a range of medical outcomes in people 55 and older
who stop driving.
A pooled analysis of results from five of the studies found former
drivers were 91 percent more likely to experience depressive
symptoms than their peers who remained on the road.
Older adults who stopped driving were also more likely to report
poor health, according to four studies that looked at results from
quality of life surveys.
One Finnish study, for example, found that 59 percent of drivers
rated their health as good, compared with just 43 percent of
ex-drivers. But it’s possible the drivers had stopped driving
because of poor health, the authors note.
Five studies found declines in physical health linked to driving
cessation, although in three of these it’s possible medical problems
forced people off the road.
Some studies also linked driving cessation to declines in social
health, which appeared more pronounced for women than men. One of
these studies, for example, found ex-drivers had a 51 percent
reduction in their social network of friends and relatives over 13
years.
Two studies linked driving cessation to mortality. One found
ex-drivers four to six times more likely to die over three years
than continuing drivers, while the other found the five-year
mortality risk 68 percent higher for non-drivers.
None of the studies were designed to show whether giving up driving
caused the problems, or vice versa.
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Another limitation is that the studies used a wide variety of
measures to assess health and often relied on surveys or symptoms
reported by patients, the authors note.
All but one of the studies exploring the connection between
depression and driving cessation was based on self-reported
symptoms, not a clinical diagnosis.
The findings highlight the need for more research to pinpoint how
taking car keys away from elderly adults may influence both physical
and mental health, the authors conclude.
“We do not know how much the observed declines are due to driving
cessation versus the extent that the physical and mental declines
themselves contributed to driving cessation in the first place,”
noted Raymond Bingham of the University of Michigan Transportation
Research Institute in Ann Arbor.
A sudden change in health, a stroke, or a more gradual shift in
driving abilities all might signal the right time to drop driving,
Bingham, who wasn’t involved in the study, added by email.
When that time comes, maintaining mobility and social connections
may help avert depression or other adverse health effects, Bingham
added.
If cessation of driving increases social isolation and access to
goods and services, “then it’s no surprise that health declines
follow,” Bingham said.
The analysis was funded in part by the AAA Foundation for Traffic
Safety and the U.S. Centers for Disease Control and Prevention.
SOURCE: http://bit.ly/1PAZ2XH Journal of the American Geriatrics
Society, online January 19, 2016.
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