Many older adults consider driving as essential to maintaining their quality of life and independence, and this may be particularly true for individuals residing in more rural areas where transportation options may be limited. Although it is normative for individuals to eventually stop driving as they age, very few plan ahead for their driving retirement (Curl et al., Reference Curl, Stowe, Cooney and Proulx2014). The process of driving cessation has been associated with a host of negative consequences for physical and mental well-being, including increased depressive symptoms, reduced network of friends, lower activity levels, and accelerated health decline (Mezuk & Rebok, Reference Mezuk and Rebok2008; Edwards et al., Reference Edwards, Lunsman, Perkins, Rebok and Roth2009; Curl et al., Reference Curl, Stowe, Cooney and Proulx2014). Previous studies have found that, at all ages, women are more likely to stop driving in later life than men, and often stop driving prematurely, and that various factors such as education and marital status influence the likelihood of cessation differently for women and men (Ross et al., Reference Ross2009; Choi et al., Reference Choi, Mezuk, Lohman, Edwards and Rebok2012). Thus, factors associated with driving cessation and its consequences for older women are important to understand, particularly factors that might help buffer the negative effects of giving up driving and that might serve as early targets for preventive interventions.
The paper on “Moderating effects of social engagement on driving cessation in older women” by Pachana and colleagues (Pachana et al., Reference Pachana, Leung, Gardiner and McLaughlin2016) in this issue makes an important contribution to the growing literature on the effects of driving cessation in later life. The study participants included 4,075 older women (aged 76–87 years) drawn from the 1921–1926 cohort of the Australian Longitudinal Study on Women's Health (ALSWH). The participants all drove at baseline and were followed for three years to assess driving cessation. The primary outcome variable was mental health, as measured by the mental health index (MHI) of the SF-36. The explanatory variables were social support factors, including social interaction, whether the women were living alone or with others, and engagement in social activities. Replicating findings from previous studies, the results indicated that women who ceased driving reported poorer mental health than those who continued. However, women with higher levels of social interactions and engagement in social activities after driving cessation succeeded in maintaining good levels of mental health. The authors concluded that the findings support the role of social support as a buffer of declining mental health in older women who cease driving.
What have we learned from this study about the relationship between driving cessation, social variables, and mental health? Clearly, ceasing driving in later adulthood is associated with a range of negative outcomes for older women, including poorer mental health. However, these effects can be moderated by social activities engagement, as indicated by a significant interaction between driving status and social activities engagement. Interestingly, there were no significant interaction effects of driving status by social interaction or driving status by living alone on mental health. So, social interaction did not moderate the effects of driving cessation on mental health, although those who ceased driving reported fewer social contacts. Women with higher levels of social interaction had significantly higher levels of mental health compared to those with lower levels of social interaction. Older women who were living alone were less likely to have stopped driving than those who were not living alone, but living alone status did not moderate the effects of driving cessation on mental health.
Current research suggests that driving cession is a predictor of declines in health, social engagement, and living a productive life. This study by Pachana et al. (Reference Pachana, Leung, Gardiner and McLaughlin2016) supports existing research showing cessation causes poorer outcomes for older adults. However, the relationship between driving cessation and health outcomes may be more complex than direct cause and effect (e.g. driving cessation causes poorer mental health outcomes, but poor mental health may cause driving cessation). Because not all of the relevant questions about social support and mental health were included at each survey, and the survey responses were combined into baseline and follow-up, it is difficult to account for the temporality of effects associated with driving cessation. Future research should investigate how changes in social support predict changes in health outcomes as they relate to driving status. In addition, several of the demographic characteristics examined (e.g. area of residence, management on income, marital status, general health) may change over time and affect the nature of the associations reported.
Although research on social engagement after an older adult stops driving is generally consistent with the findings of Pachana and colleagues (Pachana et al., Reference Pachana, Leung, Gardiner and McLaughlin2016), they did not explore factors that contribute to the reduction of out-of-home social activities. For example, a non-driving older adult will need to plan the transportation necessary to participate in any out-of-home event. This need to plan the transportation is related to a loss of spontaneity and reduces out-of-home social engagement activities (Chichuri et al., Reference Chihuri2016). There also are some other limitations with regard to the measurement of social engagement and mental health in this study. Social engagement at follow-up was assessed by a question asking participants whether they had engaged in any of the following activities the past month: gone to the movies, theatre, concert, lectures; gone to a sporting event; played cards, bingo, pool, or some other game; eaten out at a restaurant; attended a religious service; attended a class or course; used a computer/internet. Participants who had performed at least one of these activities were considered to have engaged in social activities. Aside from questions about the degree of actual social engagement in some of these activities (e.g. using the computer/internet), it is questionable whether treating social engagement as a dichotomous outcome adequately reflects differing levels of engagement. Most of the women in the sample were socially engaged in at least one of the activities. In terms of mental health as an outcome variable, the study used the MHI of the SF-36. Although the SF-36 has criterion validity and is commonly used with older adults, future studies should include more objective measures of mental health administered over longer periods of time.
Pachana et al. (Reference Pachana, Leung, Gardiner and McLaughlin2016) suggest that involvement in structured driving cessation programs could improve health outcomes of older adults; however, there is limited understanding of the differences in driving retirement planning for women, and if there are differences in participation in these programs between men and women or in other demographic factors (e.g. income). Future research should include unique experiences of women to determine if there are differences in their opinions and experiences when planning for driving retirement, similar to the differences in driving cessation when comparing women to men (Rosenbloom & Herbel, Reference Rosenbloom and Herbel2000; Unsworth et al., Reference Unsworth, Wells, Browning, Thomas and Kendig2007). Mental health is an important aspect of driving health and longevity, and maintaining healthy and engaged lifestyles continues to be important as we age. However, the process that guides the transition from driving to not driving may be the difference between continuing to live a productive life or isolation with limited ability.
You have
Access
Many older adults consider driving as essential to maintaining their quality of life and independence, and this may be particularly true for individuals residing in more rural areas where transportation options may be limited. Although it is normative for individuals to eventually stop driving as they age, very few plan ahead for their driving retirement (Curl et al., Reference Curl, Stowe, Cooney and Proulx2014). The process of driving cessation has been associated with a host of negative consequences for physical and mental well-being, including increased depressive symptoms, reduced network of friends, lower activity levels, and accelerated health decline (Mezuk & Rebok, Reference Mezuk and Rebok2008; Edwards et al., Reference Edwards, Lunsman, Perkins, Rebok and Roth2009; Curl et al., Reference Curl, Stowe, Cooney and Proulx2014). Previous studies have found that, at all ages, women are more likely to stop driving in later life than men, and often stop driving prematurely, and that various factors such as education and marital status influence the likelihood of cessation differently for women and men (Ross et al., Reference Ross2009; Choi et al., Reference Choi, Mezuk, Lohman, Edwards and Rebok2012). Thus, factors associated with driving cessation and its consequences for older women are important to understand, particularly factors that might help buffer the negative effects of giving up driving and that might serve as early targets for preventive interventions.
The paper on “Moderating effects of social engagement on driving cessation in older women” by Pachana and colleagues (Pachana et al., Reference Pachana, Leung, Gardiner and McLaughlin2016) in this issue makes an important contribution to the growing literature on the effects of driving cessation in later life. The study participants included 4,075 older women (aged 76–87 years) drawn from the 1921–1926 cohort of the Australian Longitudinal Study on Women's Health (ALSWH). The participants all drove at baseline and were followed for three years to assess driving cessation. The primary outcome variable was mental health, as measured by the mental health index (MHI) of the SF-36. The explanatory variables were social support factors, including social interaction, whether the women were living alone or with others, and engagement in social activities. Replicating findings from previous studies, the results indicated that women who ceased driving reported poorer mental health than those who continued. However, women with higher levels of social interactions and engagement in social activities after driving cessation succeeded in maintaining good levels of mental health. The authors concluded that the findings support the role of social support as a buffer of declining mental health in older women who cease driving.
What have we learned from this study about the relationship between driving cessation, social variables, and mental health? Clearly, ceasing driving in later adulthood is associated with a range of negative outcomes for older women, including poorer mental health. However, these effects can be moderated by social activities engagement, as indicated by a significant interaction between driving status and social activities engagement. Interestingly, there were no significant interaction effects of driving status by social interaction or driving status by living alone on mental health. So, social interaction did not moderate the effects of driving cessation on mental health, although those who ceased driving reported fewer social contacts. Women with higher levels of social interaction had significantly higher levels of mental health compared to those with lower levels of social interaction. Older women who were living alone were less likely to have stopped driving than those who were not living alone, but living alone status did not moderate the effects of driving cessation on mental health.
Current research suggests that driving cession is a predictor of declines in health, social engagement, and living a productive life. This study by Pachana et al. (Reference Pachana, Leung, Gardiner and McLaughlin2016) supports existing research showing cessation causes poorer outcomes for older adults. However, the relationship between driving cessation and health outcomes may be more complex than direct cause and effect (e.g. driving cessation causes poorer mental health outcomes, but poor mental health may cause driving cessation). Because not all of the relevant questions about social support and mental health were included at each survey, and the survey responses were combined into baseline and follow-up, it is difficult to account for the temporality of effects associated with driving cessation. Future research should investigate how changes in social support predict changes in health outcomes as they relate to driving status. In addition, several of the demographic characteristics examined (e.g. area of residence, management on income, marital status, general health) may change over time and affect the nature of the associations reported.
Although research on social engagement after an older adult stops driving is generally consistent with the findings of Pachana and colleagues (Pachana et al., Reference Pachana, Leung, Gardiner and McLaughlin2016), they did not explore factors that contribute to the reduction of out-of-home social activities. For example, a non-driving older adult will need to plan the transportation necessary to participate in any out-of-home event. This need to plan the transportation is related to a loss of spontaneity and reduces out-of-home social engagement activities (Chichuri et al., Reference Chihuri2016). There also are some other limitations with regard to the measurement of social engagement and mental health in this study. Social engagement at follow-up was assessed by a question asking participants whether they had engaged in any of the following activities the past month: gone to the movies, theatre, concert, lectures; gone to a sporting event; played cards, bingo, pool, or some other game; eaten out at a restaurant; attended a religious service; attended a class or course; used a computer/internet. Participants who had performed at least one of these activities were considered to have engaged in social activities. Aside from questions about the degree of actual social engagement in some of these activities (e.g. using the computer/internet), it is questionable whether treating social engagement as a dichotomous outcome adequately reflects differing levels of engagement. Most of the women in the sample were socially engaged in at least one of the activities. In terms of mental health as an outcome variable, the study used the MHI of the SF-36. Although the SF-36 has criterion validity and is commonly used with older adults, future studies should include more objective measures of mental health administered over longer periods of time.
Pachana et al. (Reference Pachana, Leung, Gardiner and McLaughlin2016) suggest that involvement in structured driving cessation programs could improve health outcomes of older adults; however, there is limited understanding of the differences in driving retirement planning for women, and if there are differences in participation in these programs between men and women or in other demographic factors (e.g. income). Future research should include unique experiences of women to determine if there are differences in their opinions and experiences when planning for driving retirement, similar to the differences in driving cessation when comparing women to men (Rosenbloom & Herbel, Reference Rosenbloom and Herbel2000; Unsworth et al., Reference Unsworth, Wells, Browning, Thomas and Kendig2007). Mental health is an important aspect of driving health and longevity, and maintaining healthy and engaged lifestyles continues to be important as we age. However, the process that guides the transition from driving to not driving may be the difference between continuing to live a productive life or isolation with limited ability.