July 31, 2002 - America faces
a strong demand for alternative means of transportation as a growing
number of senior drivers give up their driving privileges. The issue
could become a critical one as America ages, according to a new study,
which finds older men and women who outlive their ability or
willingness to drive must depend on alternative transportation for
more than a decade in later life.
"Hundreds of thousands of
older people quit driving each year and must turn to alternative
transportation. This change in status can create unforeseen economic
and social burdens that need to be addressed in the same way we have
encouraged people to think about planning for retirement and
end-of-life care. I don't think sufficient attention has been paid to
the transition from driver to non-driver in the aging population,"
says Dan Foley, M.S., a biostatistician at the National Institute on
Aging (NIA) and lead author of the study, published in the August 2002
issue of the "American Journal of Public Health."
Almost 10 percent of the
nation's drivers are older than 65, and that percentage could increase
rapidly in the next decade as the post-World War II "baby boom"
generation begins to reach that milestone. In addition, a greater
proportion of women age 65 or older is driving than in the past. By
2030, projections suggest one in five Americans will be 65 or older,
and the number of people aged 85 and older -- currently the fastest
growing segment of the older population -- could exceed 10 million.
But in Foley's study, driving cessation peaked at about age 85,
suggesting more of the oldest old may be dependent on other forms of
transportation in the future.
The investigators analyzed
data gathered in 1993 and 1995 as part of the NIA-supported Asset and
Health Dynamics Among the Oldest Old (AHEAD) study. From this
nationwide sample of people ages 70 or older, they assessed follow-up
data on 4,996 men and women who were able to drive and had access to a
car. Based on a statistical analysis, these drivers represented
approximately 13.7 million Americans aged 70 or older who were driving
in 1993, the baseline year. Overall, 82 percent of men and 55 percent
of women in this age group drove that year. Driving prevalence
declined with age, ranging from 88 percent of men in their early 70s
to 55 percent of those 85 or older. Among women, about 70 percent
drove in their early 70s compared to 22 percent still driving at age
85 or older.
Two years later, 7 percent of
the drivers had died. Another 9 percent were alive, but had quit
driving for other reasons. Overall, these findings suggest that more
than 600,000 people age 70 or older stop driving each year and become
dependent on others to meet their transportation needs. About 400,000
older drivers die of all causes annually. Other than death, poor
vision, memory impairment and an inability to perform one or more
activities of daily living (bathing, dressing, eating, transferring
between bed and chair, toileting, and getting around inside the home)
were common reasons older people stopped driving.
"Driving skills are dependent
on three areas of wellness: physical fitness, thinking clearly and
seeing well," Foley says. "Whether a person can continue driving
hinges on the severity of the disability or functional loss in one or
more of these three areas. Over time, people seem to reach thresholds
where they believe they can no longer safely drive."
Statistical analysis showed
that the average number of years a person continued to drive -- the
driving expectancy -- was significantly less than overall life
expectancy. For instance, men and women who were still driving at ages
70 to 74 were expected to drive, on average, another 11 years. But
these men were expected to live about 17 more years, and the women
nearly 21 more years. This gap between driving expectancy and overall
life expectancy means men in this age group who stopped driving were
dependent on alternative transportation for an average of six years.
For women, the gap translated into about 10 years dependence on other
transportation modes.
At age 85, those still
driving had a driving expectancy of about two years. But even at this
age, men would have 4 non-driving years of life remaining and women
nearly 6 years. Researchers found no differences in driving expectancy
between urban and rural areas.
"Driving has an essential
role in helping older men and women live independently. However, with
age, a person's competence and confidence behind the wheel may erode
to the point that quitting becomes an unfortunate necessity and
dependence on other means of transportation becomes an inevitable
reality," Foley says. "If we, as a society, fail to take steps to help
older people prepare for and cope with this transition, then the goal
of improving the quality of life in old age will be greatly
compromised, both now and in the foreseeable future."
The NIA, a component of the
National Institutes of Health, leads the federal effort in supporting
and conducting basic and clinical research on aging and the special
needs of older people. For information about the NIA, visit the
website at [http://www.nia.nih.gov/].
For other free brochures and booklets about aging and health topics of
interest to older people, visit the web site or call the NIA
Information Center at (800) 222-2225.
------------------------------------
Foley, DJ,
Heimovitz HK, Guralnik JM, Brock DB, "Driving Life Expectancy of
Persons Aged 70 Years and Older in the United States," 'American
Journal of Public Health,' vol. 92, no. 8 pp. 1284-1289.
(DJ Foley, JM Guralnik, and DB Brock are with the laboratory of
Epidemiology, Demography, and Biometry at the National Institute on
Aging., Bethesda, Maryland. HK Hemovitz is with Sytel, Inc.,
Rockville, Maryland.)
