title: Consequences of driving cessation: decreased out-of-home activity levels.
abstract: OBJECTIVE
  Increasing age, socioeconomic factors, and declining function and health have been linked to driving cessation, but little is known about the consequences of stopping driving. This study was designed to test the hypothesis that driving cessation leads to a decline in out-of-home activity levels.
  
  
  METHODS
  In 1989 a survey of driving practices was administered to surviving noninstitutionalized members of the New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE) cohort. Of 1,316 respondents, 502 were active drivers as of 1988, 92 had stopped driving between 1982 and 1987, and 722 never drove or stopped before 1982. Information on sociodemographic and health-related variables came from in-home EPESE interviews in 1982, 1985, and 1988, and from yearly phone interviews. Activity was measured at all three in-home interviews, and an activity measure was created based on self-reported participation in nine out-of-home activities. A repeated measures random-effects model was used to test the effect of driving cessation on activity while controlling for potential confounders.
  
  
  RESULTS
  Driving cessation was strongly associated with decreased out-of-home activity levels (coefficient-1.081, standard error 0.264, p < .001) after adjustment for sociodemographic and health-related factors.
  
  
  CONCLUSIONS
  The potential consequences of driving limitations or cessation should be taken into account when advising older drivers and developing alternative transportation strategies to help maintain their mobility.
authors.affiliation: Clinical Epidemiology Unit, VA Connecticut Healthcare System, West Haven 06516, USA. marottol@ynhh.com
authors.forename: R A
authors.initials: RA
authors.lastname: Marottoli
authors.lastname: de Leon CFM
authors.forename: T A
authors.initials: TA
authors.lastname: Glass
authors.forename: C S
authors.initials: CS
authors.lastname: Williams
authors.forename: L M
authors.initials: LM
authors.lastname: Cooney
authors.forename: L F
authors.initials: LF
authors.lastname: Berkman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000523:psychology*; D000704:Analysis of Variance; D001334:Automobile Driving / Q000523:psychology*; D016009:Chi-Square Distribution; D015986:Confounding Factors, Epidemiologic; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D007899:Leisure Activities / Q000523:psychology*; D008297:Male; D015233:Models, Statistical; D009017:Morbidity; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires