title: Driving status and risk of entry into long-term care in older adults.
abstract: OBJECTIVE
  Given the importance of driving in American society, older non-drivers may be unable to meet basic needs while living independently. We assessed whether not driving is an independent risk factor for entering long-term care (LTC) institutions.
  
  
  METHODS
  Data were used from 1593 older adults who participated in the Salisbury Eye Evaluation cohort study and completed an additional telephone survey. Questions on driving status and LTC entry were obtained by self/proxy report. Cox time-dependent regression procedures were used to adjust for demographic and health factors.
  
  
  RESULTS
  Former and never drivers had higher hazards of LTC entry after adjustment for demographic and health variables (hazard ratio [HR]=4.85; 95% confidence interval [CI]=3.26, 7.21; and HR=3.53; 95% CI=1.89, 6.58, respectively). Also, having no other drivers in the house was an independent risk factor for LTC entry (HR=1.72; 95% CI=1.15, 2.57).Discussion. Older adults are expected to make good decisions about when to stop driving, but the hardships imposed on older adults by not driving are not widely recognized. Innovative strategies to improve transportation options for older adults should be considered.
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21205, USA.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Freeman
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gange
authors.forename: Beatriz
authors.initials: B
authors.lastname: Muñoz
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000523:psychology / Q000706:statistics & numerical data*; D003657:Decision Making; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D008396:Maryland; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012847:Single Person / Q000523:psychology / Q000706:statistics & numerical data; D012934:Social Isolation; D011795:Surveys and Questionnaires; D014186:Transportation; D014787:Vision Tests