title: Examination of cognitive and instrumental functional performance as indicators for driving cessation risk across 3 years.
abstract: OBJECTIVE
  The purpose of this study was to prospectively examine the role of cognitive and instrumental functional performance in driving cessation while simultaneously accounting for any contributions of demographics, vision, physical performance, and health among a sample of older adults without dementia.
  
  
  METHODS
  Included in the analyses were 1,838 participants from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study who were drivers at baseline and completed the third-year assessment. Participants completed baseline assessments of sociodemographic characteristics, health, sensory function, physical function, cognitive abilities, instrumental functional performance, and depressive symptoms. Driving status was again ascertained 3 years later.
  
  
  RESULTS
  We used Cox proportional hazard analyses to examine prospective predictors of driving cessation over a 3-year period. The final model indicated four significant risk factors for driving cessation: older age (hazard ratio [HR] = 1.06, p = .009), poorer balance as measured by the Turn 360 degrees test (HR = 1.17, p = .002), slower cognitive speed of processing as measured by the Useful Field of View test (HR = 1.37, p = .004), and poorer instrumental functional performance as assessed by the Everyday Problems Test (HR = 1.59, p < .001).
  
  
  CONCLUSIONS
  Although vision, health, and physical abilities are commonly considered when determining driving capacity, cognitive speed of processing and instrumental functional performance may be better indicators of subsequent likelihood of driving cessation across 3 years among older adults. Poor health and vision may only impact driving cessation to the extent that cognitive speed of processing and instrumental functioning are affected.
authors.affiliation: Department of Psychology, University of Alabama at Birmingham, USA. mlynnack@uab.edu
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Ackerman
authors.forename: Jerri D
authors.initials: JD
authors.lastname: Edwards
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Ross
authors.forename: Karlene K
authors.initials: KK
authors.lastname: Ball
authors.forename: Melissa
authors.initials: M
authors.lastname: Lunsman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving; D003071:Cognition; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011597:Psychomotor Performance; D018570:Risk Assessment / Q000379:methods