title: Relation of driving status to incident life space constriction in community-dwelling older persons: a prospective cohort study.
abstract: BACKGROUND
  Maintaining spatial movement through the environment is an important feature of healthy aging. We examined whether being licensed to drive is associated with maintaining spatial movement in older persons initially reporting maximum spatial mobility.
  
  
  METHODS
  From the Rush Memory and Aging Project, 571 nondemented, community-dwelling older persons were identified with (i) baseline data on driving status, (ii) baseline report of spatial mobility to the largest life space zone, and (iii) at least one annual follow-up evaluation. Incident constriction of life space was the primary outcome of interest.
  
  
  RESULTS
  Over an average follow-up of 4.3 years, 303 participants reported incident constriction of life space. In a proportional hazards model adjusted for age, sex, and education, having a valid driver's license at baseline was associated with a decreased hazard of reporting a life space constriction (hazard ratio = 0.39; 95% confidence interval = 0.29-0.54). Results were unchanged after controlling for number of vascular risk factors and vascular diseases, low visual acuity, social isolation, and gait speed. Of participants reporting incident life space constriction, 188 subsequently reported reexpansion of spatial mobility to the largest zone of life space. Having a valid driver's license was associated with a greater likelihood of life space recovery (hazard ratio = 2.00; 95% confidence interval = 1.27-3.17).
  
  
  CONCLUSIONS
  In older persons, having a valid driving license was associated with reduced hazard of reporting life space constriction and a greater likelihood of life space recovery if incident life space constriction occurred.
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 South Paulina, Suite 1022, Chicago, IL 60612, USA. raj_c_shah@rush.edu
authors.forename: Raj C
authors.initials: RC
authors.lastname: Shah
authors.forename: Kinsuk
authors.initials: K
authors.lastname: Maitra
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Barnes
authors.forename: Bryan D
authors.initials: BD
authors.lastname: James
authors.forename: Sue
authors.initials: S
authors.lastname: Leurgans
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology* / Q000523:psychology; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000523:psychology; D002641:Chicago; D015331:Cohort Studies; D004777:Environment; D005260:Female; D006801:Humans; D008004:Licensure; D008297:Male; D051346:Mobility Limitation; D011446:Prospective Studies; D013037:Spatial Behavior