The driving habits of adults aged 60 years and older

OBJECTIVES: We describe the driving habits of adults aged 60 years and olde r who were interviewed in the context of a community survey focused on ment al disturbances. Our goal was to identify clinical cues that might signal d riving difficulty in older adults who might present to the primary care phy sician for health care. DESIGN: A population-based survey. SETTING: Continuing participants in a follow-up study of community-dwelling adults who were living in East Baltimore in 1981. PARTICIPANTS: Subjects were 1920 continuing participants of the Baltimore s ample of the Epidemiologic Catchment Area Program; 589 were aged 60 years a nd older and provided information on driving habits. MEASUREMENTS: Respondents were asked about their driving status: had they m ade adaptations to driving and had they experienced any adverse driving eve nts in the 2 years before the interview. Driving behaviors were assessed in relation to chronic disease, sensory impairment, functional status, and me ntal status. RESULTS: Former drivers were more likely to be older, female, and nonwhite. Diabetes, vision impairment, functional impairment, and making an error on the copy design task of the Mini-Mental State Examination (MMSE) were asso ciated with no longer driving. Women were more likely to report having made adaptations to driving, as were persons with heart disease, arthritis, vis ion impairment, and those who made an error on the copy design task of the MMSE. Heart disease and hearing impairment were associated with report of a n adverse driving event. In multivariate models that included terms for pot entially influential characteristics such as age, gender, and miles driven, only the copy design task was associated with driving status, and only hea rt disease was associated with driving adaptation and adverse driving event s. CONCLUSION: Simple tests that tap visuospatial ability, such as the copy de sign task of the MMSE, may warrant additional study for use in driving asse ssment of older adults in primary care. The results underscore the importan ce of making an inquiry about driving as a separate and independent compone nt of functional assessment.