Barriers and facilitators to social participation after driving cessation among older adults: A cohort study

Pellichero, Alice; Lafont, Sylviane; Paire‐Ficout, Laurence; Fabrigoule, Colette; Chavoix, Chantal

doi:10.1016/j.rehab.2020.03.003

Cited by 17 publications

(11 citation statements)

References 31 publications

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“…Secondly, age-friendly urban planning [20] might increase feelings of security [21] social connectedness and belonging [22]. Thirdly, driving cessation [23] increases the needs of older adults to be supported in their community mobility. Fourth, financial means [24] and health limitations [25] influence how older adults manage their community mobility needs.…”

Section: Open Accessmentioning

confidence: 99%

The health equity characteristics of research exploring the unmet community mobility needs of older adults: a scoping review

et al. 2022

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Background Unmet community mobility needs of older adults, published since the announcement of the UN sustainable development goals was synthesised to describe the health equity characteristics of research identifying unmet community mobility needs of older adults. Methods Searches were conducted in March and April 2020, 2275 articles were screened and 100 identified for data extraction. Results Findings showed underrepresentation of articles considering rural settings [9%] and originating in the global South [14%]. Gender, disability, education, and transport / driving were identified as key health equity characteristics and only 10 articles provided detail on all four of these. External factors inhibiting community mobility included built environments, service availability, and societal attitudes. Internal factors included finances, fear and apprehension, and functional limitations. Conclusions The need for standardised reporting of participant characteristics in the community mobility of older adults was highlighted. These characteristics are required by research consumers to judge equity dimensions, and the extent to which findings represent minority or marginalised groups. 15 after the UN pledge to reduce inequalities, peer reviewed primary research does not reflect a global drive to end discrimination, exclusion and reduce the inequalities and vulnerabilities that leave people behind.

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Section: Open Accessmentioning

confidence: 99%

The health equity characteristics of research exploring the unmet community mobility needs of older adults: a scoping review

et al. 2022

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“…Others in the literature report on the role that social participation plays on driving cessation. Prior to driving and after cessation social engagement declines ( 12 ). Older drivers who are socially active and provide rides to activities to family and friends avoid driving cessation longer ( 13 – 15 ).…”

Section: Discussionmentioning

confidence: 99%

Associations of Self-Care Health Behaviors With Driving Cessation Among Older Drivers

Mielenz

Whalen

Xue

et al. 2022

Front. Public Health

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Older adults are at risk of driving cessation as they age, which can result in negative health outcomes including loss of independence. This study aimed to investigate the associations of self-care health behaviors with the risk of driving cessation. Demographics, health and driving characteristics were captured from healthcare systems in Denver, CO, San Diego, CA, Ann Arbor, MI, Baltimore, MD and Cooperstown, NY for 2,990 adults at baseline then followed from July 2015 to January 2021 via in-person assessments and questionnaires. The follow-up accumulated a total of 7,348 person-years and 46 driving cessations, yielding an incidence rate of 0.63 per 100 person-years. Multivariable Cox proportional hazards regression was used to evaluate the relationship between self-care behaviors and driving cessation, stratified by gender, and accounting for multiple failure events and clustering by study site. Ability to participate in social roles and activities was associated with an 8% reduction in the risk of driving cessation [adjusted hazard ratio (HR): 0.92; 95% CI: 0.89, 0.94]. Increased participation in social activities and relationships is associated with driving longevity in older adults and should be targeted for interventions to maintain driving mobility.

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“…For older people with cognitive disorders, driving cessation can lead to a series of negative changes in terms of autonomy and mood for both the patient and the natural caregiver. Recent studies agree on the need to implement interventions to provide support for patients and natural caregivers during the process of adaptation, and then on cessation of driving ( 14 , 15 ). However, the studies carried out so far have focused on targeted interventions for patients only or natural caregivers only ( 16 , 19 , 20 ), even though interactions between patient and caregiver seem to be at the heart of this process.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Giving up driving is a challenging transition for older drivers, and can sometimes be difficult ( 15 ). It is a significant life-event, and can lead to major changes in lifestyle, such as a decrease in outward-looking activities, increased loneliness and social isolation.…”

Section: Introductionmentioning

confidence: 99%

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An innovative therapeutic educational program to support older drivers with cognitive disorders: Description of a randomized controlled trial study protocol

et al. 2022

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Older drivers face the prospect of having to adjust their driving habits because of health problems, which can include neurocognitive disorders. Self-awareness of driving difficulties and the interaction between individual with neurocognitive disorders and natural caregiver seem to be important levers for the implementation of adaptation strategies and for the subsequent voluntary cessation of driving when the cognitive disorders become too severe. This study aims to evaluate an educational program for patient/natural caregiver dyads who wish to implement self-regulation strategies in driving activity, and to improve self-awareness of driving ability. The ACCOMPAGNE program is based on seven group workshops, which target the dyad. The workshops deal with the impact of cognitive, sensory and iatrogenic disorders on driving. They tackle questions about responsibility, and about autonomy and social life. They also provide alternative solutions aimed at maintaining outward-looking activities even if driving is reduced or stopped. A randomized controlled trial is planned to evaluate the effectiveness of the program 2 months and 6 months after inclusion, and to compare this to the effectiveness of conventional approaches. The main outcome of this trial (i.e., the implementation of self-regulated driving strategies), will be measured based on scores on the “Current Self-Regulatory Practices” subscale of the Driver Perception and Practices Questionnaire. The Driving Habits Questionnaire will be used to measure secondary outcomes (indicators of driving changes; indicators of changes in mood, quality of life and caregiver burden; and self-awareness of driving abilities). Indicators will be collected for both patients and natural caregivers. This cognitive, social and psychological program should allow older individuals with cognitive disorders to drive more safely, and help to maintain the quality of life and mood of both patient and natural caregiver despite driving limitations. The patient's care path would be optimized, as he/she would become an actor in the process of giving up driving, which will, most certainly, be needed at some point in the progress of neurocognitive disorders. This process ranges from becoming aware of driving difficulties, to implementing self-regulation strategies, through to complete cessation of driving when necessary.Clinical trial registration numberNCT04493957.

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Barriers and facilitators to social participation after driving cessation among older adults: A cohort study

Cited by 17 publications

References 31 publications

The health equity characteristics of research exploring the unmet community mobility needs of older adults: a scoping review

The health equity characteristics of research exploring the unmet community mobility needs of older adults: a scoping review

Associations of Self-Care Health Behaviors With Driving Cessation Among Older Drivers

An innovative therapeutic educational program to support older drivers with cognitive disorders: Description of a randomized controlled trial study protocol

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