Car Keys Give Seniors Independence

July 21, 2006 -- When older drivers give up the keys to the car, they may be more likely to enter long-term care if they have no other transportation options.

That finding comes from a study of nearly 1,600 older adults in Salisbury, Md. -- a rural town on Maryland's Eastern Shore without public transportation.

The researchers, who included Johns Hopkins University's Ellen Freeman, PhD, stress that they're not suggesting that everyone drive indefinitely. Sooner or later, some older drivers may need to quit driving for safety's sake.

"OIder adults are expected to make good decisions about when to stop driving," the researchers write. "But the hardships imposed on older adults by not driving are not widely recognized."

Freeman's team calls for "innovative strategies," including better public transportation and help from family and friends, to curb isolation in seniors who no longer drive.

Drivers' Data

The study started in 1993-1995. Back then, participants were 65-84 years old. They got a mental skills test and took a survey, by telephone, about their medical history. Most participants -- 1,347 people -- were current drivers.

Every two years through 2003, participants completed telephone surveys for the study. Johns Hopkins University's Ellen Freeman, PhD, and colleagues checked the results.

The 2003 questionnaire included these topics:

• Have you ever driven?
• How many miles did you drive in the past year?
• Have you stopped driving?
• How many other people living with you are able to drive?

During the study, 149 participants -- 9% of the group -- entered long-term care for more than three months. Freeman's team noticed several things about those people:

• Even after taking health into account, people who had never driven or who had quit driving were about four times more likely to enter long-term care than current drivers.
• People with no other drivers in their home were 72% more likely to enter long-term care than those living with at least one other driver.

In short, not driving and not living with a driver were linked to greater odds of entering long-term care. But the big picture may not be quite that simple.

The researchers tried to isolate the effects of not driving. However, they note that there may be other factors they didn't consider.

Also, remember that the study was done in a rural town without public transportation. The results may not apply to urban areas, where people might be able to take public transportation or walk instead of driving, note Freeman and colleagues.

They call for further research to see how not driving affects older adults and how to help seniors live at home -- with safe transportation -- for as long as they want.

SOURCES: Freeman, E. American Journal of Public Health, July 2006; vol 96: pp 1254-1259. News release, Johns Hopkins Medical Institutions.