Non-cognitive factors associated with driving cessation among older adults: An integrative review

Mobility is essential for successful aging, and driving is an important indicator of mobility in the society.1 Unlike other age groups, the number of older adults with a driver's license has increased.2 In 2016, about 19% of all drivers (41 million) aged 65 years and above, and a recent aging trend has indicated that this measure will increase to 25% by 2050.3 These changes show the importance of understanding the issues related to driving, transportation, and mobility in the older adult population.4

Driving is essential for working, having access to healthcare services, and social participation. It is also a cornerstone of supporting autonomy, identity, and independence.5 Therefore, driving cessation can have a profound effect on the mobility and quality of life of older drivers.6 Driving cessation is associated with decreased quality of life, increased depression, reduced access to healthcare services, reduced physical and social functioning, admission to long-term care centers, and increased mortality.7 Therefore, driving cessation should be considered an important issue for successful aging and well-being in older adults.8

Driving cessation is a complex and heterogeneous process and the decision to stop driving, whether voluntary or involuntary, can be influenced by many factors.9 In the recent years, a number of studies have been published on the factors leading to the restriction or cessation of driving. Having information about physical, social, psychological, and other factors influencing driving cessation can help design interventions for increasing the number of years of safe driving experience in older adults .10 In fact, recognizing the factors that affect the reduction and cessation of driving is crucial, because sustainable mobility plays an important role in successful aging.4

Older drivers face unique challenges because driving is a complex task that requires a variety of skills including perceptual, physical, cognitive, behavioral, and sensory abilities. Unfortunately, increase in age may imply diminished health and the related limitations, which can negatively affect the ability to drive or lead to driving cessation. Driving cessation in older adults can sometimes help maintain the safety of all road users. In some cases, however, some policies and a series of interventions can be applied to prevent the complete stop of driving and its irreparable consequences in older adults.11

It is well known that any change in cognition may affect the ability to drive a motor vehicle safely. Cessation of driving is inevitable in older drivers with cognitive impairments and has been well noted in many studies but this study looks for the non-cognitive factors of driving cessation in the older adults.12 Up to now, many studies have been conducted on driving cessation and its effective factors in older adults. However, no integrated study has been performed on the factors influencing the decision to stop driving in older adults without cognitive impairments. Given the potentially serious consequences of driving cessation in older adults, it is important to identify the risk factors for stopping driving. This helps achieve alternative approaches that can be actualized in clinical practice to empower individuals to make a decision to retire from driving. Knowing these factors helps design interventions such as training classes, physical fitness exercises, and appropriate policymaking for effective self-regulation and adaptability to driving cessation, which enhances the safe driving experience in the older adult population. Therefore, the aim of this study was to collect evidence on the non-cognitive factors associated with driving cessation among older adults.

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