Demand
for alternative transportation to grow
as Americans outlive safe driving ability
America
faces a strong demand for alternative means of transportation as a growing
number of senior drivers give up their driving privileges. The issue could
become a critical one as America ages, according to a new study, which
finds older men and women who outlive their ability or willingness to
drive must depend on alternative transportation for more than a decade in
later life.
"Hundreds
of thousands of older people quit driving each year and must turn to
alternative transportation. This change in status can create unforeseen
economic and social burdens that need to be addressed in the same way we
have encouraged people to think about planning for retirement and
end-of-life care. I don't think sufficient attention has been paid to the
transition from driver to non-driver in the aging population," says
Dan Foley, M.S., a biostatistician at the National Institute on Aging
(NIA) and lead author of the study, published in the August 2002 issue of
the "American Journal of Public Health."
Almost
10 percent of the nation's drivers are older than 65, and that percentage
could increase rapidly in the next decade as the post-World War II
"baby boom" generation begins to reach that milestone. In
addition, a greater proportion of women age 65 or older is driving than in
the past. By 2030, projections suggest one in five Americans will be 65 or
older, and the number of people aged 85 and older -- currently the fastest
growing segment of the older population -- could exceed 10 million. But in
Foley's study, driving cessation peaked at about age 85, suggesting more
of the oldest old may be dependent on other forms of transportation in the
future.
The
investigators analyzed data gathered in 1993 and 1995 as part of the
NIA-supported Asset and Health Dynamics Among the Oldest Old (AHEAD)
study. From this nationwide sample of people ages 70 or older, they
assessed follow-up data on 4,996 men and women who were able to drive and
had access to a car. Based on a statistical analysis, these drivers
represented approximately 13.7 million Americans aged 70 or older who were
driving in 1993, the baseline year. Overall, 82 percent of men and 55
percent of women in this age group drove that year. Driving prevalence
declined with age, ranging from 88 percent of men in their early 70s to 55
percent of those 85 or older. Among women, about 70 percent drove in their
early 70s compared to 22 percent still driving at age 85 or older.
Two
years later, 7 percent of the drivers had died. Another 9 percent were
alive, but had quit driving for other reasons. Overall, these
findings suggest that more than 600,000 people age 70 or older stop
driving each year and become dependent on others to meet their
transportation needs. About 400,000 older drivers die of all causes
annually. Other than death, poor vision, memory impairment and an
inability to perform one or more activities of daily living (bathing,
dressing, eating, transferring between bed and chair, toileting, and
getting around inside the home) were common reasons older people stopped
driving.
"Driving
skills are dependent on three areas of wellness: physical fitness,
thinking clearly and seeing well," Foley says. "Whether a person
can continue driving hinges on the severity of the disability or
functional loss in one or more of these three areas. Over time, people
seem to reach thresholds where they believe they can no longer safely
drive."
Statistical
analysis showed that the average number of years a person continued to
drive -- the driving expectancy -- was significantly less than overall
life expectancy. For instance, men and women who were still driving at
ages 70 to 74 were expected to drive, on average, another 11 years. But
these men were expected to live about 17 more years, and the women nearly
21 more years. This gap between driving expectancy and overall life
expectancy means men in this age group who stopped driving were dependent
on alternative transportation for an average of six years. For women, the
gap translated into about 10 years dependence on other transportation
modes.
At
age 85, those still driving had a driving expectancy of about two years.
But even at this age, men would have 4 non-driving years of life remaining
and women nearly 6 years. Researchers found no differences in driving
expectancy between urban and rural areas.
"Driving
has an essential role in helping older men and women live independently.
However, with age, a person's competence and confidence behind the wheel
may erode to the point that quitting becomes an unfortunate necessity and
dependence on other means of transportation becomes an inevitable
reality," Foley says. "If we, as a society, fail to take steps
to help older people prepare for and cope with this transition, then the
goal of improving the quality of life in old age will be greatly
compromised, both now and in the foreseeable future."
The
NIA, a component of the National Institutes of Health, leads the federal
effort in supporting and conducting basic and clinical research on aging
and the special needs of older people. For information about the NIA,
visit the website at [http://www.nia.nih.gov/].
For other free brochures and booklets about aging and health topics of
interest to older people, visit the web site or call the NIA Information
Center at (800) 222-2225.
Foley, DJ,
Heimovitz HK, Guralnik JM, Brock DB, "Driving Life Expectancy of
Persons Aged 70 Years and Older in the United States," 'American
Journal of Public Health,' vol. 92, no. 8 pp. 1284-1289.
(DJ Foley, JM Guralnik, and DB Brock are with the laboratory of
Epidemiology, Demography, and Biometry at the National Institute on
Aging., Bethesda, Maryland. HK Hemovitz is with Sytel, Inc., Rockville,
Maryland.)
Now,
keep up to date with daily feeds of newly posted stories about America's
Seniors...click on the box to the left