Driving Cessation and Increased Depressive Symptoms: Prospective Evidence from the New Haven EPESE

Abstract

OBJECTIVES: The purpose of this study was to determine the association between driving cessation and depressive symptoms among older drivers. Previous efforts in this area have focused on the factors associated with cessation, not the consequences of having stopped. DESIGN: Cohort study. SETTING: Urban community. PARTICIPANTS: A driving survey was administered in 1989 to surviving noninstitutionalized members of the New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE) cohort. Of 1316 respondents, 502 were active drivers as of 1988, 92 had stopped driving between 1982 and 1987, and the remainder had either never driven or had stopped before 1982. MEASUREMENTS: Information about independent and dependent variables other than driving status came from the in person EPESE interviews in 1982, 1985, and 1988, except for medical conditions, which were updated yearly. Depressive symptoms were assessed by the Centers for Epidemiologic Studies-Depression (CES-D) scale. Analyses focused on the changes in depressive symptoms before and after driving cessation. Repeated measures multivariable analysis accounted for the effect of cessation on the outcome adjusting for the potential confounding due to sociodemographic and health-related factors. RESULTS: Individuals who stopped driving exhibited substantial increases in depressive symptoms during the 6-year interval. Driving cessation was among the strongest predictors of increased depressive symptoms (Coefficient 2.464, SE 0.758, P = .001) even when adjusting for sociodemographic and health-related factors. CONCLUSIONS: Driving cessation was associated with an increase in depressive symptoms even when accounting for sociodemographic and health-related factors. These consequences need to be taken into account when advising older drivers and when developing alternative transportation strategies.