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

BACKGROUND: Driving cessation is a challenging transition for older drivers. It is indeed often associated with reduced mobility, loss of autonomy and poor quality of life, as in individuals with acquired disabilities. We examined factors that inhibit or facilitate out-of-home occupations after driving cessation (shopping, visiting/helping friends/family, leisure, and associative activities) in older adults, with particular focus on the role of anticipation. METHODS: This longitudinal study was conducted with the SAFE MOVE cohort (n=1014 drivers aged≥70 years). Socio-demographic, health, cognitive, mobility and out-of-home occupations data were collected at home at baseline and by a postal questionnaire at 2-year follow-up. RESULTS: In total, 48 (5%) participants stopped driving between baseline and follow-up, at a mean age of 81.8 years; 71% of drivers who stopped reported that driving cessation affected their out-of-home occupations. Participation in social occupations started to decline before driving cessation. Retired drivers were older, had poorer health, poorer cognitive abilities, drove less at baseline but used more public transportation than active drivers. As compared with participants who did not consider driving cessation at baseline, those who did were more likely to expect a better quality of life in the event of driving cessation and to use public transportation at baseline and follow-up despite their older age and poorer health. CONCLUSION: Some factors associated with reduced social participation and driving cessation are inevitable, such as health status. However, other factors may facilitate maintenance of social participation, including anticipation of driving cessation and mobility habits. Our findings highlight the need for appropriate interventions that are widely available to older drivers before driving cessation occurs and for public policy actions facilitating alternative transport systems.