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Communication Dans Un Congrès Année : 2014

Changes in driving restriction with aging among women

Résumé

In aging populations, maintaining the well-being and the health status of the elderly people is crucial. For drivers, this requires the maintenance of driving in safely way as long as possible. Sensory, functional, and minor cognitive changes appear in the course of normal aging, and are more severe in dementia-inducing brain pathologies. They may profoundly affect driving [1], which is a complex task involving all of these functions, particularly attention and decision-making which are necessary for the selection of relevant information and situation-specific action. Many studies show that older drivers modify their driving habits [2, 3]. Any driving regulation will have the positive impact of decreasing the risk of accident. Conversely, the absence of, or insufficient driving regulation can have negative consequences in terms of road safety, and excessive regulation could increase the risk of social exclusion, depression, loss of autonomy and pathological brain aging [4, 5]. When this regulation process occurs in later life, gender differences have been reported in non-prospective studies [6-10]. Women regulate their driving more than men and do so earlier. Choi et al. think that these differences can be understood in the context of 'gender roles' [11] with the car occupying a more important place for men than women, in a context of masculinity, speed than women [12, 13] . Women could also have shorter "career" as drivers than men. They may obtain their license at an older age and stop driving for longer periods [14] . From an organizational point of view, women could also be less dependent on their car for mobility than men [11]. This difference in daily car use could facilitate driving regulation. These gender differences in images and roles could also lead women to enjoy driving less than men or to doubt in their driving abilities and this could lead to premature loss of mobility [15] and cause more men to make insufficient driving regulation. However the results of prospective studies are controversial. Some show that women are more likely to regulate than men [3, 16-18], while others have found no evidence of greater regulation in women [19-24]. These discrepancies can be partly explained by age, observation periods and different measures of regulation. As for the factors which might explain regulation, to our knowledge, only one prospective study has examined driving cessation factors in men and women separately [25]. However, this study did not include people with low global cognitive score. Nor did it take into account CNS pathologies which are known to change driving habits significantly and possibly differently in men and women. A study by Seiler et al. showed, that in demented people , women were more likely to cease driving than men at a pre-demential stage [26]. It is important to understand the regulation process in men and women, in the general population, in order to identify the factors of this regulation, factors due to pathological aging or not. In order to do so, we decided to study regulatory processes in men and in women, taking into account cognitive performance and CNS pathologies, based on prospective data providing information on changes in mobility, living arrangements, health status, cognitive performances and CNS pathologies over time. The 490 drivers of this study, 253 men and 237 women with a mean age of 76 years, were drawn from the Three-City Cohort of Bordeaux, a longitudinal study of people aged 65 years and older [27]. The participants were interviewed at home by a psychologist in 2003, 2006 and 2009 on a range of topics including socio-demographic characteristics, health (measures of motor and sensorial functions and several medical conditions) a cognitive evaluation and driving habits. A dementia diagnosis was also conducted for all participants by a neurologist. Driving restriction covers both driving cessation and a kilometer reduction. To study driving restriction factors, we used several Cox proportional hazard models with time dependent covariables. In this prospective study, the rate of driving restriction is high. Fifty seven percent of participants had restricted their driving over the follow-up. Women restricted their driving more frequently than men: 54% of men and 63% of women were reduced their distance driven or ceased to drive over six years. Pre-dementia, Parkinson's disease, advanced age and high initial mobility by car were common restriction factors in both genders. Prevalent dementia, depressive symptomatology, a decline in at least one Instrumental Activities of Daily Living and poor visual working memory performance were specific factors in men. In women, a low income, fear of falling, a slow execution time or a severe decline in global cognitive performance explain a regulation. This study confirmed that in later life women restrict their driving more than men, and that restriction factors differ according to gender. The pattern of results suggests that, when cognitive deficits are present, women restrict their driving at an earlier stage than men. It remains to be seen if excessive restriction in women could have negative consequences
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Dates et versions

hal-01428744 , version 1 (06-01-2017)

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  • HAL Id : hal-01428744 , version 1

Citer

Laetitia Marie-Dit-Asse, Colette Fabrigoule, Catherine Helmer, Bernard Laumon, Sylviane Lafont. Changes in driving restriction with aging among women. WIiT Paris 2014 : Women's Issues in Transportation - 5ème Conférence Internationale sur les Femmes et le Transport - Construire les ponts, Apr 2014, PARIS, France. 1 p. ⟨hal-01428744⟩
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