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. Author manuscript; available in PMC: 2025 Jan 1.
Published in final edited form as: Clin Gerontol. 2023 Jun 14;47(2):224–233. doi: 10.1080/07317115.2023.2224795

Driving Cessation and Late-Life Depressive and Anxiety Symptoms: Findings from the National Health and Aging Trends Study

Rachel Missell-Gray a,b,*, Adam Simning a,c
PMCID: PMC10719415  NIHMSID: NIHMS1908383  PMID: 37313655

Abstract

Objectives:

To describe the association between driving cessation and depressive and anxiety symptoms over time by assessing depression and anxiety at 1- and 4-years follow-up.

Methods:

The study examined community-dwelling adults aged 65 years and older from the National Health and Aging Trends Study who were driving at the 2015 interview and completed 1-year (N=4,182) and 4-year (N= 3,102) follow-up interviews. Outcomes were positive screens for depressive and anxiety symptoms in 2016 or 2019, and the primary independent variable was driving cessation within one year of the baseline interview.

Results:

Adjusting for socio-demographic and clinical characteristics, driving cessation was associated with depressive symptoms at 1 year (OR=2.25, 95% CI: 1.33–3.82) and 4-year follow-up (OR=3.55, 95% CI: 1.72–7.29). Driving cessation was also associated with anxiety symptoms at 1 year (OR=1.71, 95% CI: 1.05–2.79) and 4 year follow up (OR=3.22, 95% CI: 1.04–9.99).

Conclusions:

Driving cessation was associated with an increased risk of developing depressive and anxiety symptoms in later life. However, reasons for this association remain unclear.

Clinical Implications:

Although the mechanism linking driving cessation with worse mental health symptoms is uncertain, driving facilitates many important activities. Clinicians should monitor the well-being of patients who stop or intend to stop driving.

Keywords: Functioning, mobility, mental health

Introduction

In 2020, there were about 48 million licensed drivers aged 65 years and older in the U.S. (Federal Highway Administration, 2020). Driving is the primary means of transportation in the U.S. (Federal Highway Administration, 2020). Though stereotypes may depict older adult drivers as at risk for unsafe driving, there is much variability across older adult drivers and age itself is not a condition impacting driver safety (Aronson, 2019). Among older adults, driving can be critical in maintaining independence and mobility, thereby contributing to their mental health and well-being (Satariano et al., 2012).

Following driving cessation among older adults, the risk of having depressive symptoms may increase, but the evidence is inconclusive. For instance, examining a cohort of relatively healthy, cognitively intact older adults, Edwards and colleagues (2009) did not find an association between driving cessation status and depressive symptoms, although more scholars have found a strong association (Marottoli et al., 1997; Fonda et al., 2001; Ragland et al., 2005; Windsor et al., 2007). Driving anxiety is another component of driving cessation (Choi et al., 2012a), but anxiety symptoms are an underexplored mental health outcome related to driving cessation.

To help clarify the association between driving cessation and mental health symptoms, we will use a national cohort study that includes a broader spectrum of community-dwelling older adults and accounts for potentially confounding factors (e.g., medical comorbidity, functional impairment). Additionally, we will examine the association between driving cessation and depressive and anxiety symptoms at different time points to provide guidance on whether driving cessation may result in a more immediate impact on an older adult’s well-being or if the impact may worsen with time.

Background

Why Do Older Adults Stop Driving?

A robust body of literature has evaluated why older adults may stop driving. As driving requires complex cognitive skills in decision-making, executive functioning, perception, and more, cognitive impairment is a significant reason why many adults may stop driving (Anstey et al., 2006; Choi et al., 2014). Additionally, other non-cognitive factors, like worsening physical and mental health (Anstey et al., 2017; Bond et al., 2017; Gaulton et al., 2021), presence of family or friends who may assist with transportation, alternate transportation availability (e.g., public transportation or taxi services), and policies dictating driving cessation ages or limits may impact older adults’ decision to stop driving (Maliheh et al., 2023). Socio-demographic factors have also been associated with driving cessation, with older age, female gender, and Blacks and Hispanics being more likely to stop driving (Choi et al., 2012b; Dugan & Lee, 2013). Lastly, psychological health factors, like low confidence in driving abilities, depressed mood, and personality traits such as neuroticism, are other likely contributors to driving cessation (Maliheh et al., 2023).

Driving Cessation and Depressive and Anxiety Symptoms

Driving cessation is a major life transition, much like a marriage, divorce, or becoming a parent, that may increase stress (Choi et al., 2012c). Research suggests that a ‘mutually causative’ relationship may exist between health and driving cessation in aging adults (Chihuri et al., 2016). For instance, while poor health can contribute to driving cessation, evidence suggests that driving cessation can also worsen health (Chihuri et al., 2016). Loss of independence, social activities, and health-promoting activities experienced after driving cessation may lead to a decline in physical and mental health (Choi & DiNitto, 2016). Clinical approaches to support people who stop driving may include cognitive or educational support programs (Windsor & Anstey, 2006), with educational and community support programs showing promise in decreasing depressive and anxiety symptoms (Liddle et al., 2014). More work with controlled trials of interventions are needed (Rapoport et al., 2017).

Salient to older adult mental health outcomes, a small but strong body of research notes that driving cessation for older adults has been associated with poorer mental health, principally depression (Chihuri et al., 2015; 2016). A meta-analysis pooled five studies (Marottoli et al., 1997; Edwards et al., 2009; Fonda et al., 2001; Ragland et al., 2005; Windsor et al., 2007) and found that driving cessation was associated with an increased risk for depressive symptoms among older adults (odds ratio 1.91, 95% confidence interval 1.61–2.27; Chihiri et al., 2015). These four cohort studies of community-dwelling Americans (Marottoli et al., 1997; Edwards et al., 2009; Fonda et al., 2001; Ragland et al., 2005) and Australians (Windsor et al., 2007) have several strengths. Some strengths include using the well-validated Center for Epidemiological Studies Depression Scale (CES-D) to evaluate depressive symptoms (Chihuri et al., 2015) as well as even evaluating the impact of a spouse on depressive symptoms (Fonda et al., 2001).

Some of these studies, however, did not account for baseline depression status or include a large national population-based sample. Our study adds to the literature by using a relatively large nationally representative sample that accounts for a variety of potential confounders, including baseline depressive or anxiety symptoms, while also examining outcomes at two time points, 1- and 4-years post-driving cessation.

Anxiety is another factor in an older adult’s decision to stop driving, particularly anxiety specific to driving (Choi et al., 2012a). In an analysis of voluntary or involuntary decisions to stop driving by adults aged 55 and up (mean age = 75.3), driving anxiety was a common factor among older adults’ voluntary decisions to stop driving (Choi et al., 2012a). Other scholars have found driving anxiety to be prevalent in older adults aged 55 to 70 (Hempel et al., 2017; Taylor et al., 2018). In other cross-sectional data from a sample of German elders aged 85 and older, driving cessation was not associated with self-reported anxiety or depression (Hajek et al., 2021). There is thus much uncertainty about the association of driving cessation with depressive and anxiety symptoms. While anxiety may contribute to driving cessation, we are unaware of national prospective cohort data on whether driving cessation may subsequently impact anxiety. If depressive symptoms are elevated for older adults after driving cessation, it is plausible that clinical anxiety symptoms may also be present, as anxiety and depression frequently co-occur (Hirschfeld, 2001)

If driving cessation contributes to increased depressive and anxiety symptoms in older adults, it is worthwhile to understand what contributes to this association and to understand how driving cessation may affect the mental health of older adults.

Current Study

Using a community-dwelling cohort derived from a nationally representative sample of adults aged 65 and older in the US, we seek to clarify the association between driving cessation and subsequent depressive and anxiety symptoms. To build on and address gaps in prior work, we will account for potential confounders such as socio-demographic and health status variables. Additionally, we will examine the association at 1 year and 4 years of follow-up to consider whether this association varies across time. We hypothesize that driving cessation is associated with subsequent depressive and anxiety symptoms but are uncertain whether this association differs between the follow-up time points.

Method

Participants and Study Design

NHATS performs yearly in-person interviews with a nationally representative sample of US Medicare beneficiaries aged 65 years and older. NHATS replenished its cohort in 2015 (unweighted response rate of 76.8% in 2015), oversamples the oldest old and Black older adults, is administered in English and Spanish, and is publicly available at www.nhats.org (Kasper & Freedman, 2021)

For our study, we created two cohorts. The first cohort consisted of NHATS participants driving in 2015 and living in the community in 2015 and 2016. The second cohort consisted of NHATS participants driving in 2015 and living in the community from 2015 to 2019. For each cohort, we excluded people (284 from the first cohort and 162 from the second cohort) who were missing outcome or covariate information, resulting in 4,182 and 3,102 NHATS participants in the first and second cohorts, respectively. The Johns Hopkins Bloomberg School of Public Health Institutional Review Board approved NHATS (Freedman & Kasper, 2019). This manuscript was a secondary data analysis completed with de-identified publicly available data and was thus exempt from the need for review.

Outcomes

Our outcomes included positive screens (i.e., scores of 5 or higher) for depression and anxiety symptoms at 1 year (2016 interview) and 4 years (2019 interview) of follow-up. Depression and anxiety symptoms were assessed by the Patient Health Questionnaire (PHQ-2) and the Generalized Anxiety Disorder (GAD-2) scale. The PHQ-2 is a validated two-item depression screening instrument (Kroenke et al., 2003), and the Generalized Anxiety Disorder (GAD-2) scale is a validated two-item anxiety screening instrument (Kroenke et al., 2007). NHATS modified the PHQ-2 and GAD-2 to assess the prior 1-month period (rather than a two-week period) and scored both from 2 to 8 (Kasper & Freedman, 2021), with scores of 5 or higher indicating the presence of clinically significant depression or anxiety symptoms.

Independent Variable

We constructed our key dichotomous independent variable, driving cessation, based on whether NHATS participants reported no longer driving places in the past year or never driving places in the prior month (Skehan et al., 2014). Self-reported driving cessation was assessed yearly. For the 2019 cohort, we only considered driving cessation to be present if NHATS participants reported that they stopped driving in 2016 and did not resume driving between 2017–2019.

Covariates

Study covariates include socio-demographics and health status domains, many of which have been associated with depression or anxiety (Vink et al., 2008).

Socio-demographic covariates were determined at the time of the 2015 interview. They included age (65–74, 75–84, and 85+ years old), race and ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic or Other), marital status (married or living with a partner, separated or divorced, widowed or never married), education (high school diploma equivalent or less, some college or vocational school, college degree), and Medicaid status (present, absent). In the United States, Medicaid is a federal and state healthcare program assisting low-income families or individuals in paying for medical services.

Most health status covariates were also assessed at the time of the 2015 interview. They included medical comorbidity by quartile (higher quartiles indicating more chronic medical conditions), baseline depressive symptoms, baseline anxiety symptoms, impairment in self-care activities (eating, bathing, toileting, and dressing), and impairment in household activities (laundry, shopping, meal preparation, and banking). To assess self-care activities, participants were asked how much difficulty they had in performing the task in the past month even if they were using assistive/adaptive devices. When participants reported having difficulty, we classified them as having a self-care activity impairment (Kasper & Freedman, 2021). Similarly, we determined household activity impairment to be present if participants reported that, in the past month, they had any difficulty with or, because of health or functioning, they either did not perform or did not perform the household activity by themselves (Kasper & Freedman, 2021). We also assessed changes in self-reported health status from 2015 to 2016 (for cohort 1) and from 2015 to 2019 (for cohort 2). Changes in self-reported health status were organized into three groups (no change, worse health, better health).

Data Analyses

To examine driving cessation’s association with anxiety and depressive symptoms, we conducted a series of unadjusted and adjusted logistic regression analyses. In these regression analyses, positive anxiety and depressive screens served as our dichotomous outcomes. We examined driving cessation as the primary predictor, and our adjusted regression analyses accounted for participants’ socio-demographics and health status variables. We used SAS survey procedures to account for sampling design and calculate population-weighted estimates (version 9.4, SAS Institute Inc., Cary, NC).

Results

Our cohort of community-dwelling older adults (N=4,182) included a broad spectrum of older adults with regard to socio-demographics and baseline health status. For example, 63.8% (N= 1,938) of the sample was aged 65 to 74, 6.4% (N= 693) identified as non-Hispanic Black, 51.4% (N= 2,185) were female, and 39.5% (N= 1,515) had a college degree (see Table 1 for further participant characteristics).

Table 1.

Characteristics of Community-Dwelling Adults Over 65 Years Old. 2015–2016 (N=4182)

N % SE
Stopped Driving in the Past Year, Yes 235 4.1 0.3
Depressive Symptoms at Baseline, Yes 356 8.2 0.5
Depressive Symptoms in 2016, Yes 376 8.1 0.5
Depressive Symptoms in 2019a, Yes 258 7.8 0.5
Anxiety Symptoms at Baseline, Yes 290 7.0 0.5
Anxiety Symptoms in 2016, Yes 309 6.8 0.4
Anxiety Symptoms in 2019a, Yes 215 6.3 0.4
Demographics
Age In Years
 65–74 1938 63.8 0.6
 75–84 1692 29.3 0.6
 85+ 552 6.9 0.3
Gender
 Male 1997 48.6 0.9
 Female 2185 51.4 0.9
Marital Status
 Married or Living With a Partner 2432 63.7 0.8
 Separated or Divorced 565 13.7 0.6
 Widowed or Never Married 1185 22.6 0.7
Race and Ethnicity
 Non-Hispanic White 3236 86.3 0.9
 Non-Hispanic Black 693 6.4 0.4
 Hispanic or Other 253 7.3 0.8
Education
 High School Diploma/Equivalent or Less 1697 36.1 1.4
 Some College or Vocational School 970 24.5 0.8
 College Degree 1515 39.5 1.4
Medicaid, Present 323 6.4 0.4
Change in Health Status
 No Change 2472 59.5 0.9
 Worse 955 22.0 0.9
 Better 755 18.5 0.8
Total Medical Conditions
 0–25% 1064 30.4 0.9
 25–50% 1074 26.9 0.9
 50–75% 958 21.8 0.7
 75–100% 1086 21.0 0.6
Impairment in Self-Care Activities, Yes 603 12.9 0.7
Impairment in Household Activities, Yes 837 18.0 0.6
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a

The sample size was 3,102 in 2019.

Among this sample, 4.1% (N=235) reported no longer driving at the 1-year follow-up interview. Regarding mental health outcomes, 8.1% (N= 376) screened positive for depressive symptoms and 6.8% (N=309) screened positive for anxiety symptoms in 2016. In 2019, 7.8% of the sample (N= 258) screened positive for depressive symptoms, and 6.3% (N=215) screened positive for anxiety symptoms.

Logistic Regression Analyses

In multivariable analyses adjusting for socio-demographic and clinical characteristics, the participants who endorsed depressive symptoms at baseline had large association with depressive symptoms one year later (OR=8.25, 95%, CI: 6.21 −10.96, numerator, DF=1, denominator DF=55, F-value= 221.88, p=<0.001). Driving cessation was associated with depressive symptoms at 1-year follow-up as illustrated in Table 2 (odds ratio, OR=2.25, 95% confidence interval, CI: 1.33–3.82, numerator degrees of freedom, DF=1, denominator DF=55, F-value=9.57, p=0.003). At the 4-year follow-up, driving cessation was associated with more than three times the odds of having depressive symptoms (OR=3.55, 95% CI: 1.72–7.29, numerator DF=1, denominator DF=55, F-value= 12.37, p<0.001). Addtionally, participants who endorsed depressive symptoms at baseline had more than than four times the odds of endorsing depressive symptoms at the 4-year-follow up (OR=4.80, 95%, CI: 2.90–7.96, numerator, DF=1, denominator DF=55, F-value=38.64, p=<0.001).

Table 2.

Multivariable Logistic Regression Analyses Examining the Association of Depressive Symptoms with Driving Cessation in the Prior Year at One Four Year Follow-Up.a

Depressive Symptoms at 1-Yr Follow-Up N=4,182 Depressive Symptoms at 4-Yrs Follow Up N=3,102
OR 95% CIa OR 95% CIa
Driving Within the Last Year, No 2.25** 1.33–3.82 3.55*** 1.72–7.29
Depressive Symptoms at Baseline, Yes 8.25*** 6.21–10.96 4.80*** 2.90–7.96
Demographics
Age Group (Ref=65–74)
 75–84 yo 1.14 0.90–1.43 0.99 0.70–1.40
 85+ yo 0.89 0.57–1.39 0.90 0.50–1.63
Sex, Female 0.76* 0.59–0.98 1.06 0.78–1.44
Marital Status (Ref = Married or Living With a Partner)
 Separated or Divorced 1.24 0.76–1.98 1.00 0.64–1.56
 Widowed or Never Married 1.14 0.81–1.60 0.90 0.64–1.28
Race and Ethnicity (Ref=Non-Hispanic White)
 Non-Hispanic Black 1.20 0.81–1.78 1.30 0.81–2.08
 Hispanic or Other 0.94 0.54–1.62 1.44 0.69–2.98
Education (Ref= College Degree)
 High School Diploma/ Equivalent or Less 1.82** 1.25–2.65 1.75** 1.16–2.64
 Some College or Vocational School 1.79** 1.24–2.59 1.46 0.98–2.18
Medicaid, Present 1.37 0.84–2.23 1.23 0.58–2.63
Change in Health Status (Ref= Better)
 No Change 0.95 0.58–1.56 0.89 0.50–1.57
 Worse 2.04** 1.30–3.20 1.89* 1.10–3.25
Total Medical Conditions (Ref = 0–25%)
 25–50% 1.42 0.89–2.27 1.06 0.65–1.71
 50–75% 1.44 0.96–2.15 1.09 0.70–1.69
 75–100% 1.56 0.98–2.51 1.59 0.96–2.65
Impairment in Self-Care Activities, Yes 1.22 0.89–1.67 1.37 0.80–2.35
Impairment in Household Activities, Yes 2.58*** 1.90–3.50 2.09** 1.36–3.22
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Note. SAS survey procedures accounted for sampling design to calculate population-weighted adjusted estimates.

a

Intervals based on 95% Wald confidence limits.

*

p-value <0.05

**

p-value<0.01

***

p-value<0.001.

Simarily, participants who endorsed anxiety symptoms at baseline were more likely to endorse anxiety symptoms one year later (OR=10.7, 95%, CI: 6.65–17.19, numerator, DF=1, denominator DF=55, F-value=100.07, p=<0.001). At the 1-year follow-up time point, anxiety symptoms (OR=1.71, 95%, CI: 1.05 −2.79, numerator, DF=1, denominator DF=55, F-value=4.84, p= 0.032) and anxiety symptoms at the 4-year follow up interview (OR=3.22, 95% CI: 1.04–9.99, numerator DF=1, denominator DF=55, F-value=4.29, p=0.043) were both associated with driving cessation. Participants who endorsed anxiety symptoms at baseline also had greater odds of endorsing anxiety symptoms at the 4-year-follow up (OR=6.96, 95%, CI: 4.54–10.69, numerator, DF=1, denominator DF=55, F-value=82.33, p=<0.001). See Table 3 for further results.

Table 3.

Multivariable Logistic Regression Analyses Examining the Association of Anxiety Symptoms with Driving Cessation in the Prior Year at One and Four Year Follow-Up.a

Anxiety Symptoms at 1-Yr Follow-Up N=4,182 Anxiety Symptoms at 4-Yrs Follow Up N=3,102
OR 95% CIa OR 95% CIa
Driving Within the Last Year, No 1.71* 1.05–2.79 3.22* 1.04–9.99
Anxiety Symptoms at Baseline, Yes 10.7*** 6.65–17.19 6.96*** 4.54–10.69
Demographics
Age Group (Ref=65–74)
 75–84 yo 0.96 0.69–1.34 0.90 0.66–1.23
 85+ yo 0.79 0.50–1.25 1.13 0.62–2.07
Sex, Female 1.01 0.75–1.36 0.97 0.68–1.38
Marital Status (Ref = Married or Living With a Partner)
 Separated or Divorced 1.14 0.70–1.85 1.56 0.94 −2.58
 Widowed or Never Married 0.78 0.57–1.06 0.90 0.58–1.38
Race and Ethnicity (Ref=Non-Hispanic White)
 Non-Hispanic Black 1.11 0.71–1.74 0.92 0.51–1.64
 Hispanic or Other 0.67 0.38–1.17 1.22 0.63–2.36
Education (Ref= College Degree)
 High School Diploma/ Equivalent or Less 1.81* 1.13–2.91 2.21*** 1.40–3.47
 Some College or Vocational School 1.30 0.81–2.08 1.45 0.82–2.55
Medicaid, Present 1.12 0.67–1.86 0.83 0.48–1.44
Change in Health Status (Ref= Better)
 No Change 1.17 0.80–1.72 1.35 0.77–2.36
 Worse 1.86** 1.23–2.82 2.08* 1.13–3.83
Total Medical Conditions (Ref = 0–25%)
 25–50% 1.10 0.63–1.93 1.58 0.85–2.95
 50–75% 0.89 0.55–1.43 1.27 0.70–2.31
 75–100% 1.39 0.83–2.33 2.43** 1.40–4.23
Impairment in Self-Care Activities, Yes 1.35 0.88–2.08 1.65* 1.09–2.52
Impairment in Household Activities, Yes 2.86*** 1.89–4.31 1.60 0.99–2.58
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Note. SAS survey procedures accounted for sampling design to calculate population-weighted adjusted estimates.

a

Intervals based on 95% Wald confidence limits.

*

p-value <0.05

**

p-value<0.01

***

p-value<0.001.

Discussion

Among our national cohort of community-dwelling older adults, driving cessation was associated with an increased risk of having depressive and anxiety symptoms. The association of driving cessation with depressive and anxiety symptoms was present at both 1-year and 4-year follow-ups. Although the odds ratio point estimates were higher at 4 years of follow-up, the 95% confidence intervals overlapped. Consequently, although the risk of depressive and anxiety symptoms appeared higher at 4 years compared to 1 year following driving cessation, we are unable to state that the strength of this association varied across time. Our findings regarding increased risk of depressive symptoms after driving cessation are similar compared to other studies (Chihuri et al., 2015).

Driving is crucial to the well-being of many older adults, and driving cessation may impact an older adult’s mood in various ways. Driving may facilitate well-being by fostering social connection and decreasing social isolation (Qin et al.,2020; Curl et al., 2014), and increasing independence and mobility (Edemekong et al., 2022). Driving is also related to health promotion as a means to attend medical appointments (Syed et al., 2013) and obtain healthy food and medications. Particularly in the US, opportunities for public transportation and walkable neighborhoods are limited for many communities, thus making driving a critical component of health and wellness in aging (Aronson, 2019).

Overall, potential pathways between driving cessation and depressive symptoms remain unclear. However, psychological factors, like perceived control, may explain increased depressive symptoms in older adults (Windsor et al., 2007). Additionally, planful choice-making in driving cessation or driving reduction may lead to less severe depressive symptoms than a sudden and unplanned cessation of driving (Ang et al., 2019; Vivoda et al., 2021). Social support has the potential to buffer the negative effects of driving cessation on depressive symptoms and decrease the negative response to the stress of stopping driving (Rebok & Jones, 2016; Stinchcombe et al., 2021). Older adults may be particularly prone to experience the adverse effects of decreased transportation, such as social isolation and loneliness, due to increased disability and poorer health, as well as smaller social circles, further increasing depressive and anxiety symptoms (Lamanna et al., 2020; Qin et al., 2020).

Prior work found that older adults who ceased driving and encountered transportation barriers (e.g., no alternate transportation or public transportation) were more likely to endorse depressive symptoms compared to the adults who never drove (Choi & DiNitto, 2016), highlighting how there are many nuances of driving cessation that may impact its effect on depressive symptoms. Qualitative work has noted how older adults may experience feelings of loss, particularly in identity, in response to driving cessation (Musselwhite & Shergold, 2012), with phases of pre-decision, decision, and post-cessation, where the post-cessation phase may be an important time for emotional intervention (Liddle et al., 2008).

There are other possible avenues of further inquiry to help us understand the association between driving cessation and mental health symptoms. Other avenues to explore include examining how driving cessation impacts social connectedness and access to healthcare services, both of which may affect mental and physical health outcomes. To build on this work, future research could examine issues related to why older adults stopped driving and consider the mechanisms (e.g., decreased social engagement and connection) by which driving cessation may affect depressive and anxiety symptoms in older adults. Additional work may examine how mental health outcomes may vary depending on the reason why older adults stopped driving.

This study has some notable strengths. First, this study includes a cohort derived from a large and nationally representative sample of U.S. adults aged 65 years and older. Second, our analyses controlled for baseline levels of depression and anxiety as well as other potential confounders (e.g., change in self-reported health status), allowing us to better isolate the association between driving cessation and depressive and anxiety symptoms at follow-up. Third, we are unaware of recent cohort studies that have concurrently examined the association of driving cessation with depressive and anxiety symptoms.

Our study also has several limitations. First, we examined depressive and anxiety symptoms rather than the presence of a diagnosed depressive or anxiety disorder. However, older adults are more likely than younger cohorts to present with subthreshold depression and anxiety symptoms (Meeks et al., 2011), so the evaluation of symptoms is valuable. Second, we lack information on the exact dates when the older adults stopped driving, which precludes a more in-depth examination of the temporal association of driving cessation with mental health symptoms. Third, we lack information on why the older adults decided to stop driving, which could provide important insights into how driving cessation may impact mental health and well-being. Lastly, we did not examine alternate transportation means available to older adults who stopped driving.

Conclusion

This study adds to the literature by examining a large, contemporary, and diverse national sample of older adults, controlling for baseline characteristics and changes in health status. This study suggests that driving cessation is associated with subsequent depressive and anxiety symptoms among community-dwelling older adults.

Clinical Implications.

  • Community-dwelling older adults who stop driving appear to be at high risk for having depression and anxiety symptoms.

  • We recommend clinicians consider screening for driving cessation among older adults.

  • Clinicians should closely monitor the well-being and mental health of older adults who stop or intend to stop driving.

Acknowledgments:

The funders had no role in the article’s design, data analysis, the decision to publish, or manuscript preparation. The authors report that there are no competing interests to declare.

Funding Sources:

Dr. Simning was supported by the National Institute on Aging (grant number K23AG058757). The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Institutes of Health.

Biographies

Author Biographies:

Rachel Missell-Gray, MS, is a Human Subjects Research Coordinator in the Department of Psychiatry at the University of Rochester Medical Center and a doctoral student at the Margaret Warner Graduate School of Education and Human Development focusing on gerontology.

Adam Simning, MD, Ph.D., is an Assistant Professor in the Department of Psychiatry at the University of Rochester Medical Center and provides consultative clinical care to 50+ nursing homes through the University of Rochester’s Skilled Nursing Facility Telepsychiatry Program.

Data Availability Statement

The data that support the findings of this study are openly available at https://www.nhats.org, from the National Health and Aging Trends Study. Produced and distributed by www.nhats.org with funding from the National Institute on Aging (grant number U01AG32947).

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are openly available at https://www.nhats.org, from the National Health and Aging Trends Study. Produced and distributed by www.nhats.org with funding from the National Institute on Aging (grant number U01AG32947).

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