Driving Retirement and Dementia: Does Sex Matter?

For many older adults, being licensed to drive and having access to a vehicle are associated with mobility and independence. Set against this backdrop, driving retirement tends to be viewed as losing a privilege, losing the ability to move about freely, and being reliant on others to meet transportation needs.

 

While significant, individual feelings of loss need to be balanced against more far-reaching issues of safety. When the quality of one’s driving deteriorates, driving retirement is necessary to ensure the safety of the person with dementia and other people on the roads.

 

This gains importance when you consider the number of drivers with dementia will increase in the coming decades, and many people with dementia are resistant to hanging up their car keys.

 

Knowing this, research collaborators within the Canadian Consortium on Neurodegeneration in Aging (CCNA) have explored some of the factors underlying the decision to retire from driving.  Dr. Mary Tierney, who leads the program on Women, Gender, Sex and Dementia (WGSD) of the CCNA worked with Drs. Mark Rapoport and Gary Naglie, who lead the Driving and Dementia team, to examine whether sex makes a difference to the decision to retire from driving, and – if so – how to use insights to tailor decision-making supports.

 

Through a meta-analysis of 20 longitudinal studies – focused on sex differences in driving cessation in older adults with or without dementia – the researchers reported in a paper (led by Dr. Tierney and Nicolette Baines of the WGSD program) that driving cessation is significantly more prevalent in women with dementia than men. What’s more, the same pattern was found in women and men without dementia.

 

The researchers point to several explanations as to why dementia status didn’t play a role in the higher prevalence of women ceasing driving than men. Older women in this cohort have less driving experience, which may explain why they have more traffic-related stress and avoidance tendencies, are less likely to engage in risk-taking behaviors while driving, drive less frequently, and are more likely to self-regulate their driving. By that same token, as more women hold drivers’ licenses and gain experience driving, these sex differences may not persist.

 

This CCNA meta-analysis is the first of its kind to study sex differences in driving cessation among individuals with and without dementia. Although a previous review identified that women are more likely to cease driving than men (Morgan et al., 2009), the role of dementia was not examined.

 

Overall, this report highlights the need for more research on the reasons for the observed sex differences, which may be due to biological sex differences as well as gender differences in roles and relationships between men and women. Longitudinal studies are also needed in order to estimate the incidence of sex differences in driving cessation in participants who have undergone diagnostic assessments to both include and exclude dementia. These longitudinal studies should also compare driving cessation in regions with different population densities and transportation options.

 

Above all, their findings show that sex and gender differences may have important implications for supportive responses offered to drivers with dementia both prior to and following driving cessation.