The Role of Perceived Control in Explaining Depressive Symptoms Associated With Driving Cessation in a Longitudinal Study

Centre for Mental Health Research, Australian National University, Acton, ACT 0200, Australia.
The Gerontologist (Impact Factor: 3.21). 05/2007; 47(2):215-23. DOI: 10.1093/geront/47.2.215
Source: PubMed


The purpose of this article was to investigate the role of control beliefs in mediating the relationship between driving cessation and change in depressive symptoms in a population-based sample of older adults.
We report results from a prospective, community-based cohort study that included two waves of data collected in 1992 and 1994. Participants consisted of 700 men and women aged 70 and older, including 647 drivers and 53 participants who ceased driving between baseline (1992) and follow-up (1994). Participants took part in interviews that included assessments of driving status, sociodemographic characteristics, self-rated health, sensory function, depressive symptoms (through the Center for Epidemiologic Studies-Depression scale), and expectancy of control. Using multilevel general linear models, we examined the extent to which driving status, expectancy of control, and relevant covariates explained change in depressive-symptom scores between baseline and follow-up.
Driving cessation was associated with an increase in depressive symptoms from baseline to follow-up. The higher depressive-symptom scores of ceased drivers relative to those of individuals who remained drivers at both waves was partly explained by a corresponding decrease in the sense of control among ceased drivers, and increased control beliefs among drivers.
Interventions aimed at promoting the maintenance of personal agency and associated control beliefs could be protective against the negative psychological concomitants of driving cessation.

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    • "independent and flexible access to social and leisure activities (Gardezi et al., 2006), and is correlated with increased depressive symptoms (Windsor et al., 2007) and earlier need for residential care (Freeman et al., 2006). It has therefore been associated with negative consequences like social isolation, reduced community mobility, and feelings of sadness or helplessness (Gardezi et al., 2006; Curl et al., 2014). "
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    ABSTRACT: Background: It is recognized that people with dementia are likely to need to stop driving at some point following diagnosis. Driving cessation can lead to negative outcomes for people with dementia and their family caregivers (FC), who often experience family conflict and tension throughout the process. Family experiences surrounding driving cessation have begun to be explored but warrant further examination. Methods: Using a descriptive phenomenological approach, semi-structured interviews were undertaken with key stakeholders, including 5 retired drivers with dementia, 12 FC, and 15 health professionals (HP). Data were analyzed inductively to explore the needs and experiences of people with dementia and FC. Results: The data revealed a range of possible interactions between people with dementia and FC. These were organized into a continuum of family dynamics according to levels of collaboration and conflict: in it together, behind the scenes, active negotiations, and at odds. At the in it together end of the continuum, people with dementia and FC demonstrated collaborative approaches and minimal conflict in managing driving cessation. At the at odds end, they experienced open conflict and significant tension in their interactions. Contextual factors influencing family dynamics were identified, along with the need for individualized approaches to support. Conclusions: The continuum of family dynamics experienced during driving cessation may help clinicians better understand and respond to complex family needs. Interventions should be tailored to families' distinctive needs with consideration of their unique contextual factors influencing dynamics, to provide sensitive and responsive support for families managing driving cessation.
    International Psychogeriatrics 09/2015; DOI:10.1017/S1041610215001441 · 1.93 Impact Factor
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    • "Older drivers are also projected to account for 40% of the expected increases in crash involvement (Lyman et al., 2002; Evans, 2000). Cessation of driving restricts mobility and is associated with subsequent depression and decreased wellbeing (Marottolli et al., 1997; Windsor et al., 2007). Empirical data are needed to distinguish between safe and unsafe older drivers so that decision-making in applied settings, including clinics and Department of Motor Vehicle offices (DMV), is better tailored to both preservation of mobility and public safety. "
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    ABSTRACT: The extent to which deficits in specific cognitive domains contribute to older drivers' safety risk in complex real-world driving tasks is not well understood. We selected 148 drivers older than 70 years of age both with and without neurodegenerative diseases (Alzheimer disease-AD and Parkinson disease-PD) from an existing driving database of older adults. Participant assessments included on-road driving safety and cognitive functioning in visuospatial construction, speed of processing, memory, and executive functioning. The standardized on-road drive test was designed to examine multiple facets of older driver safety including navigation performance (e.g., following a route, identifying landmarks), safety errors while concurrently performing secondary navigation tasks ("on-task" safety errors), and safety errors in the absence of any secondary navigation tasks ("baseline" safety errors). The inter-correlations of these outcome measures were fair to moderate supporting their distinctiveness. Participants with diseases performed worse than the healthy aging group on all driving measures and differences between those with AD and PD were minimal. In multivariate analyses, different domains of cognitive functioning predicted distinct facets of driver safety on road. Memory and set-shifting predicted performance in navigation-related secondary tasks, speed of processing predicted on-task safety errors, and visuospatial construction predicted baseline safety errors. These findings support broad assessments of cognitive functioning to inform decisions regarding older driver safety on the road and suggest navigation performance may be useful in evaluating older driver fitness and restrictions in licensing. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Accident Analysis & Prevention 12/2014; 75C:236-244. DOI:10.1016/j.aap.2014.12.007 · 1.87 Impact Factor
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    • "Increased depressive symptoms (Marottoli et al., 1997; Windsor et al., 2007), reduced life satisfaction (Liddle et al., 2012), and social isolation (Lister, 1999) are psychosocial issues commonly reported by older retired drivers when compared to older current drivers. These psychosocial changes may stem from a loss of independence, a lack of personal control, and reduced participation in important life roles, all of which have been linked to driving cessation (Liddle et al., 2012; Ragland et al., 2005; Windsor et al., 2007). Together, these consequences may lead to uncertainties in personal identity which can have major implications on an individual's self-esteem, psychological state and well-being (Eisenhandler, 1990; King et al., 2011; Liddle et al., 2008). "
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    ABSTRACT: Background: Driving cessation has demonstrated impacts on well-being and lifestyle. Despite the recognized reluctance of older people to plan for driving cessation, this study has identified a new group who has a stated plan to stop driving within 12 months. Although gradual reduction of driving has been documented as part of the usual driving cessation, this study explored the differences between retired drivers and those with a stated plan to retire within 12 months in sociodemographic, well-being and lifestyle outcomes. Methods: This study extracted all baseline data from a clinical trial exploring the effectiveness of a group program for older retiring and retired drivers. Sociodemographic data included age, gender, health status, educational level, and living situation. All participants completed measures related to episodes away from home, well-being, and lifestyle. These were compared using parametric and nonparametric statistical analysis. Results: Participants (n = 131) included 68 retired drivers (mean age 79.8 years) and 63 retiring drivers (mean age 77.8 years). Retiring drivers engaged in more episodes away from home (p = 0.03), and more social activities (p = 0.02), used less alternative transport (p < 0.001), displayed fewer anxiety (p = 0.05), and depressive (p = 0.01) symptoms, but demonstrated lower transport and lifestyle self-efficacy (p = 0.04). Conclusion: Both retired and retiring drivers require support for driving cessation and community engagement. Retiring drivers may be in a critical position to engage in driving cessation interventions to improve self-efficacy and begin adapting community mobility.
    International Psychogeriatrics 04/2014; 26(7):1-10. DOI:10.1017/S104161021400060X · 1.93 Impact Factor
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