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Introduction Driving is a primary means of mobility. Driving cessation is associated with poor mental health outcomes, including increased risk of depression. We investigated the relationship between driving status and depression symptoms in a large Canadian sample of mid-aged and older adults. We examined whether social support buffers the relationship between driving status and depression symptoms as well as whether the effects depend on gender. Methods: Data were drawn from baseline data from the Canadian Longitudinal Study on Aging (CLSA), a large prospective study of health and aging. At baseline, 1165 participants were classified as former drivers; 40,840 participants were classified as current drivers. Through hierarchical linear regression models, we examined whether the effect of driving status on depression symptoms (CESD-10) was moderated by social support indices (MOS-SSS). Results: Driving cessation was associated with higher symptoms of depression (B = 0.539, 95% CI, 0.237 to 0.842, p < .001). The relationship between driving status and depression symptoms was moderated by social support indices. Former driving men who reported low social support had the greatest number of depression symptoms; the effect of driving status on depression symptoms became attenuated at higher levels of social support. Conclusion: Findings highlight the importance of social support in offsetting poor mental health outcomes associated with driving cessation.

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... In turn, employees show positive health outcomes when working in environments with high levels of affective organizational commitment as part of OCB (Boyd & Nowell, 2020;Colenberg, Jylhä, & Arkesteijn, 2020) and the presence of social support (Cvenkel, 2018;Engelen et al., 2019). A study has found a link between the importance of social support in off-setting poor mental health outcomes associated with driving cessation (Stinchcombe et al., 2021). ...
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Objective The paper explores the mediating effect of workplace social support on the relationship between organizational citizenship behaviour and employee mental health amongst public service employees in South Africa. Methods A survey approach was utilized amongst a sample of 289 conveniently selected public service employees in the Eastern Cape Province of South Africa. Results The results confirm that a direct relationship exists between organizational citizenship behaviour and employee mental health. Further, the association is made significant only through the mediation effect of workplace social support. Discussion The study focuses on the importance of intra-organizational behaviours such as organizational citizenship in promoting employee mental health aspects. Such a focus becomes essential, especially when the South African public service is noted to be in a state of flux and often affects employee work behaviours, including their health. The findings heighten focus on the importance of developing behaviours such as those that promote organizational citizenship coupled with efforts related to workplace social support. In essence, by serving others within the workplace and the entire organization, employees contribute to their mental health. The findings are a valuable precursor to interventions that assist not only the organization but also employees.
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Driving cessation, often due to health-related changes, can be a particularly challenging and troublesome transition in older adulthood that can lead to social isolation. While policy makers have long recognized the potential impact of an aging population on Canada's health care and national pension plans, the transportation needs of older adults have received relatively less attention. For older adults residing in small towns and rural areas who rely, more often than not, on the personal automobile there is usually limited or no access to public transportation. For policy makers to respond effectively to the transportation needs of an aging population, particularly those living in rural areas, the first step is to understand the travel behaviours of older adults living in such areas, particularly as they approach the transition when they will cease to drive. This paper reports on qualitative research exploring the driving-related challenges and needs faced by older adults in small towns and rural areas near Hamilton, Ontario, Canada. Results revealed four major themes: lack of transportation options in rural areas, changes in driving behaviours, the lack of planning for driving cessation, and the social isolation that comes from the loss (or potential loss) of one's driver's license.
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Objectives: Drawing on the "Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa" (HAALSI) baseline survey, we present data on older adults' social networks and receipt of social support in rural South Africa. We examine how age and gender differences in social network characteristics matched with patterns predicted by theories of choice- and constraint-based network contraction in older adults. Method: We used regression analysis on data for 5,059 South African adults aged 40 and older. Results: Older respondents reported fewer important social contacts and less frequent communication than their middle-aged peers, largely due to fewer nonkin connections. Network size difference between older and younger respondents was greater for women than for men. These gender and age differences were explicable by much higher levels of widowhood among older women compared to younger women and older men. There was no evidence for employment-related network contraction or selective retention of emotionally supportive ties. Discussion: Marriage-related structural constraints impacted on older women's social networks in rural South Africa, but did not explain choice-based network contraction. These findings suggest that many older women in rural Africa, a growing population, may have an unmet need for social support.
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Driving simulators are powerful tools for use in research and applications concerned with the evaluation and improvement of driving performance. The value of this technology is contingent upon carefully considering the technical features of the simulator itself (e.g., type of visual display, vehicle control model), the development of appropriate hypothesis-motivated driving scenarios, and the selection of meaningful outcome measures with respect to the questions being addressed and the populations of interest. The Toronto Rehabilitation Institute's iDAPT Centre for Rehabilitation Research recently developed DriverLab, a 7 degrees-of-freedom, motion-based simulator, containing a passenger vehicle, 360 degree visual projection screen, and unique rain and glare simulators ( To maximize the efficiency and effectiveness of the research conducted within this unique facility, a workshop was organized during which experts across several fields (academia, clinical, industry, government) met in four separate groups to discuss four targeted themes including: (1) use of simulators for driving assessment; (2) effects of drugs on driving safety; (3) effects of automated vehicle technologies (AVTs; e.g., adaptive cruise control) on driving safety; and (4) techniques for mitigating simulator sickness. This paper describes the consensus achieved by the driving assessment group. The driving assessment group was specifically tasked with characterizing the role of driving simulators in assessing driving performance across a range of applications and populations including individuals with sensory, motor, or cognitive impairments, psychiatric disorders and neurological disorders. The group includes experts in driving evaluations of medically-at-risk drivers (Hyde); clinical assessment of fitness-to-drive (Hebert, Naglie, Law, Classen); and researchers studying the perceptual, cognitive, and emotional factors associated with driving performance and/or simulation design (Bédard, Classen, Campos, Hebert, Yung). The team also includes representation by government organizations that employ a large workforce of occupational drivers (Canada Post) and those involved in road safety initiatives. © 2017 Campos, Bédard, Classen, Delparte, Hebert, Hyde, Law, Naglie and Yung.
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Background: Numerous studies report an association between social support and protection from depression, but no systematic review or meta-analysis exists on this topic. Aims: To review systematically the characteristics of social support (types and source) associated with protection from depression across life periods (childhood and adolescence; adulthood; older age) and by study design (cross-sectional v cohort studies). Method: A systematic literature search conducted in February 2015 yielded 100 eligible studies. Study quality was assessed using a critical appraisal checklist, followed by meta-analyses. Results: Sources of support varied across life periods, with parental support being most important among children and adolescents, whereas adults and older adults relied more on spouses, followed by family and then friends. Significant heterogeneity in social support measurement was noted. Effects were weaker in both magnitude and significance in cohort studies. Conclusions: Knowledge gaps remain due to social support measurement heterogeneity and to evidence of reverse causality bias.
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Objectives: To determine what effect driving cessation may have on subsequent health and well-being in older adults. Design: Systematic review of the evidence in the research literature on the consequences of driving cessation in older adults. Setting: Community. Participants: Drivers aged 55 and older. Measurements: Studies pertinent to the health consequences of driving cessation were identified through a comprehensive search of bibliographic databases. Studies that presented quantitative data for drivers aged 55 and older; used a cross-sectional, cohort, or case-control design; and had a comparison group of current drivers were included in the review. Results: Sixteen studies met the inclusion criteria. Driving cessation was reported to be associated with declines in general health and physical, social, and cognitive function and with greater risks of admission to long-term care facilities and mortality. A meta-analysis based on pooled data from five studies examining the association between driving cessation and depression revealed that driving cessation almost doubled the risk of depressive symptoms in older adults (summary odds ratio = 1.91, 95% confidence interval = 1.61-2.27). Conclusion: Driving cessation in older adults appears to contribute to a variety of health problems, particularly depression. These adverse health consequences should be considered in making the decision to cease driving. Intervention programs ensuring mobility and social functions may be needed to mitigate the potential adverse effects of driving cessation on health and well-being in older adults.
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The aging process is marked by a series of transitions that influence multiple domains of well-being. One important transition for older adults is the process of driving cessation. Numerous studies have examined risk factors for driving cessation among older adults to identify at-risk older drivers for road safety. Recent research has focused on the consequences of driving cessation in later life for health and well-being. However, these reports have been largely empirical and are not drawn from a defined conceptual framework. Establishing a theoretical model of 'how driving cessation interacts with other processes and domains of aging' will promote synthesis of seemingly disparate findings and also link the empirical research on cessation to the broader field of gerontology. This article describes a conceptual model for articulating and examining the components of the driving cessation process based on the stress-coping paradigm. This model situates driving cessation within the context of exogenous stressors, individual vulnerabilities and coping strategies, and environmental hazards and buffers over the lifespan. This model could assist in guiding intervention strategies aimed at reducing premature driving cessation in older drivers with ameliorable impairments while assisting at-risk older drivers to reduce or stop driving in a less stressful way.
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The purpose of this article is to determine whether the positive association between social support and well-being is attributable more to an overall beneficial effect of support (main- or direct-effect model) or to a process of support protecting persons from potentially adverse effects of stressful events (buffering model). The review of studies is organized according to (a) whether a measure assesses support structure or function, and (b) the degree of specificity (vs. globality) of the scale. By structure we mean simply the existence of relationships, and by function we mean the extent to which one’s interpersonal relationships provide particular resources. Special attention is paid to methodological characteristics that are requisite for a fair comparison of the models. The review concludes that there is evidence consistent with both models. Evidence for a buffering model is found when the social support measure assesses the perceived availability of interpersonal resources that are responsive to the needs elicited by stressful events. Evidence for a main effect model is found when the support measure assesses a person’s degree of integration in a large social network. Both conceptualizations of social support are correct in some respects, but each represents a different process through which social support may affect well-being. Implications of these conclusions for theories of social support processes and for the design of preventive interventions are discussed.
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We derived and tested a short form of the Center for Epidemiologic Studies Depression Scale (CES-D) for reliability and validity among a sample of well older adults in a large Health Maintenance Organization. The 10-item screening questionnaire, the CESD-10, showed good predictive accuracy when compared to the full-length 20-item version of the CES-D (kappa = .97, P < .001). Cutoff scores for depressive symptoms were > or = 16 for the full-length questionnaire and > or = 10 for the 10-item version. We discuss other potential cutoff values. The CESD-10 showed an expected positive correlation with poorer health status scores (r = .37) and a strong negative correlation with positive affect (r = -.63). Retest correlations for the CESD-10 were comparable to those in other studies (r = .71). We administered the CESD-10 again after 12 months, and scores were stable with strong correlation of r = .59.
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To understand the consequences of driving cessation in older adults, the authors evaluated depression in former drivers compared with active drivers. Depression (as assessed using the Center for Epidemiological Studies Depression Scale), driving status, sociodemographic factors, health status, and cognitive function were evaluated for a cohort of 1953 residents of Sonoma County, California, aged 55 years and older, as part of a community-based study of aging and physical performance. The authors re-interviewed 1772 participants who were active drivers at baseline 3 years later. At baseline, former drivers reported higher levels of depression than did active drivers even after the authors controlled for age, sex, education, health, and marital status. In a longitudinal analysis, drivers who stopped driving during the 3-year interval (i.e., former drivers) reported higher levels of depressive symptoms than did those who remained active drivers, after the authors controlled for changes in health status and cognitive function. Increased depression for former drivers was substantially higher in men than in women. With increasing age, many older adults reduce and then stop driving. Increased depression may be among the consequences associated with driving reduction or cessation.
Objective: This study investigated the impact of driving cessation on social isolation in older adults. Method: Data were obtained from Rounds 1 through 6 of the National Health and Aging Trends Study. The study sample consisted of 6,916 Medicare beneficiaries aged 65 or above who were eligible drivers at baseline. Mixed-effects ordered logistic regression and piecewise regression were used to examine the impact of driving cessation on social isolation. Results: In multivariable mixed-effects ordered logistic regression, past-year nondrivers had a twofold increase in the odds of being in a higher social isolation category (odds ratio [OR] = 2.1, p < .001). Piecewise regression analysis showed that social isolation scores increased by 0.08 points ( p = .024) following an incident of driving cessation. Discussion: Driving cessation is associated with a higher risk of social isolation in older adults. Interventions to reduce social isolation among older adults may improve public health by targeting older adults who have recently stopped driving.
Throughout our lives, we rely on others and are relied on in turn. This is especially apparent in times of need, but also in ordinary daily goal pursuit. Among the people with whom we interact supportively, members of our families feature very prominently. Because the extent to which we are embedded in social networks and can rely on their help should we need it are consistent predictors of better health and longevity, it is not surprising that of the many forms of social exchange practiced with others, social support is the most frequently studied. This chapter provides a conceptual overview of social support and related constructs, discusses theories on how different forms of social support may be associated with health outcomes, and briefly reviews social support interventions in the area of coping with stress and disease. To account for the role of family processes, choice of social support theories reviewed in this chapter was guided not only by their impact on the field alone, but also by their assumptions on the role of specific support sources or providers, including members of our family.
Introduction: Older adults are at a greater risk of injury and death in a motor-vehicle accident. While the ability to drive safely can be challenging with aging, the concept of self-regulation and associated support system have attracted more attention in recent years, especially in developed countries. This review describes the mechanism and summarizes the potential factors that influenced self-regulation of driving amongst older adults to provide new insights into a broader framework for transportation and safe mobility. Methods: We systematically searched 12 online databases for qualitative studies exploring the experiences of older adults aged 60 years and above on their decision to self-regulate their driving. Thematic synthesis was performed to identify elements influencing driving reduction and cessation. The confidence profile of each findings from the meta-synthesis was appraised using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) tool. Results: A total of 17 studies representing views of 712 older adults from four countries were included. Three major themes were identified with each representing a transition phase that can either facilitate or hinder older drivers from ceasing completely or reducing their driving, when transitioning from pre-decision phase to post-cessation phase. Conclusions: Our findings suggest that there is a mismatch between the current traffic collation prevention measures, such as age-specific mandatory license renewal system and travel needs of older adults. As such, it is time for the authorities, researchers, and public from various fields and perspectives to collaborate, sustain, and improve safety and mobility in older adults. Practical applications: Adequate regulations and guidelines from the medical community and legal authorities are warranted to assist older adults and caregivers. Social support (e.g., feedback, assurance, or transportation support) from family members, friends, and healthcare professionals are crucial for a smooth transition. Provision of alternative transportations in rural areas are needed and future interventions should focus on engaging and educating older adults to consider alternative transportation modes for mobility. Age-specific mandatory license renewal procedure can be useful in screening for at-risk groups.
This article discusses what is currently known about three important topics related to older driver safety and mobility: screening and evaluation, education and training interventions, and in-vehicle technology. Progress is being made to improve the safe mobility of older adults in these key areas; however, significant research gaps remain. This article advances the state of knowledge by identifying these gaps, and proposing further research topics will improve the lives of older adults. In addition, we discuss several themes that emerged from the review, including the need for multidisciplinary, community-wide solutions; large-scale, longitudinal studies; improved education/training for both older adults themselves and the variety of stakeholders involved in older adult transportation; and programs and interventions that are flexible and responsive to individual needs and differences.
The Canadian Longitudinal Study on Aging is following 50,000 men and women aged 45–85, every three years for at least 20 years. Of the total, 20,000 (Tracking participants) are randomly selected within age/sex strata in each province, and 30,000 (Comprehensive participants) are randomly selected within age/sex strata from within 25–50 km of 11 sites across the country (Victoria, Vancouver, Surrey, Calgary, Winnipeg, Ottawa, Hamilton, Montreal, Sherbrooke, Halifax, and St. Johns). Data collection methods include telephone and face-to-face interviews, physical assessments, biological samples, and linkage to administrative databases. Initiated in 2010, the second wave of data collection is currently underway. The CLSA has engaged in a number of “firsts” in Canada. In this presentation we will highlight the study design and content, sampling, recruitment, baseline data collection, and ascertainment of health outcomes. Ethical legal and social issues, as well as accommodation strategies to improve retention in future waves will be presented.
In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to (a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages; (b) use a developmental perspective to elucidate patterns of gender differences across the life span; and (c) incorporate additional theory-driven moderators (e.g., gender equity). For major depression diagnoses and depression symptoms, respectively, we meta-analyzed data from 65 and 95 articles and their corresponding national data sets, representing data from 1,716,195 and 1,922,064 people in over 90 different nations. Overall, odds ratio (OR) = 1.95, 95% confidence interval (CI) [1.88, 2.03], and d = 0.27 [0.26, 0.29]. Age was the strongest predictor of effect size. The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13-15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked. (PsycINFO Database Record
This study investigates the role of online social connectedness as a buffer against depression in older adults who cease driving. A survey of 108 over-65 year olds (M = 73.7, SD = 7.37) was conducted. Measures included online and offline social connectedness; depression; online activities; and general health. The online activities in which older adults most frequently engaged were communicating with family and friends, reading the news, and banking. Face-to-face social connectedness was by far the strongest predictor of depression. However, online social connectedness did significantly moderate the effects of driving cessation on depression. The results suggest that online social connectedness can help protect older people from depressive symptoms following driving cessation.
Objective: The purpose of this study was to identify the associations between health and health care utilization with driving patterns in a cohort of older adults. Method: In 2012, a total of 1,826 surviving participants in the Rancho Bernardo cohort were sent a health and driving pattern survey; 1,277 were returned. Results: The majority of the respondents (1,151, 91%) were still driving. Older age, female sex, hospitalizations, emergency department (ED) visits and physical therapy visits, neurological disease, depression, limited vision, and limited hearing were associated with non-driving status. A total of 809 (71%) of drivers reported no citations or crashes in the last 5 years. Discussion: The vast majority of older drivers in this cohort continued to drive, and did so safely. Health care utilization, medications, medical conditions, and self-assessment of health were associated with non-driving status. Prospective studies are needed to clarify the temporal relationships between these factors.
Background: Driving cessation in later life is associated with depression. This study examines if social support can buffer the negative effects of driving cessation on older women's mental health. Methods: Participants were drawn from the 1921–1926 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) and included 4,075 older women (aged 76–87 years) who drove at baseline, following them for three years to assess driving cessation. The outcome variable was mental health, measured by the mental health index (MHI) of the SF-36. The explanatory variables were social support factors, including social interaction, whether the women were living alone or with others, and engagement in social activities. Control variables included age, country of birth, area of residence, ability to manage on income, marital status, and general health. Results: Main effect results showed that poor mental health was predicted by driving cessation, low levels of social interaction, and non-engagement in social activities. There was a significant interaction effect of driving status by social activities engagement on mental health. Women who remained active in their engagement of social activities were able to maintain a good level of mental health despite driving cessation. Conclusion: Engagement and participation in social activities can help older women who stopped driving maintain a good level of mental health.
Social support, which is the perception or experience that one is cared for, esteemed, and part of a mutually supportive social network, has beneficial effects on mental and physical health. We review the psychobiological pathways whereby these effects may occur and detail the circumstances under which socially supportive efforts may misfire. Origins of social support include genetic factors and the early environment. We examine gender and cultural differences in how social support is experienced. Under some circumstances, providing social support confers the same benefits as receiving it. A myriad number of social support interventions, including those delivered via the internet, have been evaluated and have the potential to provide emotional and informational support to people who might otherwise lack social support.
The safety and mobility needs of older women are two sides of the same coin. Current generations of older women are extremely mobile because of their access to the car; future generations will be even more dependent on the car for their mobility but may suffer even greater mobility losses when they reduce or cease driving. But if they continue to drive when they should no longer do so, crash and death rates will soar. In order to address their safety and mobility needs we need a three-fold strategy: 1) alter the roadway system to make it safer and easier for older drivers and pedestrians, 2) develop a range of supportive transit and paratransit alternatives, and 3) retrofit the low density communities in which most older will age in place or to which they will move.
Objective: To examine cross sectional associations between mobility with or without disability and social engagement in a community-based sample of older adults. Methods: Social engagement of participants (n = 676) was outside the home (participation in organizations and use of senior centers) and in home (talking by phone and use of Internet). Logistic or proportional odds models evaluated the association between social engagement and position in the disablement process (no mobility limitations, mobility limitations/no disability, and mobility limitations/disability). Results: Low mobility was associated with lower level of social engagement of all forms (Odds ratio (OR) = 0.59, confidence intervals (CI): 0.41-0.85 for organizations; OR = 0.67, CI: 0.42-1.06 for senior center; OR = 0.47, CI: 0.32-0.70 for phone; OR = 0.38, CI: 0.23-0.65 for Internet). For social engagement outside the home, odds of engagement were further reduced for individuals with disability. Discussion: Low mobility is associated with low social engagement even in the absence of disability; associations with disability differed by type of social engagement.
Derived and tested a short form of the Center for Epidemiologic Studies Depression Scale (CES-D) for reliability and validity among 1,206 well older adults (aged 65–98 yrs). The 10-item screening questionnaire, the CESD-10, showed good predictive accuracy when compared to the full-length 20-item version of the CES-D. The CESD-10 showed an expected positive correlation with poorer health status scores and a strong negative correlation with positive affect. Retest correlations for the CESD-10 were comparable to those in other studies. The CESD-10 was administered again after 12 mo. Data were based on 80% of the original sample. Scores were stable with strong correlation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Mobility is fundamental to active aging and is intimately linked to health status and quality of life. Although there is widespread acceptance regarding the importance of mobility in older adults, there have been few attempts to comprehensively portray mobility, and research has to a large extent been discipline specific. In this article, a new theoretical framework for mobility is presented with the goals of raising awareness of the complexity of factors that influence mobility and stimulating new integrative and interdisciplinary research ideas. Mobility is broadly defined as the ability to move oneself (e.g., by walking, by using assistive devices, or by using transportation) within community environments that expand from one's home, to the neighborhood, and to regions beyond. The concept of mobility is portrayed through 5 fundamental categories of determinants (cognitive, psychosocial, physical, environmental, and financial), with gender, culture, and biography (personal life history) conceptualized as critical cross-cutting influences. Each category of determinants consists of an increasing number of factors, demonstrating greater complexity, as the mobility environment expands farther from the home. The framework illustrates how mobility impairments can lead to limitations in accessing different life-spaces and stresses the associations among determinants that influence mobility. By bridging disciplines and representing mobility in an inclusive manner, the model suggests that research needs to be more interdisciplinary and current mobility findings should be interpreted more comprehensively, and new more complex strategies should be developed to address mobility concerns.
RÉSUMÉ Les Canadiens vivent plus longtemps et les personnes plus âgées composent une part croissante de la population (14% en 2006, projeté d’atteindre 20% d’ici 2021). L’Étude longitudinale canadienne sur le vieillissement (ÉLCV) est une étude longitudinale nationale portant sur le développement adulte et le vieillissement qui recrutera 50 000 Canadien(ne)s âgé(e)s de 45 à 85 ans et qui les suivra pendant au moins 20 ans. Tous les participants fourniront un ensemble d’informations communes sur plusieurs aspects de la santé et du vieillissement, et 30 000 passeront un examen approfondi couplé au don de spécimens biologiques (sang et urine). L’ÉLCV deviendra une source de données riches pour l’étude d’inter-relations complexes entre les facteurs biologiques, physiques, psychosociaux et sociaux qui affectent le vieillissement en santé.
The objective of this study was to evaluate the impact of driving cessation on social integration and perceived support from relatives and friends among older adults. Data came from the population-based Baltimore Epidemiologic Catchment Area Study. We restricted analyses to participants aged 60+ with a history of driving (n=398). Social integration (number and frequency of contact) and perceived social support from relatives/friends, driving status (continuing or ceased), and demographic and health characteristics were assessed at interviews 13 years apart. The potential mediating role of ability to use public transit was also investigated. We used repeated measures random-intercept models to evaluate the effect of driving cessation on social network characteristics over time. Former drivers were older, were more likely to be female and non-White, had lower education, had poorer self-rated health, and had lower Mini-Mental State Examination scores relative to continuing drivers. Over the follow-up period, cessation was associated with reduced network of friends (odds ratio=0.49, p<.05). This association was not mediated by ability to use public transportation. Cessation had no impact on support from friends or relatives. Social integration is negatively affected by driving cessation even among elders who feel competent in using alternative forms of transportation, at least concerning networks of friends.
This paper describes the development and evaluation of a brief, multidimensional, self-administered, social support survey that was developed for patients in the Medical Outcomes Study (MOS), a two-year study of patients with chronic conditions. This survey was designed to be comprehensive in terms of recent thinking about the various dimensions of social support. In addition, it was designed to be distinct from other related measures. We present a summary of the major conceptual issues considered when choosing items for the social support battery, describe the items, and present findings based on data from 2987 patients (ages 18 and older). Multitrait scaling analyses supported the dimensionality of four functional support scales (emotional/informational, tangible, affectionate, and positive social interaction) and the construction of an overall functional social support index. These support measures are distinct from structural measures of social support and from related health measures. They are reliable (all Alphas greater than 0.91), and are fairly stable over time. Selected construct validity hypotheses were supported.
This study examined the relationships among social support, life strain, and mental health in a sample of 210 rural elderly individuals. Life strain was operationalized as economic deprivation, illness disability, and ADL impairment. Demographic characteristics had little effect on mental health. Physical health status was highly predictive of life satisfaction and psychological distress among rural elderly individuals. Disability associated with chronic illness and ADL impairment was related to increased reports of symptoms of emotional and psychosomatic distress. Measures of social contacts and instrumental support exerted small to moderate effects on life satisfaction, psychosomatic distress, and emotional distress. Affective support moderated the effects of health-related strain on mental health.
Increasing age, socioeconomic factors, and declining function and health have been linked to driving cessation, but little is known about the consequences of stopping driving. This study was designed to test the hypothesis that driving cessation leads to a decline in out-of-home activity levels. In 1989 a survey of driving practices was administered to surviving noninstitutionalized members of the New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE) cohort. Of 1,316 respondents, 502 were active drivers as of 1988, 92 had stopped driving between 1982 and 1987, and 722 never drove or stopped before 1982. Information on sociodemographic and health-related variables came from in-home EPESE interviews in 1982, 1985, and 1988, and from yearly phone interviews. Activity was measured at all three in-home interviews, and an activity measure was created based on self-reported participation in nine out-of-home activities. A repeated measures random-effects model was used to test the effect of driving cessation on activity while controlling for potential confounders. Driving cessation was strongly associated with decreased out-of-home activity levels (coefficient-1.081, standard error 0.264, p < .001) after adjustment for sociodemographic and health-related factors. The potential consequences of driving limitations or cessation should be taken into account when advising older drivers and developing alternative transportation strategies to help maintain their mobility.
We estimated total life expectancy and driving life expectancy of US drivers aged 70 years and older. Life table methods were applied to 4699 elderly persons who were driving in 1993 and reassessed in a 1995 survey. Drivers aged 70 to 74 years had a driving life expectancy of approximately 11 years. A higher risk of mortality among men as a cause of driving cessation offset a higher risk of driving cessation not related to mortality among women that resulted in similar driving life expectancies. Nationwide, many elderly drivers quit driving each year and must seek alternative sources of transportation. Because of differences in life expectancy, women require more years of support for transportation, on average, than men after age 70.
Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale)
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Does online social connectedness buffer risk of depression following driving cessation An analysis of older drivers and ex-drivers
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Transportation and aging: an updated research agenda for advancing safe mobility
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Driving life expectancy of persons aged 70 years and older in the United States
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Social support and protection from depression: systematic review of current findings in Western countries
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