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Automobile driving in seniors: Factors affecting driving restriction in men and women

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Background/Objectives: Independence for older people is linked to driving, this being their main mode of travel. Even in normal aging, sensory, functional, and cognitive deficits appear, and are more severe in brain pathology leading to dementia. These may profoundly affect driving, which is a complex task involving all of these functions. Many studies show that older drivers modify their driving habits (reduced distance, avoiding certain driving situations ...). When this regulation process occurs in later life, gender differences have been reported. Women regulate their driving more than men and do so earlier. Gender differences in image and roles could lead women to loss mobility prematurely and lead men to make insufficient driving regulation. The purpose of the study was to investigate driving regulation with a focus on gender, cognitive deficits and Central Nervous System pathologies. Design: Longitudinal Study over six years. Setting: the Three-City Cohort of Bordeaux, a longitudinal study of 2104 people aged 65 years and above. Participants: 523 drivers, 273 men and 250 women. Measurements: Our range of measurements included socio-demographic characteristics, driving habits, health variables, cognitive evaluation and dementia diagnosis. Results: Fifty seven percent of the population aged 76 years on average restricted their driving over six years. In gender specific models, pre-dementia, Parkinson's disease, advanced age and high initial mobility by car were common factors of restriction in both genders. But other restriction factors were gender specific. In men, prevalent dementia, depressive symptomatology and a decline in at least one Instrumental Activities in Daily Living were specific factors. The only cognitive factor was low performance in the Benton Visual Retention Test. Specific restriction factors in women were low income and fear of falling. Slow Trail Making Test A execution time or a severe decline in Mini Mental Status Examination performance were the cognitive factors specifically associated with female restriction. Conclusion: The results could allow advising certain persons to make changes in driving behavior, in order to conciliate mobility and security in older drivers.

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