Community mobility using private and public transportation is important for maintaining health, social participation and living well in later life. This international cross-sectional cohort study (N = 246) reported on the health and driving status of older adults from seven countries where the mobility patterns of drivers and non-drivers were compared in terms of city and rural areas, weather, as well as their respective differences in the number of out-of-home places accessed and quality of life. Older adults participated in a semi-structured interview and completed four standardised instruments: the EQ-5D-5L, modified PULSES health profile, modified Transportation Questionnaire, and the Transport – Participation in Activities and Places Outside the Home. Results suggested inclement weather and place of residence negatively impacted out-of-home activities but did not increase use of public transportation. Drivers accessed more out-of-home activities than non-drivers, suggesting higher community participation among this group, and quality of life was generally high among all participants, but slightly higher for drivers. Findings indicate that a complex myriad of factors can influence community mobility in older adults and further investigations are needed to understand patterns of transport in later life, particularly with regard to those factors that promote and maintain transport mobility, and relationships between transport mobility, community participation and quality of life.

Most older adults perceive themselves as good drivers; however, their perception may not be accurate, and could negatively affect their driving safety. This study examined the accuracy of older drivers’ self-awareness of driving ability in their everyday driving environment by determining the concordance between the perceived (assessed by the Perceived Driving Ability [PDA] questionnaire) and actual (assessed by electronic Driving Observation Schedule [eDOS]) driving performance. One hundred and eight older drivers (male: 67.6%; age: mean = 80.6 years, standard deviation [SD] = 4.9 years) who participated in the study were classified into three groups: underestimation (19%), accurate estimation (29%), and overestimation (53%). Using the demographic and clinical functioning information collected in the Candrive annual assessments, an ordinal regression showed that two factors were related to the accuracy of self-awareness: older drivers with better visuo-motor processing speed measured by the Trail Making Test (TMT)-A and fewer self-reported comorbid conditions tended to overestimate their driving ability, and vice versa.

The purpose of this study was to examine whether vehicle type based on size (car vs. other = truck/van/SUV) had an impact on the speeding, acceleration, and braking patterns of older male and female drivers (70 years and older) from a Canadian longitudinal study. The primary hypothesis was that older adults driving larger vehicles (e.g., trucks, SUVs, or vans) would be more likely to speed than those driving cars. Participants (n = 493) had a device installed in their vehicles that recorded their everyday driving. The findings suggest that the type of vehicle driven had little or no impact on per cent of time speeding or on the braking and accelerating patterns of older drivers. Given that the propensity for exceeding the speed limit was high among these older drivers, regardless of vehicle type, future research should examine what effect this behaviour has on older-driver road safety.

We examined the relations between perceived health (e.g., self-perceived health status) and driving self-regulatory practices (e.g., frequency of driving, avoiding challenging driving situations) as mediated by driving attitudes and perceptions (i.e., driving comfort, positive and negative attitudes towards driving) in data collected for 928 drivers aged 70 and older enrolled in the Candrive II study. We observed that specific attitudes towards driving (e.g., driving comfort, negative attitudes towards driving) mediate the relations between health symptoms and self-regulatory driving behaviours at baseline and over time. Only negative attitudes towards driving fully mediated the relationships between changes in perceived health symptoms and changes in driving behavior. Perceived health symptoms apparently influence the likelihood of avoiding challenging driving situations through both initial negative attitudes towards driving as well as changes in negative attitudes over time. Understanding influences on self-regulatory driving behaviours will be of benefit when designing interventions to enhance the safety of older drivers.

We investigated whether convenience sampling is a suitable method to generate a sample of older drivers representative of the older-Canadian driver population. Using equivalence testing, we compared a large convenience sample of older drivers (Candrive II prospective cohort study) to a similarly aged population of older Canadian drivers. The Candrive sample consists of 928 community-dwelling older drivers from seven metropolitan areas of Canada. The population data was obtained from the Canadian Community Health Survey – Healthy Aging (CCHS-HA), which is a representative sample of older Canadians. The data for drivers aged 70 and older were extracted from the CCHS-HA database, for a total of 3,899 older Canadian drivers. Two samples were demonstrated as equivalent on socio-demographic, health, and driving variables that we compared, but not on driving frequency. We conclude that convenience sampling used in the Candrive study created a fairly representative sample of Canadian older drivers, with a few exceptions.

The number of older drivers will continue to increase as the population ages. Health care professionals have the responsibility of providing care and maintaining confidentiality for their patients while ensuring public safety. This article discusses the ethics of clinical decision-making pertaining to reporting health-related driving risk of older drivers to licensing authorities. Ethical considerations inherent in reporting driving risk, including autonomy, confidentiality, therapeutic relationships, and the uncertainty about determining individual driving safety and risk, are discussed. We also address the moral agency of reporting health-related driving risk and raise the question of whose responsibility it is to report. Issues of uncertainty surrounding clinical reasoning and concepts related to risk assessment are also discussed. Finally, we present two case studies to illustrate some of the issues and challenges faced by health care professionals as they seek to balance their responsibilities for their patients while ensuring road safety for all citizens.

In this study, we examined the Candrive baseline data (n = 928; aged 70 to 94; 62% were men) to determine whether driver characteristics (i.e., age, gender, height, weight, BMI) and certain functional abilities (i.e., Rapid Paced Walk, Timed Up and Go) influenced the types of vehicles driven. There were significant differences with respect to type of vehicle and mean driver age (F = 3.58, p = 0.003), height, (F = 13.32, p < 0.001), weight (F = 14.31, p < 0.001), and BMI (F = 4.40, p = 0.001). A greater proportion of drivers with osteoporosis (χ2 = 21.23, p = 0.020) and osteo/rheumatoid arthritis (χ2 = 21.23, p = 0.020) drove small and medium-sized cars compared to larger ones. Further research is needed to examine older driver-vehicle interactions, and the relationship to demographics and functional abilities, given the vulnerability of this age group to automotive-related injuries.

The purpose of this study was to determine if season or weather affected the objectively measured trip distances of older drivers (≥ 70 years; n = 279) at seven Canadian sites. During winter, for all trips taken, trip distance was 7 per cent shorter when controlling for site and whether the trip occurred during the day. In addition, for trips taken within city limits, trip distance was 1 per cent shorter during winter and 5 per cent longer during rain when compared to no precipitation when controlling for weather (or season respectively), time of day, and site. At night, trip distance was about 30 per cent longer when controlling for season and site (and weather), contrary to expectations. Together, these results suggest that older Canadian drivers alter their trip distances based on season, weather conditions, and time of day, although not always in the expected direction.

This study examined a cohort of 227 older drivers and investigated the relationship between performance on the electronic Driver Observation Schedule (eDOS) driving task and: (1) driver characteristics; (2) functional abilities; (3) perceptions of driving comfort and abilities; and (4) self-reported driving restrictions. Participants (male: 70%; age: M = 81.53 years, SD = 3.37 years) completed a series of functional ability measures and scales on perceived driving comfort, abilities, and driving restrictions from the Year 2 Candrive/Ozcandrive assessment protocol, along with an eDOS driving task. Observations of participants’ driving behaviours during the driving task were recorded for intersection negotiation, lane-changing, merging, low-speed maneuvers, and maneuver-free driving. eDOS driving task scores were high (M = 94.74; SD = 5.70) and significantly related to participants’ perceived driving abilities, reported frequency of driving in challenging situations, and number of driving restrictions. Future analyses will explore potential changes in driving task scores over time.

We hypothesized that changes over time in cognitive performance are associated with changes in driver perceptions, attitudes, and self-regulatory behaviors among older adults. Healthy older adults (n = 928) underwent cognitive assessments at baseline with two subsequent annual follow-ups, and completed scales regarding their perceptions, attitudes, and driving behaviours. Multivariate analysis showed small but statistically significant relationships between the cognitive tests and self-report measures, with the largest magnitudes between scores on the Trails B cognitive task (seconds), perceptions of driving abilities (β = –0.32), and situational driving avoidance (β = 0.55) (p < 0.05). Cognitive slowing and executive dysfunction appear to be associated with modestly lower perceived driving abilities and more avoidance of driving situations over time in this exploratory analysis.

To date, associations between psychosocial driving variables and behaviour have been examined only cross-sectionally. Using three waves of data collected annually from 928 older drivers (mean age = 76.21 years; 62% male) enrolled in the Candrive II cohort, we examined in this study whether changes in attitudes and perceptions towards driving (decisional balance and day and night driving comfort) were associated with changes in older adults’ reported restrictions in driving practices and perceived driving abilities. Multi-level models revealed that older adults who showed an increase in negative attitudes towards driving over time were more likely to report more-restricted practices (greater avoidance of challenging driving situations) and perceived declines in driving abilities compared to individuals whose attitudes towards driving remained stable across two years. This work supports previous findings and offers a new understanding of how attitudes relate to driving perceptions (e.g., comfort) and self-regulation in older adults over time.

This article presents a study that compared participation by elderly individuals living in the community according to primary transportation mode used, and estimated the association between transportation, personal factors, and environmental factors. Participants included 90 adults aged 65 and older (M = 76.3 years; SD = 7.7). They were classified according to their primary transportation mode: driver, passenger, public transport user, walk, or adapted transport/taxi user. Participation was measured with the Craig Handicap Assessment and Reporting Technique (CHART) and the Nottingham Leisure Questionnaire (NLQ). Overall, results indicated that drivers, public transport users, and walkers had higher participation levels compared to passengers and adapted transport/taxi users. This study suggests that clinicians should consider older adults’ use of transportation in an attempt to encourage and maximize their participation.