Date of Award

5-31-2017

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Gerontology

First Advisor

Elizabeth Dugan

Second Advisor

Jan E. Mutchler

Third Advisor

Nina M. Silverstein

Abstract

Driving in an important mode of transportation for older adults, yet many will outlive their driving years and cease driving. Driving status has been associated with many quality of life factors including depression, isolation, entry into long term care and even mortality. Previous studies have suggested that a decline in cognition is associated with driving status however ‘cognitive function’ is often defined broadly, and the tests used to measure cognition overlap throughout the literature. This study explored the relationship between cognition and driving status with the aim of identifying a test or battery of tests that is more strongly associated with cessation that may serve to target older adults for intervention or assistance with transition to non-driving status.

The initial ADAMS sample (N=1,770) is drawn from a large, nationally representative dataset that offers a variety of neuropsychological tests for assessment as well as covariates that have been observed to be associated with driving. Wave A (2002) assessments were completed by 686 respondents and were analyzed at baseline for driving status. Respondents were approximately 81.6 years (7.1 SD), and mostly women (female, 58.5%; male, 41.5%). Driving status over time (2004) was analyzed with HRS data (N=681). Overall, results suggested that poorer performance on neuropsychological tests was associated with increased likelihood of driving cessation. Correlational analysis suggested that the Memory domain is most strongly associated with driving status. Logistic and multinomial regression analyses indicated three tests are strong predictors of driving over time including SYMB (OR=1.39, p=.01), AF (OR=2.40, p=.01), and FULD (OR=2.49, p=.05). Results also suggest that two additional tests TMTA (OR=.63, p=.01) and TMTB (OR=.66, p=.01) should be considered for a best fit battery.

Results from this study suggest that although memory may be strongly associated as a domain, specific tests not related to memory may be better predictors of driving cessation over time. This study identified a series of inexpensive and easy to administer tests that can be completed in a practitioner’s office, one that is often familiar to a client. Specific tests (AF & FULD) are not commonly found in the driving literature and warrant additional research.

Comments

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