4.6 Article

15-year incidence of driving cessation and associated risk factors: The Blue Mountains Eye Study

Journal

MATURITAS
Volume 177, Issue -, Pages -

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.maturitas.2023.107796

Keywords

Driving cessation; Vision impairment; Older drivers; Epidemiology

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This study analyzed the 15-year incidence of driving cessation and its associated vision-related risk factors in an older Australian population-based cohort. The cumulative incidence of driving cessation was 20.7% among the 2379 participants, with women more likely to cease driving than men. Cataract and age-related macular degeneration were found to be associated with increased risk of cessation, while better visual acuity at baseline helped prolong driving.
Objectives: To report the 15-year incidence of driving cessation and its associated vision-related risk factors in an older Australian population-based cohort.Study design: 15-year data from a sample of 2379 participants who indicated that they were driving at baseline from The Blue Mountains Eye Study was analysed. Questions about driving cessation was asked at all four visits and was recorded as a binary response (Yes/No). Clinical vision examinations were performed at each visit to determine presenting and best-corrected visual acuity and any incident eye diseases (Yes/No).Main outcome measures: The cumulative 15-year incidence of driving cessation was calculated using interval censored data progression-free survival analyses. Age-and sex-adjusted and multivariable-adjusted interval censored Cox proportional hazard models were used to report the hazard ratios (HRs) for associations of baseline and incident vision status with driving cessation.Results: The 15-year cumulative incidence of driving cessation amongst the 2379 participants was 20.7 %, with women more likely to cease driving than men (p = 0.0005). Cataract (HR 1.98 (95 % confidence interval(Cl) 1.45-2.71)) and age-related macular degeneration (HR 1.85 (95%Cl 1.37-2.50)) were associated with increased risk of driving cessation whilst presenting and best-corrected visual acuity in the better eye were protective against cessation (presenting: HR 0.96 (95%Cl 0.95-0.98); best-corrected: HR 0.93 (95%Cl 0.91-0.95)) in age and sex-adjusted models, with these factors remaining independently associated in the multivariable-adjusted models.Conclusion: Cumulative incidence of driving cessation increased with older age and was higher in females. Cataract and age-related macular degeneration were independently associated with cessation, whilst better visual acuity at baseline helped prolong driving.

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