Driving Transitions and Mental Health in Disabled Elders

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DESCRIPTION (provided by applicant): Most prior research in driving and aging has focused on demographic and medical factors associated with driving cessation. However, little is known about the psychosocial influences on driving transitions, the severity or trajectory of subsequent mental health problems, or why some older adults are better able than others to make these transitions with less psychological distress. Driving decisions are especially salient for the growing numbers of older adults with vision problems. The primary aim of the proposed longitudinal study is to examine how the transition from driver to ex-driver may be more or less difficult for older drivers with vision problems, depending on their personal, social, and contextual resources. Conceptually, the study draws upon recent health behavior change models that examine the conditions under which a person is willing and able to change a health behavior (e.g., driving self-regulation and cessation). The proposed study will extend prior research on driving in later life by using a prospective and theoretically guided approach. Specific aims of the proposed research are: 1. To identify the extent of driving self-regulation and the occurrence of driving cessation, and to examine both their short- and long-term impact on mental health outcomes (i.e., depression, vision-specific mental health, psychological well-being) among visually impaired older adults. 2. To examine the influence of personal resources (e.g., personal goal structures, self-regulatory coping tendencies), social resources (e.g., influence of family, friends and professionals) and contextual resources (e.g., alternative transportation) on decisions regarding driving self regulation and cessation over time. 3. To identify the key personal, social and contextual resources that, concurrently and over time, mediate the impact of driving self-regulation and cessation on mental health outcomes. 4. To explore the extent to which participants and informants are congruent in reports of driving behaviors and interactions regarding decision-making, and to explore the influence of congruence on driving cessation and mental health outcomes. Participants will be 380 older adult drivers (age 55+) recruited from a community-based vision rehabilitation agency. Data will be collected through in-person interviews at baseline and at 1- and 2-year follow-ups, as well as brief quarterly telephone interviews at 4, 8, 16, and 20 months. In addition, baseline and 1- and 2-year telephone interviews with an informant (family or friend) will be conducted. Analyses will address concurrent associations (cross sectional) and prospective relationships (longitudinal) using Regression-, Individual Growth-, and Structural Equation Modeling techniques.