The Graying of America: Gender affects decision to give up driving

Unfortunately, failure to cease driving in very late adulthood, when it should occur, may have tragic consequences, as in the terrible accident caused recently in Santa Monica, Calif., by an 86-year-old driver.

Of concern is the level of cognitive or mental functioning possessed by an older driver. Some indication of its importance was demonstrated by researchers in North Carolina with a large sample of older drivers applying for renewal of their driver's license. They found that older drivers scoring in the lowest 25 percent on two cognitive tests reported more often driving fewer than 3,000 miles per year than older drivers scoring in the highest 25 percent. That is, impaired cognitive functioning seemed to lead to reduced driving and to avoid driving under hazardous conditions.

Level of cognitive functioning as a contributing factor in deciding to cease driving was given a thorough examination by Drs. Barbara Freund and Maximiliane Szinovacz of Eastern Virginia Medical School. They also examined the role played by an older driver's gender or sex.

The participants were 2,261 men and 3,199 women age 70 and older who had been included in a national survey. Each participant answered two questions, the first being "Are you able to drive" and the second being "Do you limit your driving to nearby places or do you drive on longer trips." Based on their answers they were classified in one of three groups: does not drive, drives short distances only, and drives long distances as well as short distances.

Each participant received a battery of cognitive tests that measured memory ability, knowledge, language proficiency and orientation. On the basis of their performances on these tests they were classified as being severely cognitively impaired. mildly cognitively impaired and cognitively unimpaired. Only 5 percent of the men and 6 percent of the women were classified as mildly impaired, and only 3 percent of each sex as severely impaired.

There were several striking sex differences in cessation or reduction of driving. Of the unimpaired men only 8 percent did not drive, compared to 22 percent of the women, Of those mildly impaired, 19 percent of the men and 64 percent of the women did not drive. For those severely impaired, the comparable values were 43 percent and 76 percent.

These outcomes indicate that older women are more likely than older men to know that their cognitive competence has declined to the point that they should no longer be driving.

Further support for this sex difference comes from the percentages of those who drive only short and both short and long distances. For severely impaired men, 37 percent drove short distances only and 20 percent drove long as well as short distances. For mildly impaired men, 50 percent drove short distances only and 32 percent drove both short and long distances. For severely impaired women the percentages were much smaller (18 percent for short only, 6 percent for both short and long). Frequencies were also much smaller for mildly impaired women (28 percent for short only, 8 percent for short and long).

Why the striking gender difference? A probable reason is that many older men seem to be highly masculine in gender, possessing characteristics believed by them to be necessarily true to be considered a man. Driving an automobile is likely to be one of these characteristics. To give up driving is to lose some of their masculinity and therefore their self-worth.

Interventions by family members, friends and counselors need to be applied that will convince the minority of cognitively impaired older people who are still driving to give it up. They represent a great risk for themselves and others.

Dr. Donald H. Kausler, emeritus professor of psychology at the University of Missouri-Columbia, is author of The Graying of America: An Encyclopedia of Aging, Health, Mind, and Behavior.