Freeman Ellen E, Gange Stephen J, Muñoz Beatriz, West Sheila K
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Public Health. 2006 Jul;96(7):1254-9. doi: 10.2105/AJPH.2005.069146. Epub 2006 May 30.
Given the importance of driving in American society, older non-drivers may be unable to meet basic needs while living independently. We assessed whether not driving is an independent risk factor for entering long-term care (LTC) institutions.
Data were used from 1593 older adults who participated in the Salisbury Eye Evaluation cohort study and completed an additional telephone survey. Questions on driving status and LTC entry were obtained by self/proxy report. Cox time-dependent regression procedures were used to adjust for demographic and health factors.
Former and never drivers had higher hazards of LTC entry after adjustment for demographic and health variables (hazard ratio [HR]=4.85; 95% confidence interval [CI]=3.26, 7.21; and HR=3.53; 95% CI=1.89, 6.58, respectively). Also, having no other drivers in the house was an independent risk factor for LTC entry (HR=1.72; 95% CI=1.15, 2.57).Discussion. Older adults are expected to make good decisions about when to stop driving, but the hardships imposed on older adults by not driving are not widely recognized. Innovative strategies to improve transportation options for older adults should be considered.
鉴于驾驶在美国社会中的重要性，不驾车的老年人在独立生活时可能无法满足基本需求。我们评估了不驾车是否是进入长期护理（LTC）机构的独立风险因素。
数据来自1593名参与索尔兹伯里眼部评估队列研究并完成额外电话调查的老年人。通过自我/代理报告获取有关驾驶状态和进入长期护理机构的问题。使用Cox时间依赖性回归程序来调整人口统计学和健康因素。
在调整人口统计学和健康变量后，曾经驾车者和从未驾车者进入长期护理机构的风险更高（风险比[HR]=4.85；95%置信区间[CI]=3.26, 7.21；以及HR=3.53；95% CI=1.89, 6.58）。此外，家中没有其他驾车者是进入长期护理机构的独立风险因素（HR=1.72；95% CI=1.15, 2.57）。讨论。预计老年人会就何时停止驾车做出明智的决定，但不驾车给老年人带来的困难并未得到广泛认可。应考虑创新策略以改善老年人的交通选择。
