Predictors of driving among older Australian women from 2002 to 2011: A longitudinal analysis of Australian Longitudinal Study on Women's Health based on the World Health Organization's Healthy Ageing Framework

Introduction: The number of older drivers is quickly rising as the world's population is ageing. Driving was found to be essential in improving older people's quality of life. However, in assessing factors associated with driving in old age, previous studies have focused on medical conditions and sociodemographic factors, such as age and sex. Little is known about the effect of environment and social roles in determining driving in old age. Objective: This study aimed to identify the predictors of driving among women as they age from 76 to 81 to 85-90 years based on the World Health Organization's (WHO) Healthy Ageing framework. Method: The study analysed longitudinal data from the 1921-26 cohort of the Australian Longitudinal Study on Women's Health (ALSWH), nine years of follow up from survey waves three (aged 76-81 years) to six (aged 85-90 years). The study examined factors associated with driving based on the WHO's healthy ageing approach. Generalised estimating equation (GEE) models were used to identify predictors of driving over time. Result: At baseline (ages 76-81 years), 55.7% of women were driving themselves, and this was their main means of transport. Over time, the odds of driving decreased as the women aged. In multivariable analyses, personal factors including education, providing care, grandparenting, and volunteering had positive associations with driving. In addition, the environmental factors of living in remote, outer regional and inner regional Australia, living in the states of Victoria and Western Australia, and living alone were also positively associated with driving. In contrast, medical conditions like diabetes, stroke, visual impairment, and need for assistance with daily tasks had negative associations with driving. Conclusion: Age alone does not determine driving. Therefore, the context of personal, social, and environmental factors should also be considered and aligned with the healthy ageing goals when developing driving policy for older people.