Neighbourhood transportation, elapsed years, and well-being after surrendering the driver's licence in older Japanese adults: The JAGES longitudinal study.

This study aimed to examine how the associations between surrendering driving licence and changes in self-rated health and social interactions among older adults differ by the years elapsed since surrendering and the number of public transportation systems (PTS) in the neighbourhood. We used the 2013 and 2016 survey data from the Japan Gerontological Evaluation Study targeting residents aged ≥65 years in 30 municipalities in Japan. Two-waves longitudinal data from 4894 older adults were evaluated. Based on the difference-in-differences method, the interaction terms of respondents' driving status, which was the categorical exposure variable representing respondents' driving status for three years during the study period, and a dummy variable of year (2016) were used as explanatory variables in logistic regression analyses to examine changes in outcomes (poor self-rated health and infrequent meeting with friends) between 2013 and 2016 by driving status during this period. Analyses were stratified based on neighbourhood PTS ('more PTS' and 'fewer PTS' groups). We found that, while surrendering licence within three years was associated with increased probability of poor self-rated health in more PTS group, the confidence interval was large. Although surrendering licence within three years was associated with decreased social interactions, this association weakened if licence was surrendered more than three years ago. These associations were not markedly affected by neighbourhood PTS. Our findings suggested that, regardless of neighbourhood PTS, support and care to promote social interactions at or shortly after surrendering licence may be beneficial to the well-being of older adults who lost their driving licence.

[Qualitative study on decision-making process in "voluntary" withdrawal of driver's license: Transitions in self-concept, body image, and social relationships due to aging].

Objectives　Although previous studies have discussed the "voluntary" withdrawal of older drivers' driving license to prevent traffic accidents, there is less evidence about the experience of giving up driving. The present study investigated the decision-making process in the "voluntary" withdrawal of the driver's license and the conceptual meaning of "voluntary" among individuals who have experienced or shortly plan the event, as well as the transitions in their social relationships, social interactions, and body image perceptions.Methods　Qualitative research was undertaken to examine the explanatory research question in City A, Ibaraki prefecture, Japan. A semi-structured interview was conducted with eight male participants. They were asked related questions, for example, the meaning of driving, lifestyle changes, and so on. Data were recorded and transcribed into transcripts to be analyzed using the grounded theory approach.Results　The qualitative data revealed that when participants perceived their "body" as alienated from their "self" during driving or daily living, they became confused because they needed to be conscious of the aroused existence of the "self" that operates their "body," which was previously integrated with their "self." This awareness led the individuals to the process of "voluntary" withdrawal from driving in coping with their reflected "self" while they gradually distrusted their "self" regarding their deteriorating "body." Some participants lost their "self" and felt that they were forced to stop driving "voluntarily" when their "self" was determined as belonging to a risky "body," whereas others could decide "voluntary" driving cessation and realize their "self" through social interactions when they "re-evaluated" their "self" in light of their life stories. Both types of participants had "difficulties" after driving cessation; however, the latter effectively emphasized the re-construction of the "self" and "self"-based decision-making process due to aging.Conclusion　The decision-making process in the withdrawal of a driver's license due to aging resembled the process of coping with disabilities. Previous relationships between "self," "body," and society might be affected by age- or illness-triggered events. Encouraging the re-construction of "self" and its relationships might alleviate the psychological impact on elderly people facing "voluntary" retirement from driving.