The Longitudinal Association of Physical Function and Frailty on Driving Strategic Self-Regulation Among Older Adults

Older adults self-regulate their driving as it becomes more challenging. This study evaluated physical performance and frailty to see their impact on strategic self-regulation in older drivers. The AAA Longitudinal Research on Aging Drivers study was a multisite prospective cohort study. The Fried Frailty Phenotype (FFP) and the National Health and Aging Trends Study (NHATS) Short Physical Performance Battery (SPPB) were administered to 2990 older drivers. Mixed-effects Poisson regression models estimated strategic self-regulation associated with the SPPB and the FFP adjusting for age, sex, visual perception, cognition, miles driven, and urban/rural status. Compared to older drivers with good SPPB scores, strategic self-regulation increased 17% among those with fair scores and 38% among those with poor scores. Compared to older drivers who were not frail, strategic self-regulation increased 6% among pre-frail drivers and 26% among frail drivers. Strategic self-regulation increased in a dose-response relationship with both frailty and physical function.