About 65% of older adults who stop driving report wishing they could still drive, according to the AAA Foundation’s LongROAD cohort study of 2,990 adults aged 65 to 79. That regret rate — among the highest documented for any elder-care decision — reflects what driving represents in car-dependent societies: not a leisure activity but a primary mechanism for social participation, medical appointments, and daily errands. The Chihuri 2016 meta-analysis of 16 longitudinal cohorts across the US, UK, Australia, Netherlands, and Japan found that driving cessation was associated with a doubled risk of depression and five-fold higher rates of long-term care entry, with effects persisting after adjusting for baseline health status.
The comparison is not between a safe choice and a risky one. IRTAD data across OECD countries show that drivers aged 80 and older have a per-mile fatal crash rate roughly double that of drivers aged 35 to 64, approaching rates associated with teenage drivers. About 15 to 25% of older drivers report at least one near-miss or driving difficulty in the past year — a signal that a meaningful minority are aware of declining capability even while continuing to drive. The asymmetry in the data is that continuing generates fewer subjective regrets while producing more objective risk; stopping generates more subjective regrets while producing a set of health consequences that are real but partly confounded by the health deterioration that prompted cessation.
Reverse causation is the dominant methodological concern. Drivers who stop usually do so because of a health crisis or family pressure following a crash or cognitive screen, meaning the depression and mortality outcomes measured in follow-up studies may partly reflect the pre-existing decline that triggered cessation rather than the cessation itself. This does not eliminate the causation — social isolation and loss of autonomy plausibly do worsen health independently — but it makes the direction of effect difficult to quantify. The practical implication is that the timing and circumstances of stopping matter: planned gradual reduction under the person’s own agency produces better outcomes than abrupt cessation following a crash. Country context also matters substantially: in dense urban areas with accessible public transit, the isolation effect of stopping driving is far smaller than in the US suburbs and rural areas where most American elders live.