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Gender Differences in Mortality Risk After Driving Cessation Among Older Men and Women: a Mediation Analysis

机译:老年人和妇女戒烟后死亡率风险的性别差异:调解分析

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摘要

Driving is the most important personal transportation mode in the US for maintaining mobility. Previous studies of older adults who stop driving have identified several health risks associated with driving cessation, including less access to health care, increased dependency, social isolation, and elevated risk of mortality. The purpose of this analysis was to examine driving status as a predictor of mortality among community-dwelling older men and older women. Data were drawn from a prospective panel study of successful aging project of 1000 older adults (mean age = 80). Participants’ driving status was measured at baseline and mortality rates were observed across the subsequent 10 years. Extended Cox proportional hazard model indicated a 76% (p<0.001) significantly higher mortality risk for non-drivers versus drivers. This relationship was mediated by health conditions and functional status for both older men and older women. Among older men, health status fully mediates the association between driving cessation and mortality risk. A partial mediation effect of health status on the association between driving cessation and mortality risk was found among older women. Older women who stopped driving faced 56% (p>0.01) higher relative mortality risk than their driver counterparts. Social and cultural issues such as gender stereotype, autonomy, and social connection with their implication for driving may explain existing gender differences among older adults.
机译:驾驶是美国最重要的个人交通模式,用于维持移动性。前一位停止驾驶的老年人的研究已经确定了与驾驶停止相关的几个健康风险,包括减少对医疗保健,增加依赖,社会隔离和死亡风险的升高。该分析的目的是检查驾驶状态作为社区住宅年龄较大的男性和老年女性的死亡率的预测。从1000名老年人成功衰老项目的预期小组研究中汲取数据(平均年龄= 80)。参与者的驾驶状态是在基线测量的,在随后的10年中观察到死亡率。扩展的Cox比例危险模型表示76%(P <0.001)非司机与司机的死亡率明显更高。这种关系是由健康状况和老年男性和老年妇女的健康状况和功能状况的介导的。在老年人中,健康状况充分调解驾驶停止和死亡率风险之间的关联。老年妇女发现了驾驶停止和死亡率风险之间的健康状况的部分调解效应。停止驾驶的老年妇女面临56%(P> 0.01)的相对死亡率比其司机对应物更高。社会和文化问题,如性别刻板印象,自主权和与其驾驶含义的社会联系可以解释老年人的现有性别差异。

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