Sex Differences in Instrumental Activities of Daily Living and Transportation Modes by Driving Status Among Older...

Planning for driving cessation is essential to support older adults' well-being and access to alternative transportation. As transportation needs vary by activity and sex, it is important to understand how these factors influence mobility after driving cessation. This study aimed to clarify sex differences in transportation modes for daily activities among older adults with different driving status.

This study examined transportation modes used for instrumental activities of daily living (IADLs) and the level of engagement (i.e., frequency of participation) among community-dwelling older adults, stratified by driving status (current, retired, never) and sex. Cross-sectional data were obtained from a 2023 self-administered survey of residents aged 75-80 years in Chitose City, Japan, including 916 current drivers, 238 retired drivers, and 281 never drivers.

Nearly all participants engaged in shopping and visiting medical facilities. Current drivers showed higher engagement in IADLs, primarily by driving themselves. Retired and never drivers engaged in fewer IADLs, particularly men, who were less likely to receive rides from others. In contrast, women were more often driven by others, especially among nondrivers. Men reported higher bicycle use across driving statuses. Multivariable analyses showed that driving status was strongly associated with essential IADLs, whereas discretionary IADLs were influenced by sex and social support.

These findings suggest that mobility support for older adults should consider both sex and driving status. Occupational therapists and policymakers should tailor interventions-such as safe bicycle use training and transportation support-to promote equitable community mobility. Supporting meaningful engagement in daily activities is vital for maintaining health, independence, and social participation after driving cessation.