Desmond O'Neill MD FRCPI, Consultant Geriatrician, Centre for Mobility Enhancement, Adelaide and Meath Hospital, Dublin, Ireland Michael Kirby MRCPI MRCPsych, Research Registar, Mercer's Institute for Research on Aging, St. James Hospital, Dublin, Ireland Irene Bruce RGN, Researech Nurse Brian Lawlor MD MRCPI MRCPsych, Professor of Old Age psychiatry, Mercer's Institue for Research on Aging, St James's Hosptial, Dublin, Ireland.

There is relatively little research on factors which impair transportation in later life. Our study attempted to assess the impact of health on driver cessation and mobility among a cohort of older people in the community. Two hundred and eighteen patients over the age of 65 from two general practices, were assessed with psychometric and mental state testing, a medical and drug history and a transportation history. One hundred and twelve had never driven, 38 had stopped driving and 68 were current drivers. The main reasons for giving up driving were health (29%) and expense (34%). Apart from hypertension, there was a low prevalence of self-reported target illnesses in the driving population but 14 of the 68 current drivers were on psychoactive medications. Ex-drivers were more likely to use a bus at least three times a week than current drivers, but significantly less used it daily compared to those who had never driven. Our study confirms that health issues impact in a marked way on continued driving in older people. One in five of the older drivers use psychoactive medications and ex-drivers do not seem to make as much use of public transport as those who have never driven. This may represent a conditioning to the independence, security and comfort of the car as a means of transport or may reflect a higher degree of morbidity in ex-drivers.