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REGARDING SIMS AND COLLEAGUES' "SELF-REPORTED HEALTH AND DRIVING CESSATION IN COMMUNITY-DWELLING OLDER DRIVERS"

Department of Epidemiology University of Michigan Ann Arbor, Michigan
Department of Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland

Address correspondence to Briana Mezuk, PhD, Robert Wood Johnson Health and Society Scholar, Department of Epidemiology, University of Michigan, 109 Observatory, 3644 SPH Tower, Ann Arbor, MI 48109. E-mail: bmezuk{at}umich.edu

To the Editor:

Dr. Richard Sims and colleagues studied the utility of self-reported health (SRH) in predicting driving cessation among a group of community-dwelling older drivers (1). In this study they also assessed depressive symptomology as measured by the Geriatric Depression Scale (GDS). As might be expected, over 75% of the group who described their self-reported health as fair to poor scored above five on the GDS, while less than 25% of the group who described their health as good to excellent had scores in that range. However, in the multiple logistic regression models reported in this article, the estimates of the effect of self-reported health on predicting driving cessation are not adjusted for GDS scores. Although physician-diagnosed depression was included as one component of the Charlson Comorbidity Index (CCI), which the authors did include in the model, depression in older adults is often underdiagnosed (2), and thus this measure of depression is not as sensitive as the GDS score. Given that depressive symptoms have been associated with functional impairment (3), incident disability (4), and driving cessation (5), it would be interesting to learn whether the association between SRH and driving cessation is attenuated when depressive symptoms are accounted for in the model. Furthermore, it would be interesting for the authors to estimate and compare the predictive discriminative ability of the GDS to the other measures (SRH, the Short Physical Performance Battery [SPPB], and the CCI) the authors presented in this report.

References

1. Sims R, Ahmed A, Sawyer P, Allman P. Self-reported health and driving cessation in community-dwelling older drivers. J Gerontol A Biol Sci Med Sci. 2007;62A:789-793.[Abstract/Free Full Text]
2. Rabins P. Barriers to diagnosis and treatment of depression in elderly patients. Am J Geriatr Psychiatry. 1996;4:79-84.
3. Broadhead W, Blazer D, George L, Tse C. Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA. 1990;264:2524-2528.[Abstract/Free Full Text]
4. Armenian H, Pratt L, Gallo J, Eaton WW. Psychopathology as a predictor of disability: a population-based follow-up study in Baltimore, Maryland. Am J Epidemiol. 1998;148:269-275.[Abstract/Free Full Text]
5. Ragland D, Satariano W, MacLeod K. Driving cessation and increased depressive symptoms. J Gerontol A Biol Sci Med Sci. 2005;60A:399-403.[Abstract/Free Full Text]

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