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Introduction There is growing evidence to suggest the importance of self-regulatory practices amongst older adults to sustain mobility. However, the decision to self-regulate driving is a complex interplay between an individual's preference and the influence of their social networks including spouse. To our best knowledge, the influence of an older adult's spouse on their decisions during driving transition has not been explored. Materials and methods This qualitative descriptive study was conducted amongst married older adults aged 60 years and above. All interview responses were transcribed verbatim and examined using thematic approach and interpretative description method. Results A total of 11 married couples were interviewed. Three major themes emerged: [1] Our roles in driving; [2] Challenges to continue driving; and, [3] Our driving strategies to ensure continued driving. Older couples adopted driving strategies and regulated their driving patterns to ensure they continued to drive safely. Male partners often took the active driving role as the principal drivers, while the females adopted a more passive role, including being the passenger to accompany the principal drivers or becoming the co-driver to help in navigation. Other coping strategies include sharing the driving duties as well as using public transportation or mixed mode transportation. Discussion Our findings suggest spouse play a significant role in their partners' decision to self-regulate driving. This underscores a need to recognise the importance of interdependency amongst couples and its impact on their driving decisions and outcomes.

Introduction Much of the research on transportation and safe mobility focuses on older adult's thoughts and feelings on driving transition in high-income countries, but there is limited knowledge on this process and its consequences in low-and-middle-income countries. Moreover, there is very little understanding of the transition process involving other forms of transport, specifically the motorcycle. This study aimed to understand the process of driving/riding cessation involving former car drivers and former motorcycle riders, including the motivations that act as driving forces influencing the decision to cease driving/riding, challenges faced during the transition, and strategies adopted to adjust to life without driving/riding. Methods Older Malaysian adults aged 60 years and above who had ceased driving and/or riding were interviewed and responded to questions relating to their decision to stop driving/riding. All interview responses were transcribed verbatim and examined using a thematic approach to identify the factors contributing to this decision. Results Five themes and 16 sub-themes were identified: [1] being a driver/rider; [2] making the adjustment; [3] making the decision; [4] experiencing multiple losses; and, [5] coping with transition. Physical, psychological, and social factors were important contributors to driving/riding cessation. Motorcycle riders were at higher risk of road crash and ceased more readily than car drivers. Renewing license, transitioning from riding to driving, and utilising multiple alternative means of transportation were unique coping strategies adopted during post-cessation phase. Conclusions The current findings suggest that cessation is a transition outcome of self-regulation and a successful transition requires discovery of safer mobility opportunities beyond driving and riding. These findings provide direction for the development of culturally sensitive policy and interventions by taking into consideration travel mode preferences and distribution in countries with mixed travel modes to assist retiring car drivers and motorcycle riders to maintain mobility and access in safety.

Purpose of the study This study aims to estimate the burden of road traffic accidents and death among older adults. Design and methods A systematic literature review was conducted on 10 electronic databases for articles describing Road Traffic Accident(RTA) mortality in older adults until September 2016. A random-effects meta-regression analyses was conducted to estimate the pooled rates of road traffic accidents and death. Results A total 5018 studies were identified and 23 studies were included. Most of the reported older adults were aged between 60 and 74 years, with majority being male gender and sustained minor trauma due to Motor-Vehicle Collision (MVC). The overall pooled mortality rate was 14% (95% Confidence Interval, CI: 11%, 16%), with higher mortality rates in studies conducted in North America (15%, 95% CI: 12%, 18%) and older adults admitted to trauma centers (17%, 95% CI: 14%, 21%). Secondary analysis showed that the very elderly adults (aged >75 years) and pedestrians had higher odds of mortality death (Odds Ratio, OR: 2.05, 95% CI: 1.25, 3.38; OR: 2.08, 95% CI: 1.63, 2.66, respectively). Implication A new comprehensive trauma management guidelines tailored to older adults should be established in low and middle-income countries where such guidelines are still lacking.