Sex Differences in Instrumental Activities of Daily Living and Transportation Modes by Driving Status Among Older Adults.
Tsutomu Sasaki, Masao Ichikawa, Kyohei Yamada and 2 others
Current drivers aged 75–80 in Japan did more everyday activities and reported better health than non-drivers.
Among non-drivers, the sex gap was in transport mode — men cycled more, women were driven by others more — not in activity frequency.
Key findings
1Current drivers reported better physical health, mental health, and life satisfaction than retired or never drivers (all adjusted p < 0.001), and engaged in more everyday activities — shopping, leisure, eating out, visiting others, hobbies — than non-drivers (adjusted p < 0.05).
2Men used bicycles more than women for IADLs regardless of driving status (e.g., 32% of men vs 9% of women for shopping among current drivers; 46% vs 21% among retired drivers), while women were more likely to be driven by others (e.g., 56% vs 42% for shopping among current drivers).
3In ordinal regression, driving status was the main factor for how often people did essential activities (shopping, medical visits), while sex and having someone available to drive them were more important for discretionary activities (leisure, eating out, visiting others, hobbies).
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What it does not show
Cross-sectional snapshot: cannot tell whether stopping driving caused lower activity and worse health, or whether declining health led people to stop driving. The authors state this explicitly. Single city in rural Hokkaido, Japan; transport infrastructure, public transit availability, and cultural norms around driving and cycling differ from most other settings. Only 17 male never drivers were analysed, so any finding about that subgroup is unstable and should not be generalised. Response rate was 24–31%; non-respondents may differ in activity level or health from those who completed the questionnaire. Self-reported data on IADL frequency, transport mode, and health perceptions; no objective activity or transport-use measures. Underlying reasons for transport choice (health, family situation, transit access) were not assessed, and residual confounding cannot be excluded.
Declared interests
Funded by the Japan Society for the Promotion of Science (JSPS KAKENHI, grant 23K10537). The authors declare no conflicts of interest.
The easy way to misread this
Do not read the lower activity levels and worse health of retired and never drivers as proof that stopping driving causes decline — this is a single time-point survey, and poorer health may have led people to stop driving in the first place. Also, the sex difference in how often non-drivers did activities did not reach significance; the significant sex differences were in which transport mode they used (bicycle vs. being driven), not in how frequently they went out.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →