Older people who keep driving are more likely to stay out of nursing homes or assisted living centers than those who give it up or who have never driven, researchers report.

Their study, in the current American Journal of Public Health, found that nondrivers were four times as likely as drivers to end up in long-term care.

“Older adults are expected to make good decisions about when to stop driving,” the authors write, “but the hardships imposed on older adults by not driving are not widely recognized.” The study was led by Ellen E. Freeman of the Johns Hopkins School of Medicine.

The researchers said they were not encouraging drivers to stay on the road past the point when they could drive safely. But they said that when people did stop driving, especially when they lived in areas without good public transportation systems, the personal and societal costs could be heavy.

For older people, the loss of personal mobility can mean an inability to secure basic necessities. From a public policy point of view, their entry into nursing homes can carry a heavy price tag. And they may have no real medical need to be there.

One solution, the researchers said, could be to try to come up with innovative transportation options for nondrivers.

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