966516

brief-report2020
JAGXXX10.1177/0733464820966516Journal of Applied GerontologyRoe et al.

Brief Report
Journal of Applied Gerontology

Reaction to a Pandemic: Social 1­–5

© The Author(s) 2020
Article reuse guidelines:
Distancing and Driving Among Older sagepub.com/journals-permissions
https://doi.org/10.1177/0733464820966516
DOI: 10.1177/0733464820966516

Adults During COVID-19 journals.sagepub.com/home/jag

Catherine M. Roe1, Christopher B. Rosnick1  ,

Angela Colletta1, and Ganesh M. Babulal1 

Abstract
Coronavirus disease 2019 (COVID-19) has produced considerable morbidity and mortality worldwide, and older adults are
at especially high risk for developing severe COVID-19. A cohort study of driving behavior from January 1, 2019, to April 25,
2019, and January 1, 2020, to April 25, 2020, was conducted. We hypothesized that older adults would reduce the number
of days driving and number of trips/day they make after COVID-19 case acceleration. Data from 214 adults aged 66.5 to
92.8 years were used. Women comprised 47.6% of the sample and 15.4% were African American. Participants reduced the
proportion of days driven during the pandemic (.673 vs. .382 [p < .001]) compared with same period the year before (.695
vs. .749). Trips/day showed a similar decline (p < .001). Participants also took shorter trips (p = .02), drove slower (p <
.001), had fewer speeding incidents (p < .001), and had different trip destinations (p < .001). These results indicate that older
adults reduce their driving behavior when faced with a pandemic.

Keywords
social distancing, pandemic, COVID-19, driving, older adult

Introduction Since 2017, we have been following the everyday driving

behavior of a cohort of older adults using an unobtrusive data
Detailed examination of human behavior during a pandemic logger installed in their personal vehicle. After installation, par-
can help identify ways to slow disease transmission and miti- ticipants continue to drive normally in their own environments,
gate disease severity and mortality. The highly contagious traveling when and where they choose. Because we have com-
Coronavirus disease 2019 (COVID-19) has produced con- prehensive demographic and medical history data, we can
siderable morbidity and mortality worldwide. As of April 25, identify participants who are at high risk for COVID-19.
2020, the last day that data were collected for this report, We examined changes in daily driving behavior of older
COVID-19 had infected more than 2.8 million people and adults before and after the onset of very rapid increase in the
killed at least 200,000 worldwide (CNN, 2020). With no number of U.S. COVID-19 cases and compared that behavior
available vaccine or treatment, efforts to fight the disease with the same time period during the previous year. We hypoth-
have largely focused on social distancing. esized that, as a response to social distancing recommenda-
COVID-19 disproportionately impacts older adults (Centers tions, older drivers would reduce the number and length of trips
for Disease Control and Prevention [CDC], 2020b). they took, and that these reductions would be especially pro-
Moreover, this age group is at greater risk of developing nounced among older adults with characteristics and medical
serious complications due to the virus and accounts for the conditions associated with higher rates of COVID-19.
vast majority of deaths due to the virus (Landry et al., 2020;
WHO Regional Office for Europe, 2020). Medical risk fac-
tors for COVID-19 (e.g., heart disease, diabetes) are espe- Manuscript received: June 11, 2020; final revision received:
September 21, 2020; accepted: September 23, 2020.
cially prevalent among older adults (CDC, 2020b). African
Americans are at higher risk for contracting COVID-19 and 1
Washington University School of Medicine, St. Louis, MO, USA
are more likely to die from the disease (CDC, 2020a; Yancy,
Corresponding Author:
2020). Therefore, social distancing is especially important Catherine M. Roe, Washington University School of Medicine, Campus
for older adults, African Americans, and those with medical Box 8111, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
risk factors. Email: [email protected]
2 Journal of Applied Gerontology 00(0)

Table 1.  Demographic Characteristics of the Sample (N = 214) 2020, was operationalized based on the point at which the
and Medical Conditions Linked to COVID-19. number of COVID-19 cases in the United States began to
increase rapidly (see Figure 1), presuming that most resi-
Demographics and risk factors
dents would be aware of the United States spread of COVID-
Age, mean (SD), years 76.2 (5.7) 19 by then. Figure 1 also shows the number of cases per day
Women, n (%) 100 (46.7) for Missouri and Illinois separately, as well as sentinel events
Education, mean (SD), years 16.6 (2.3) (school closings and stay-at-home orders) indicating part of
African American race, n (%) 33 (15.4) the institutional reaction to the growing COVID-19 crisis.
State of residence Daily driving data prior to (Pre-2020: January 1, 2020, to
 Missouri, n (%) 189 (88.3) March 14, 2020) and after (Post-2020: March 15, 2020, to
 Illinois, n (%) 22 (10.3) April 25, 2020) the index date were compared with each
 Colorado, n (%) 1 (0.5) other, and with the same dates the year before (Pre-2019:
 Tennessee, n (%) 1 (0.5) January 1, 2019, to March 14, 2019, and Post-2019: March
 Texas, n (%) 1 (0.5) 15, 2019, to April 25, 2019). Two-hundred fifty-seven par-
Employment status (N = 200) ticipants were active on January 1, 2019, but only data from
 Retired, n (%) 174 (87.0)
N = 214 participants (aged 66.5–92.8 years) with complete
 Employed, n (%) 23 (11.5)
data collection over the four time periods were included.
 Homemaker, n (%) 2 (1.0)
Driving behavior was captured using the Driving Real
 Unemployed, n (%) 1 (0.5)
World In-Vehicle Evaluation System (DRIVES) and a com-
 Texas, n (%) 1 (0.5)
Risk factors
mercial GPS data logger (G2 Tracking Device™, Azuga
 Obese, n (%) 62 (29.7) Inc., San Jose, CA, USA) plugged into the vehicle’s onboard
  Heart disease, n (%) 23 (10.8) diagnostics–II (OBD-II) port (Babulal et al., 2016, 2019;
 Hypertension, n (%) 120 (56.1) Roe et al., 2019). From ignition-on, the data logger records
 Diabetes, n (%) 24 (11.2) the position (latitude and longitude), date, time, and speed
  Number of risk factors of the vehicle every 30 s, along with safety-related events
  0, n (%) 62 (29.0) whenever they occur (e.g., hard braking) until ignition-off.
  1, n (%) 88 (41.1) Trips to selected destinations were examined by finding the
  2, n (%) 54 (25.2) closest landmark within 0.2 miles of a participant trip end
   3 or more, n (%) 10 (4.7) using Missouri and Illinois “Points of Interest” and “Places
of Worship” landmarks extracted from OpenStreetMap
(Haklay & Weber, 2008; Ramm, 2020) (Supplemental
Method Table 1).

Population
Statistical Analysis
Participants were recruited from Washington University
Knight Alzheimer Disease Research Center studies and General linear models tested the within-subjects effects of
enrolled in a longitudinal study examining driving perfor- Time (same participant, Pre vs. Post period within a year)
mance in preclinical Alzheimer disease (R01-AG056466). and Year (same participant, 2019 vs. 2020) and their interac-
Participants were cognitively normal, Clinical Dementia tion on seven driving behaviors. This model treated Time and
Rating (CDR) (Morris, 1993) = 0; ≥65 years old; had a Year as fixed factors (Wolfinger & Chang, 1995), and
valid driver’s license; drove at least once per week; and adjusted for the repeated natures of the Time and Year vari-
met minimal visual acuity for driving. Most were retired ables. Days driving and number of trips per day for each of
(Table 1). Participants completed an annual assessment the four periods were examined for all participants. Among
that includes a physical, neurological exam, and health his- participants taking trips, mean length in miles and speed in
tory. The study protocol was approved by the Washington miles/hour of each trip, along with mean number of three
University Institution Research Protection Office types of aggressive behaviors (hard braking, hard accelera-
(201412024), and written informed consent was obtained. tion, speeding)/mile/trip, were compared for each Time ×
We operationally defined “high risk” for COVID-19 Year combination. Analyses were repeated for each between-
based on the Centers for Disease Control’s designations as subject factor (age group [based on a median split], gender,
being at high risk for contracting or for experiencing severe race, and medical conditions). Analyses were conducted
illness due to race or existing medical conditions (CDC, using SAS 9.4 (SAS Institute, Inc., Cary, NC, USA), alpha of
2020a, 2020b). Confirmed COVID-19 case data were .05 (two-sided), and statistical significance was determined
obtained from the Johns Hopkins Center for Systems Science using the Benjamini–Hochberg procedure (Benjamini &
and Engineering (Gardner, 2020) for the total United States Hochberg, 1995; McDonald, 2009) with a false-discovery
and for Missouri and Illinois. An index date of March 15, rate of .05 to address multiple comparison concerns.
Roe et al. 3

Figure 1.  Driving behavior before and after the onset of the pandemic during 2020, and compared with driving during the same time
periods in the year prior to the pandemic. (A) Percent of persons driving each day and (B) mean number of trips per day and miles per
trip presented with number of confirmed COVID-19 cases for the entire United States, Missouri, and Illinois (second Y axis).
Note. Reference lines indicate when school closure and stay-at-home orders went into effect in state, which may have impacted trips made and/or
number of other drivers on the road. IL = Illinois; MO = Missouri; SAH = stay at home.

Results States). Refuting our hypotheses, the extent of social distanc-

ing change with pandemic onset was unrelated to most per-
Participants (N = 214; Table 1) were aged 66.5 to 92.8 years. sonal characteristics of drivers. This may be a “floor effect”
Time × Year interactions were found for proportion of days since participants took few trips after the index date. They
driving, trips/day, miles/trip, speed/trip, and overspeeding also showed less speeding during the pandemic which, spec-
such that after the index date participants drove on fewer ulatively, may have been due to less highway driving, and/or
days, went on fewer trips, went on shorter trips, and had less high-speed passing behavior with fewer other drivers on
fewer speeding events than before COVID-19 (Supplemental the road. Many businesses were also closed. Older drivers
Table 2, Figure 1). Women reduced their percentage of days did not decrease their travel for food shopping, health care,
driving more than men, but changes in driving behavior were and money/banking. These destinations are generally essen-
unrelated to demographics and medical risk factors other- tial to everyday life; however, they also occurred with less
wise (Supplemental Tables 3 and 4). Participants decreased frequency than other destination categories before COVID-
the number of days they drove and trips/day for the purposes 19, so there was less room for decline.
of education, leisure, worship, eating at restaurants, going to Study participants were highly educated and primarily
public places, and general shopping, but not for food shop- resided in Missouri and Illinois, therefore the extent to which
ping, health, money, and accommodations (Supplemental these findings extend to other populations is unknown. The
Table 5, Figure 2). number of African American participants was small (N =
33). Data on lung disease, an important risk factor for
COVID-19, were unavailable at the time of manuscript sub-
Discussion
mission, but will be obtained and examined in a future report.
Older adults dramatically decreased the number of trips they Study strengths include the ability to longitudinally and con-
took and number of days driving, after the index date (i.e., tinuously study the driving behavior/social distancing of
the time that most persons would presumably have been older adults before and during the COVID-19 pandemic.
aware that the pandemic was spreading across the United This allowed us to examine and rule out the possibility that
4 Journal of Applied Gerontology 00(0)

Figure 2.  Type of trips made. Trips per day for the entire sample to selected destinations over the Pre–Post study periods in (A) 2019
and (B) 2020.

behavior change was an artifact linked to seasonal changes in (R01-AG056466), and the investigators/staff of the Knight
driving behavior, or to variation in the specific participants Alzheimer’s Disease Research Center. Additional thanks to
comprising the cohort across the study period. Vaisakh Puthusseryppady and Dr. Michael Hornberger for their
In conclusion, our results suggest that when faced with a help in obtaining the OpenStreetMap data.
pandemic, older adults reduce their driving behavior, which
Declaration of Conflicting Interests
will likely help to prevent transmission of COVID-19 among
themselves and in their communities. This appears to be true The author(s) declared no potential conflicts of interest with respect
even among those who are not at especially high risk for get- to the research, authorship, and/or publication of this article.
ting the disease. Travel may increase as social distancing rec-
ommendations are lifted (Stoddart et al., 2020). We will Funding
continue to track these participants as they navigate this pan- The author(s) disclosed receipt of the following financial support for
demic and its aftermath, and will explore additional demo- the research, authorship, and/or publication of this article: This work
graphic, medical, and environmental factors that may be was supported by the National Institute on Aging (grant numbers:
R01-AG056466, R03-AG055482, P50-AG05681, P01-AG03991,
related to transmission of COVID-19.
and P01-AG026276); Fred Simmons and Olga Mohan; and the
Charles and Joanne Knight Alzheimer’s Research Initiative. The
Acknowledgments funders had no role in the design and conduct of the study; collec-
The authors thank the participants, investigators/staff of the tion, management, analysis, and interpretation of the data; and prep-
Driving Performance in Preclinical Alzheimer’s Disease study aration, review, or approval of the manuscript.
Roe et al. 5

ORCID iDs Gardner, L. (2020, January 23). Mapping COVID-19. Johns

Hopkins Whiting School of Engineering. https://systems.
Christopher B. Rosnick https://orcid.org/0000-0003-3915-9177
jhu.edu/research/public-health/ncov/
Ganesh M. Babulal https://orcid.org/0000-0001-7966-3509 Haklay, M., & Weber, P. (2008). OpenStreetMap: User-generated
street maps. IEEE Pervasive Computing, 7(4), 12–18.
Supplemental Material Landry, M. D., Van den Bergh, G., Hjelle, K. M., Jalovcic, D., &
Supplemental material for this article is available online. Tuntland, H. K. (2020). Betrayal of trust? The impact of the
COVID-19 global pandemic on older persons. Journal of
Applied Gerontology, 39(7), 687–689.
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