Risk Factors for Self-reported Driving Under the Influence of Alcohol and/or Illicit Drugs Among Older Adults

Namkee G. Choi, PhD; Diana M. DiNitto, PhD; C. Nathan Marti, PhD

Disclosures

Gerontologist. 2016;56(2):282-291. 

In This Article

Conceptual Framework and Hypotheses

Driving under the influence of alcohol and/or other drugs may be explained using alcohol (or drug) expectancy theory, psychosocial vulnerability, and poor decision-making tendencies. According to expectancy theory, people engage in certain behaviors because they expect particular outcomes (reinforcing effects) as a result of engaging in the behavior. Those with more positive alcohol outcome expectations (e.g., social and physical pleasure, relaxation, coping, and assertiveness) are therefore likely to drink more (Devine & Rosenberg, 2000; Jones, Corbin, & Fromme, 2001; Oei & Baldwin, 1994). Schell, Chan, and Morral (2006) also found that those with more positive alcohol expectancies tended to persist in driving after drinking. However, not all adults who drink at problem levels drive under the influence or engage in other hazardous behaviors. Sadava (1985) found a weak-to-moderate correlation between self-reported alcohol consumption and alcohol-related problems, showing that heavy alcohol use is a necessary but not sufficient condition for problem behaviors. In addition to frequency and quantity of alcohol consumption, other drug involvement and psychosocial vulnerability (e.g., work-related and life-change stress and emotional problems) contributed significantly to alcohol-related problem behaviors (Sadava).

Studies have found that older adults drink for the same reasons as younger adults—to enhance positive mood or well-being, obtain social rewards (e.g., celebrate special occasions with family and friends), cope with and attenuate negative emotions (e.g., to forget worries and improve depressed or anxious mood), or for medicinal purposes (Gilson et al., 2013; Immonen, Valvanne, & Pitkälä, 2011). Gilson and colleagues found that enhancement motives (but not social and coping motives) were associated with drinking quantity and that coping motives had strong direct associations with drinking problems. Others (Devanand, 2002; Satre, Sterling, Mackin, & Weisner, 2011) have found significant associations between late-life depression and alcohol/drug use. In addition to emotional distress, previous research has shown that poor decision-making tendencies, as indicated by other legal transgressions and other forms of irresponsibility rooted in impulsivity and lack of self-control, may also contribute to DUI (Cavaiola, Strohmetz, & Abreo, 2007; Keane, Maxim, & Teevan, 1993). However, it remains unknown if psychosocial vulnerability (e.g., depression) and poor decision-making tendencies are associated with DUI in older adults.

Based on expectancy theory and the perspective that psychosocial vulnerability and poor decision-making tendencies contribute to alcohol (or drug)-related problem behaviors, we tested the following hypotheses: The likelihood of DUI among older adults will be positively associated with (H1) quantity and frequency of alcohol consumption, (H2) use of any illicit drug, (H3) depression (an indicator of psychosocial vulnerability), and (H4) any arrest history (an indicator of poor decision-making tendencies). Potential differences between those aged 50–64 and aged 65+ in DUI risk factors were also examined. Although age and gender differences in substance use and DUI have been well established (Maxwell & Freeman, 2007; SAMHSA, 2011), associations between DUI and health status are less well established. Given the scant previous research on DUI in older adults, we also examined sociodemographic and health correlates of DUI in both age groups.

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