BackgroundOlder adults who cease driving have poorer health than those who continue to drive. However, it is unclear whether the transition to driving cessation itself results in health declines or whether driving cessation subsequently exacerbates health declines over time.MethodsThe current study addresses these questions using multilevel modeling among 690 older adults from the Advanced Cognitive Training for Independent and Vital Elderly study. Driving status and health, as indicated by the SF-36 questionnaire, self-rated health, physical performance (Turn 360° Test), and depressive symptoms were assessed at baseline and at 1-, 2-, 3-, and 5-year follow-up visits.ResultsThe transition to driving cessation was accompanied by significant declines in physical and social functioning, physical performance, and physical role (ps <. 05). Health declines after driving cessation were steeper for general health.ConclusionsThe transition to driving cessation is associated with health declines for older adults as measured by several indicators. Additionally, general health declines more sharply following driving cessation. These findings highlight the importance of interventions to sustain driving mobility among older adults.