Heart failure is a risk factor for incident driving cessation among community-dwelling older adults: findings from a prospective population study.

Academic Article

Abstract

  • BACKGROUND: Heart failure (HF) patients often depend on driving for access to specialty care. We analyzed a public-use copy of the Cardiovascular Health Study (CHS) data to determine if HF is a risk factor for driving cessation and to identify other risk factors for driving cessation among those with HF. METHODS AND RESULTS: Of the 5,383 community-dwelling drivers aged ≥65 years (mean age 73 years, 55% women, 13% African American), 839 had HF: 246 had baseline prevalent HF and 593 developed incident HF before driving cessation during 9 years of follow-up. Incident driving cessation occurred at rates of 3,980 and 3,709 per 10,000 person-years of follow-up for those with and without HF, respectively (unadjusted hazard ratio [HR] associated with HF as a time-varying variable: 2.13, 95% confidence interval [CI] 1.83-2.47; P < .001). This association remained unchanged after multivariable risk adjustment (HR 1.43, 95% CI 1.21-1.68; P < .001). Among the 839 older drivers with HF, independent predictors for incident driving cessation were age ≥75 years (HR 1.99, 95% CI 1.44-2.73; P < .001), female gender (HR 1.93, 95% CI 1.37-2.74; P < .001), difficulty walking half a mile (HR 1.47 (1.04-2.08); P = .028), vision problems (HR 1.47, 95% CI 1.07-2.02; P = .018), and stroke as a time-varying covariate (HR 1.96, 95% CI 1.38-2.79; P < .001). CONCLUSIONS: HF is an independent risk factor for incident driving cessation among community-dwelling older drivers. Several patient characteristics predicted driving cessation in older HF patients, which may be targets for interventions to prevent driving cessation among these patients.
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    Keywords

  • Age Factors, Aged, Aging, Automobile Driving, Confidence Intervals, Female, Health Status, Heart Failure, Humans, Male, Prevalence, Prospective Studies, Psychometrics, Residence Characteristics, Risk Factors, Self Report, Vision Disorders
  • Digital Object Identifier (doi)

    Author List

  • Sims RV; Mujib M; McGwin G; Zhang Y; Ahmed MI; Desai RV; Aban IB; Sawyer P; Anker SD; Ahmed A
  • Start Page

  • 1035
  • End Page

  • 1040
  • Volume

  • 17
  • Issue

  • 12