Article

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

Veterans Affairs Medical Center, Birmingham, Alabama, USA.
Journal of cardiac failure (impact factor: 3.25). 12/2011; 17(12):1035-40. DOI:10.1016/j.cardfail.2011.08.014 pp.1035-40
Source: PubMed

ABSTRACT 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.
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).
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

13% African American
 
5,383 community-dwelling drivers
 
839 older drivers
 
9 years
 
age 73 years
 
Cardiovascular Health Study
 
community-dwelling older drivers
 
female gender
 
Heart failure
 
incident HF
 
independent risk factor
 
multivariable risk adjustment
 
older HF patients
 
patient characteristics
 
public-use copy
 
risk factor
 
risk factors
 
specialty care
 
unadjusted hazard ratio [HR]
 
vision problems
 

Marjan Mujib