title: Heart failure is a risk factor for incident driving cessation among community-dwelling older adults: findings from a prospective population study.
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.
  
  
  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.
authors: Veterans Affairs Medical Center, Birmingham, Alabama, USA.
authors: Richard V
authors: RV
authors: Sims
authors: Marjan
authors: M
authors: Mujib
authors: Gerald
authors: G
authors: McGwin
authors: Yan
authors: Y
authors: Zhang
authors: Mustafa I
authors: MI
authors: Ahmed
authors: Ravi V
authors: RV
authors: Desai
authors: Inmaculada B
authors: IB
authors: Aban
authors: Patricia
authors: P
authors: Sawyer
authors: Stefan D
authors: SD
authors: Anker
authors: Ali
authors: A
authors: Ahmed
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D001334:Automobile Driving / Q000523:psychology*; D016001:Confidence Intervals; D005260:Female; D006304:Health Status; D006333:Heart Failure; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011594:Psychometrics; D012111:Residence Characteristics; D012307:Risk Factors; D057566:Self Report; D014786:Vision Disorders