Heart Failure Is a Risk Factor for Incident Driving Cessation Among Community-Dwelling Older Adults: Findings From a Prospective Population Study

BackgroundHeart 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 ResultsOf 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).ConclusionsHF 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.