Fausto Bernadette A, Badana Adrian N S, Valdes Olivia M, Athilingam Ponrathi, Edwards Jerri D
School of Aging Studies, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
Department of Psychology, Florida Atlantic University, 3200 College Avenue, Fort Lauderdale, FL 33314, United States.
J Transp Health. 2017 Dec;7(Pt B):202-208. doi: 10.1016/j.jth.2017.10.003. Epub 2017 Nov 3.
Cognitive dysfunction is a predictor of driving cessation in older adults and a common sequela of heart failure (HF). Although HF has been associated with an increased risk of driving cessation, the independent relationship between HF and driving cessation after cognitive function is considered remains to be established. The objective of these analyses is to examine HF as an independent predictor of driving cessation across three years among a cohort of older drivers in the United States. Analyses included 850 older adults who completed sensory, cognitive, and physical measures at baseline and mobility and health measures at a three-year follow-up. Cox regression was used to examine the effects of HF, stroke, vision, cognition, and physical function as predictors of incident driving cessation over three years. Participants with HF were over three times more likely to cease driving, = 3.19, 95% CI [1.27, 8.02], = .014. However, HF was no longer a significant predictor of driving cessation when cognitive performance was considered, = 1.70, 95% CI [0.67, 4.30], = .262. These findings suggest that the risk of driving cessation may be a consequence of the cognitive dysfunction associated with HF, rather than from HF itself. Cognitive training should be investigated among persons with HF to potentially prolong driving mobility.
认知功能障碍是老年人停止驾驶的一个预测因素,也是心力衰竭(HF)的常见后遗症。尽管HF与停止驾驶风险增加有关,但在考虑认知功能后,HF与停止驾驶之间的独立关系仍有待确定。这些分析的目的是在美国一组老年驾驶员队列中,研究HF作为三年内停止驾驶的独立预测因素。分析纳入了850名老年人,他们在基线时完成了感官、认知和身体测量,并在三年随访时完成了活动能力和健康测量。使用Cox回归分析HF、中风、视力、认知和身体功能作为三年内停止驾驶事件预测因素的影响。患有HF的参与者停止驾驶的可能性高出三倍多,= 3.19,95%置信区间[1.27, 8.02],= .014。然而,当考虑认知表现时,HF不再是停止驾驶的显著预测因素,= 1.70,95%置信区间[0.67, 4.30],= .262。这些发现表明,停止驾驶的风险可能是与HF相关的认知功能障碍的结果,而不是HF本身导致的。应该对HF患者进行认知训练,以潜在地延长驾驶活动能力。