Gaulton Timothy G, Neuman Mark D, Brown Rebecca T, Betz Marian E
Department of Anesthesiology and Critical Care, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
J Am Geriatr Soc. 2021 Aug;69(8):2231-2239. doi: 10.1111/jgs.17178. Epub 2021 Apr 17.
Driving has not been considered as part of the social cost of acute illness and may go unnoticed in the post-hospital care of older adults. Decreases in driving after hospitalization and at-risk populations have not been investigated.
To determine the association between driving reduction and cessation and hospitalization in older adults by using nationally representative data.
Retrospective cohort analysis.
Health and Retirement Study survey from 2004 to 2014.
Adults aged 65 years and older who were able to drive and had an available car (n = 12,110; 40,364 interviews).
Self-report of a hospitalization requiring an overnight stay, changes in driving patterns including driving cessation or limitations over a 2-year period, comorbid conditions, health utilization, and behaviors.
Of hospitalizations in adults aged 65 years and older, 22% were associated with a decrease in driving patterns within 2 years. The relative risk of a reduction or cessation in driving was 1.62 (95% CI: 1.54, 1.70, p < 0.001) when there was a hospitalization compared with when a hospitalization did not occur. Baseline functional, cognitive, and visual impairment, fair or poor self-rated health, and diabetes were identified as independent risk factors for decreased driving patterns after hospitalization.
Changes in driving patterns are common after a hospitalization in older adults. The findings suggest that driving, although not a current goal of post-hospital care, is important to the continued autonomy and community mobility of older adults and needs to be addressed as part of discharge planning and their recovery.
驾驶尚未被视为急性疾病社会成本的一部分，在老年人的院后护理中可能未被关注。住院后驾驶能力下降情况以及高危人群尚未得到研究。
利用具有全国代表性的数据，确定老年人驾驶减少及停止与住院之间的关联。
回顾性队列分析。
2004年至2014年的健康与退休研究调查。
65岁及以上能够驾驶且有可用汽车的成年人（n = 12,110；40,364次访谈）。
需要过夜住院的自我报告、驾驶模式的变化，包括两年内驾驶停止或受限、合并症、医疗利用情况及行为。
在65岁及以上成年人的住院病例中，22%与两年内驾驶模式下降有关。与未住院相比，住院时驾驶减少或停止的相对风险为1.62（95%可信区间：1.54, 1.70，p < 0.001）。基线功能、认知和视觉障碍、自我健康评价为一般或较差以及糖尿病被确定为住院后驾驶模式下降的独立危险因素。
老年人住院后驾驶模式变化很常见。研究结果表明，驾驶虽然不是当前院后护理的目标，但对老年人持续的自主性和社区出行很重要，需要作为出院计划及其康复的一部分加以解决。
