Association of hospitalization with driving reduction and cessation in older adults

BACKGROUND: 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 has not been investigated. OBJECTIVE: To determine the association between driving reduction and cessation and hospitalization in older adults by using nationally representative data. DESIGN: Retrospective cohort analysis SETTING: Health and Retirement Study survey from 2004 to 2014 PARTICIPANTS: Adults aged 65 years and older who were able to drive and had an available car (n = 12,110; 40,364 interviews) MEASUREMENTS: 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. RESULTS: 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 to 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 following hospitalization. CONCLUSIONS: 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.