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 have 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 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. 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.