RESUMO
BACKGROUND: Judgement and reaction times during complex tasks like driving may be impaired in older adults with chronic heart failure (HF). This study sought to report the driving habits and reaction times of older patients with HF in a specially designed urban driving simulation. METHODS AND RESULTS: We conducted a prospective observational study in HF patients and controls. Patients in both groups underwent cognitive testing and screening for depression. Current drivers undertook a questionnaire regarding driving habits followed by an urban road driving simulation consisting of 3 laps. Five separate hazards appeared in the third lap without warning. Reaction times and stopping distances to the hazards were calculated. Of 247 patients with HF approached for the study, 124 had already voluntarily stopped driving owing to HF (nâ¯=â¯92) or other medical conditions (nâ¯=â¯32), 60 had never had a license, and 32 declined to participate. Of the 74 controls approached, 1 was not currently driving owing to a medical condition and 46 declined to participate. Patients in both groups had similar levels of cognitive function, mood and driving habits. 30 patients with HF (mean age, 74 ± 5 years; median NT-proBNP 1510 pg/mL [interquartile range (IQR), 546-3084 pg/L]) and 26 controls (mean age, 73 ± 5 years; median NT-proBNP 135 pg/mL [IQR, 73-182 pg/L]) completed the simulation. During lap 3, there was no difference in the driving speed between patients (mean 22.0 ± 4.5 mph) and controls (mean 21.7 ± 3.3 mph; Pâ¯=â¯.80). Patients had longer reaction times (median, 1.10 seconds; IQR, 0.98-1.30 seconds) than controls (median, 0.96 seconds; IQR, 0.83-1.10 seconds; Pâ¯=â¯.02), but there was no difference in stopping distances (patients: median, 43.9 m [IQR, 32.2-49.5 m]; controls: median, 38.1 m [IQR, 32.3-48.8 m]; Pâ¯=â¯.31). CONCLUSIONS: Many older adults with HF no longer drive. Those who continue to drive seem to be safe to drive on simulated urban roads.