Driving Habits and Reaction Times on a Driving Simulation in Older Drivers With Chronic Heart Failure

Abstract

Background: Judgement and reaction times during complex tasks like driving may be impaired in older adults with chronic heart failure (HF).Objectives: This study sought to report the driving habits and reaction times of older patients with HF in a specially designed urban driving simulation. Methods: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 questionnaire regarding driving habits followed by an urban road driving simulation consisting of three laps. Five separate hazards appeared in the third lap without warning. Reaction times and stopping distances to the hazards were calculated. Results: Of 247 patients with HF approached for the study, 124 had already voluntarily stopped driving due to HF (n=92) or other medical conditions (n=32), 60 had never had a license, and 32 declined to participate. Of the 74 controls approached, 1 was not currently driving due 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 (SD) age 74 (±5) years, median (IQR) NT-proBNP 1510 (546-3084) pg/L] and 26 controls [mean age 73 (±5) years, median NT-proBNP 135 (73-182) pg/L] completed the simulation. During lap 3, there was no difference in the driving speed between patients (mean 22.0 SD 4.5 mph) and controls (mean 21.7 SD3.3 mph; p=0.80). Patients had longer reaction times [median 1.10 (IQR 0.98-1.30) seconds) than controls [median 0.96 (IQR 0.83-1.10) seconds, p=0.02], but there was no difference in stopping distances [patients: median 43.9 (IQR 32.2-49.5) metres; controls: median 38.1 (IQR 32.3-48.8) metres, p=0.31)].