Clinical Predictors of Older Driver Performance on a Standardized Road Test
Clinical Predictors of Older Driver Performance on a Standardized Road Test
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DOI：
10.1080/15389580802260026
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发表时间：
2008-01-01
影响因子：
2
通讯作者：
Joo, Yongsung
中科院分区：
文献类型：
--
作者：
Classen, Sherrilene;Horgas, Ann;Joo, Yongsung
目标.确定临床变量（人口统计学、认知测试、合并症和药物）与老年人标准化道路测试失败之间的关系。分析2005年1月1日至2007年5月1日期间在最佳天气条件下进行的道路研究。标准化测试在佛罗里达的国家老年驾驶员研究和培训中心（NODRTC）举行，包括127名年龄在65岁及以上的成年人，他们持有当前的驾驶执照，通过广告从佛罗里达的盖恩斯维尔社区招募。测量包括人口统计学，自我报告的药物和医疗条件，认知测试，包括跟踪制作部分B，全球评级分数（通过/失败），和驾驶员操纵分数（0-273，273表示完美驾驶或零错误）。共有127名老年人完成了该方案。平均年龄为74.8岁（SD = 6.3）; 46.5%为女性。试运行部分B的平均时间为114.3秒（SD为83）。在127名驾驶员中，平均机动得分总和为238.9（SD为25.0），24名（19%）未通过驾驶员测试。未通过测试的比值比估计值包括高龄（6.7，95% CI 2.2 - 19.8）、存在神经系统疾病（2.8，95% CI 1.2 - 6.5）和完成连线B部分认知测试的时间延长（2.5，95% CI 1.0 - 5.9）。相反，降低失败风险的比值比估计包括服用非糖尿病激素药物（例如，甲状腺和雌激素药物; 0.3，95%CI 0.09 - 0.7）和具有肌肉骨骼诊断（0.3，95%CI 0.1 - 0.7）。据我们所知，这是第一项研究，以检查医疗预测失败的标准化道路测试。年龄大和练习B部分的时间长是测试失败的两个主要预测因素和较低的机动得分总和。我们的研究还发现，有神经系统的诊断（主要是脑血管和帕金森病）预测测试失败。神经系统类药物也预测了较低的动作总和评分。需要做进一步的研究来解释肌肉骨骼疾病和激素药物的明显保护作用。
Objectives. To determine the relationship between clinical variables (demographics, cognitive testing, comorbidities, and medications) and failing a standardized road test in older adults.Methods. Analysis of on-the road studies performed in optimal weather conditions, between January 1, 2005, and May 1, 2007. The standardized testing was held at the National Older Driver Research and Training Center (NODRTC), Florida, and included 127 adults aged 65 and older with current driver licenses, recruited by advertisement from the Gainesville, Florida, community. Measurements consist of demographics, self-reported medications and medical conditions, cognitive testing including Trail Making Part B, global rating score (pass/fail), and driver maneuver score (0-273, with 273 indicating perfect driving or zero errors).Results. A total of 127 older adults completed the protocol. Mean age was 74.8 years (SD = 6.3); 46.5% females. Mean time for Trail Making Part B was 114.3 seconds (SD of 83). Among the 127 drivers, the mean Sum of Maneuvers Score was 238.9 (SD of 25.0) and 24 (19%) failed the driver test. Odds ratio estimates for failing the test included advanced age (6.7, 95% CI 2.2 to 19.8), presence of a neurological disease (2.8, 95% CI 1.2 to 6.5), and prolonged time to complete the Trail Making Part B cognitive test (2.5, 95% CI 1.0 to 5.9). Conversely, odds ratio estimates lowering the risk of failure included taking a non-diabetic hormonal medications (e.g., thyroid and estrogen drugs; 0.3, 95% CI .09 to 0.7) and having a musculoskeletal diagnosis (0.3, 95% CI .1 to 0.7).Conclusions. To our knowledge, this is the first study to examine the medical predictors of failing a standardized road test. Advanced age and prolonged time on Trail Making Part B were the two major predictors of test failure and a lower Sum of Maneuvers Score. Our study also found that having a neurological diagnosis (primarily cerebrovascular and Parkinson's disease) predicted test failure. Medications from neurological class also predicted a lower Sum of Maneuvers Score. Further study needs to be done to explain the apparent protective effect of musculoskeletal conditions and hormonal medications.