Measures of visual function and time to driving cessation in older adults
Measures of visual function and time to driving cessation in older adults
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DOI：
10.1097/01.opx.0000175008.88427.05
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发表时间：
2005-08-01
影响因子：
1.4
通讯作者：
West, SK
中科院分区：
文献类型：
--
作者：
Freeman, EE;Muñoz, B;West, SK
目的.老年人可能会限制他们的驾驶，一旦他们的视觉功能已经受到损害，大概是为了确保他们的安全。重要的是要确定导致驾驶停止的视觉功能丧失的类型，以更好地了解视力和驾驶之间的关系。方法.数据来自索尔兹伯里眼科评估项目，该项目是一项对2520名老年人进行的队列研究，为期8年，收集了4轮数据。客观地评估视觉功能的多项措施，并通过受试者或代理人的自我报告收集驾驶信息。采用考克斯回归分析，在调整人口统计学和健康变量后，检查基线和2年视力、对比敏感度、视野和眩光敏感度变化评分较差的患者是否更有可能在基线后停止驾驶。结果视力、对比敏感度、中心或较低周边视野基线评分较差的患者更有可能停止驾驶（趋势p值< 0.05）。此外，那些视力、对比敏感度或周边视野下降2年的人更有可能停止驾驶（趋势p值< 0.05）。随着视力变量进入相同的模型，基线视力和2年视力丧失不再具有统计学意义。对比敏感度、中心视野和较低周边视野基线评分较差的患者更有可能停止驾驶（趋势p值< 0.05），对比敏感度和较低周边视野丧失2年的患者更有可能停止驾驶（趋势p值< 0.05）。没有检测到与性别、家中其他司机或认知障碍的相互作用。结论.我们提出的前瞻性数据表明，老年人在多项视力指标中得分较差的人更有可能停止驾驶，对比敏感度和视野与驾驶停止最相关。
Purpose. Older adults may place restrictions on their driving once their visual function has become compromised, presumably in an effort to ensure their safety. It is important to identify the types of visual function loss that lead to driving cessation to better understand the relationship between vision and driving. Methods. Data were used from the Salisbury Eye Evaluation project, a cohort study of 2520 older adults followed for 8 years with four rounds of data collection. Multiple measures of visual function were objectively assessed and driving information was collected through self-report from subjects or proxies. Cox regression was used to examine whether those with worse baseline and 2-year change scores in acuity, contrast sensitivity, visual fields, and glare sensitivity were more likely to stop driving after baseline after adjusting for demographic and health variables. Results. Those with worse baseline scores in acuity, contrast sensitivity, central or lower peripheral visual fields were more likely to stop driving (trend p values < 0.05). Also, those who experienced 2-year losses in acuity, contrast sensitivity, or lower peripheral visual fields were more likely to stop driving (trend p values < 0.05). With the vision variables entered into the same model, baseline acuity and 2-year acuity loss were no longer statistically significant. Those with worse baseline scores in contrast sensitivity, central and lower peripheral visual fields were more likely to stop driving (trend p values < 0.05), and those who had 2-year losses in contrast sensitivity and lower peripheral visual fields were more likely to stop driving (trend p values < 0.05). Interactions with gender, other drivers in the house, or cognitive impairment were not detected. Conclusions. We present prospective data that indicate that older adults with worse scores in multiple measures of vision are more likely to stop driving and that contrast sensitivity and visual fields are most associated with driving cessation.