The Effect of the Global Positioning System on the Driving Performance of People with Mild Alzheimer's Disease
The Effect of the Global Positioning System on the Driving Performance of People with Mild Alzheimer's Disease
复制标题
全球定位系统对轻度阿尔茨海默病患者驾驶表现的影响
DOI：
10.1159/000365922
复制
发表时间：
2014
期刊：
影响因子：
3.5
通讯作者：
T. Falkmer
中科院分区：
文献类型：
--
作者：
J. Yi;Hoe C Lee;R. Parsons;T. Falkmer
前言：阿尔茨海默病(AD)的首发症状包括注意力缺陷、记忆力丧失以及在地形和空间方向上的缺陷。阿尔茨海默病患者可能会因为导航能力的下降而在驾驶中出现寻路困难。尽管全球定位系统(GPS)的使用已被证明对老年人驾驶是一种有用的帮助，但没有证据表明这种好处可能延伸到患有AD的司机。目的：本研究旨在探讨GPS在帮助轻度AD患者安全找到目的地方面的有效性。方法：由全科医生或老年精神科医生诊断为轻度至极轻度阿尔茨海默病的28名司机完成了所有临床和心理测量评估，包括简易精神状态检查、跟踪测试B和门与人测试。在驾驶评估中，对所有参与者进行了3次不同GPS设置(正常、仅限视觉和仅限音频)的驾驶试验。参与者被要求遵循GPS的指令，并在驾驶模拟器上执行各种驾驶任务。参与者的驾驶表现是根据AD司机特有的标准进行评估的。驾驶评估标准首先被组合起来，形成整体驾驶表现分数：分数越高，表示整体驾驶表现越好。这项研究的另一个结果是参与者成功地导航到预定的目的地。结果：受试者的驾驶成绩在3种设置之间存在差异(F=72.8p<；0.001)，3种设置之间的配对比较有统计学意义(p<；0.001)。驾驶成绩得分在纯听觉设置下最高(平均值：20.0，SD：2.2)，在正常设置下中等(平均值：16.7，SD：2.6)，在纯视觉设置下最低(平均值：14.3，SD：3.3)。与纯视觉设置相比，使用纯音频设置(OR：37.2，95%CI：9.2-151.2)和普通设置(OR：37.2，95%CI：4.8-286.9)的司机更有可能成功找到目的地(P<；0.05)。结论：这项研究发现，在没有GPS视觉输出的情况下，使用单一、简单的听觉指令可以潜在地帮助轻度AD患者提高驾驶能力并到达目的地。
Introduction: The initial symptoms of Alzheimer's disease (AD) include attention deficits, memory loss and deficiencies in topographic and spatial orientation. People with AD may have way-finding difficulties in driving due to the deterioration of their navigation ability. Although the use of the Global Positioning System (GPS) has been proven to be a useful aid for older people in driving, there is no evidence to suggest that the benefit could extend to drivers with AD. Aim: This study aims to investigate the effectiveness of the GPS in assisting drivers with mild AD in finding their destination safely. Method: Twenty-eight drivers with mild to very mild AD, diagnosed by a general practitioner or a psychogeriatrician, completed all clinical and psychometric assessments including the Mini Mental State Examination, Trail Making Test B and Doors and People Test. During the driving assessment, 3 driving trials with different settings (normal, visual-only and audio-only) of the GPS were administered to all participants. The participants were required to follow instructions from the GPS and perform a variety of driving tasks on a driving simulator. The driving performances of participants were assessed by criteria specific to AD drivers. The driving assessment criteria were first combined to form the overall driving performance score: a higher score indicated a better overall driving performance. The other outcome of this study was the success of participants to navigate to a predetermined destination. Results: The driving performance of participants was different among the 3 settings (F = 72.8, p < 0.001) and the pairwise comparison between the 3 settings was significant (p < 0.001). The driving performance score was highest in the audio-only setting (mean: 20.0, SD: 2.2), moderate in the normal setting (mean: 16.7, SD: 2.6) and lowest in the visual-only setting (mean: 14.3, SD: 3.3). When compared with the visual-only setting, drivers using the audio-only setting (OR: 37.2, 95% CI: 9.2-151.2) and normal setting (OR: 37.2, 95% CI: 4.8-286.9) were more likely to successfully find their destination (p < 0.05). Conclusion: This study has found that using single, simple auditory instructions with the absence of the visual output of the GPS could potentially help people with mild AD to improve their driving ability and reach their destination.