Cognitive Decline and Older Driver Crash Risk.
Cognitive Decline and Older Driver Crash Risk.
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DOI：
10.1111/jgs.15378
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发表时间：
2018-07
影响因子：
6.3
通讯作者：
Crane PK
中科院分区：
文献类型：
--
作者：
Fraade-Blanar LA;Ebel BE;Larson EB;Sears JM;Thompson HJ;Chan KCG;Crane PK
研究无痴呆的老年驾驶员与认知相关的汽车碰撞风险。纵向队列研究的回顾性次要分析。我们的研究使用了来自成人思想变化（ACT）研究的数据，并结合了华盛顿州的事故报告和执照记录。数据从2002年到2015年。来自华盛顿州、年龄在65岁及以上、持有有效驾照的团体健康登记者（N= 2，615）。采用项目反应理论（CASI-IRT）评分的认知能力筛查工具评估认知功能。研究结果是警方报告的机动车碰撞。我们使用了一个负二项混合效应模型，其中稳健的标准误聚集在个体上，并考虑了自上次研究访问以来撞车风险，认知水平和下降量之间的关联。协变量包括年龄、性别、教育、酒精、抑郁、医学共病、视力、听力和身体功能。个人在痴呆症诊断，死亡或未能更新他们的执照时被审查。在平均7年的随访中，350人（13%）至少发生过一次撞车事故。CASI-IRT评分低1个单位与调整后的撞车发生率比（1.26）较高相关（95%置信区间= 1.08-1.51）。除了认知水平，研究访问之间的认知下降量与撞车风险无关。这项研究表明，在老年驾驶员中，CASI-IRT的表现较差可能是机动车碰撞的风险因素，即使在没有诊断出痴呆症的人中也是如此。需要进一步的研究来了解驾驶行为，并为认知功能差的老年人提供驾驶决策。
To examine automobile crash risk associated with cognition in older drivers without dementia. Retrospective secondary analysis of longitudinal cohort study. Our study used data from the Adult Changes in Thought (ACT) Study merged with Washington State crash reports and licensure records. Data were available from 2002 to 2015. Group Health enrollees from Washington State aged 65 and older with active driver’s licenses (N=2,615). Cognitive function was assessed using the Cognitive Abilities Screening Instrument scored using item response theory (CASI-IRT). The study outcome was police-reported motor vehicle crash. We used a negative binomial mixed-effects model with robust standard errors clustered on the individual and considered associations between crash risk, level of cognition, and amount of decline since the previous study visit. Covariates included age, sex, education, alcohol, depression, medical comorbidities, eyesight, hearing, and physical function. Individuals were censored at dementia diagnosis, death, or failure to renew their license. Over an average of 7 years of follow-up, 350 (13%) people had at least one crash. A 1-unit lower CASI-IRT score was associated with a higher adjusted incidence rate ratio of crash of 1.26 (95% confidence interval = 1.08–1.51). Beyond level of cognition, amount of cognitive decline between study visits was not associated with crash risk. This study suggests that, in older drivers, poorer performance on the CASI-IRT may be a risk factor for motor vehicle crashes, even in individuals without diagnosed dementia. Further research is needed to understand driving behavior and inform driving decisions for older adults with poor cognitive function.
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影响因子：
5.9
作者：
Lyman, JM;McGwin, G;Sims, RV
通讯作者：
Sims, RV
影响因子：
5
作者：
McGwin, G;Sims, RV;Roseman, JM
通讯作者：
Roseman, JM
影响因子：
3
作者：
Fishman, PA;Goodman, MJ;Rosetti, MCO
通讯作者：
Rosetti, MCO
影响因子：
39.2
作者：
Larson, EB;Wang, L;Kukull, W
通讯作者：
Kukull, W
DOI：
10.1046/j.1532-5415.2003.51481.x
发表时间：
2003-10-01
影响因子：
6.3
作者：
Duchek, JM;Carr, DB;Morris, JC
通讯作者：
Morris, JC