Mild functional decline and driving performance of older drivers without a diagnosed dementia: Study of leukoaraiosis and cognitive function
Mild functional decline and driving performance of older drivers without a diagnosed dementia: Study of leukoaraiosis and cognitive function
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DOI：
10.1016/j.trf.2020.09.016
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发表时间：
2020-11-01
影响因子：
4.1
通讯作者：
Imai, Yasuo
中科院分区：
文献类型：
--
作者：
Renge, Kazumi;Park, Kaechang;Imai, Yasuo
涉及老年驾驶员的机动车碰撞有所增加，并成为一个重要的社会问题。众所周知，认知功能的下降，包括痴呆症，会影响驾驶性能。一系列使用简易精神状态检查（MMSE）和其他痴呆症测试的研究试图通过尽早识别可能无法保持驾驶性能的老年驾驶员来预防机动车碰撞。此外，老年驾驶员的表现可能会恶化，即使他们没有痴呆症的诊断。因此，我们集中在认知功能评估的MMSE和脑白质疏松症（LA）的诊断之间的关系，或在大脑白色物质的变化，与不同方面的驾驶行为导致老化。合格的驾驶教练评估参与者的驾驶行为在驾驶学校的户外驾驶课程。通过可穿戴式无线传感器获取交叉口处的视觉搜索时长和搜索角度。从车速脉冲信号中记录车速和最低车速。在无信号交叉口的信号和视觉搜索的持续时间记录使用车载摄像机。通过对教练员的评价和两种工具的评分，验证MMSE评分和LA评分对驾驶成绩的影响。结果表明，较低的MMSE评分和较高的LA等级可以预测老年驾驶员在经历痴呆症或认知功能明显下降之前驾驶表现不佳的某些方面。基于这些结果，我们讨论的对策，可以防止涉及老年驾驶员的机动车碰撞。(C)2020作者（S）爱思唯尔有限公司出版
Motor vehicle collisions involving older drivers have increased and become an important social issue. It is known that the decline of cognitive function, including dementia, affects driving performance. A series of studies using the Mini-Mental State Examination (MMSE) and other tests of dementia have attempted to prevent motor vehicle collisions by identifying as early as possible older drivers who may be unable to maintain their driving performance. Further, the performance of older drivers may deteriorate even if they do not have a diagnosis of dementia. Therefore we focused on the relationship between cognitive functioning assessed by the MMSE and diagnosis of leukoaraiosis (LA), or changes in the cerebral white matter, with different aspects of driving behavior resulting from aging. Qualified driving instructors evaluated participants' driving behaviors on an outdoor driving course at a driving school. Visual search duration and angle at intersections were obtained by wearable wireless sensors. Vehicle speed and minimum vehicle speed were recorded from vehicle speed pulse signals. Duration of signaling and visual searches at unsignalized intersections were recorded using an in-vehicle camera. We assessed instructors' evaluations and the scores on two instruments to evaluate the effects of MMSE scores and the grade of LA on driving performance were verified. The results suggest that lower MMSE scores and higher LA grade can predict some aspects of poor driving performance in older drivers before they experience dementia or an evident decline in cognitive functioning. Based on these results, we discuss countermeasures that may prevent motor vehicle collisions involving older drivers. (C) 2020 The Author(s). Published by Elsevier Ltd.