Driving cessation in older men with incident dementia.
Driving cessation in older men with incident dementia.
复制标题
患有突发性痴呆的老年男性应停止驾驶。
DOI：
10.1111/j.1532-5415.2000.tb06889.x
复制
发表时间：
2000
影响因子：
6.3
通讯作者：
White,LR
中科院分区：
文献类型：
--
作者：
Foley,DJ;Masaki,KH;Ross,GW;White,LR
目的：在檀香山-亚洲老龄化研究中，确定老年痴呆症患者的患病率和停止驾驶的情况。设计：来自一项以社区为基础的痴呆症发病研究的回顾性队列数据。设置：檀香山心脏项目和檀香山-亚洲老龄化研究。参与者：共有643名男性在檀香山的第四次和第五次检查之间接受了阿尔茨海默病或其他痴呆症发病率的评估心脏计划。测量：驾驶历史，痴呆症的诊断，握力，步行速度，站立平衡测试，采访者的视力状态的评级，和神经科医生的笔记上提到的驾驶行为从非正式采访的照顾者或家庭informant.RESULTS：驾驶的患病率显着下降的认知功能水平。在162名被评估并发现认知功能正常的男性中，78%的人仍然开车，相比之下，287名认知功能差但没有临床痴呆的男性中有62%，96名新诊断为非常轻度痴呆的男性中有46%（临床痴呆评分= 0.5），98名新诊断为轻度痴呆的男性中有22%（CDR = 1）。在23名被诊断为中度或更严重的阶段性事件痴呆（CDR > 1）的男性中，只有一人在驾驶。在59名仍在驾驶的痴呆症患者中，约有10%依赖副驾驶，根据对神经科医生笔记的回顾，只有一名驾驶员被报告参与了撞车事故。结论：偶发性痴呆是停止驾驶的主要原因。根据这些数据，我们估计全国75岁及以上的男性司机中约有4%（约175，000名男性）患有痴呆症。这个数字将随着75岁以上驾驶员的预计增长而增加。
OBJECTIVE: To determine the prevalence and cessation of driving among older men with incident dementia in the Honolulu‐Asia Aging Study.DESIGN: Retrospective cohort data from a community‐based study of incident dementia.SETTING: The Honolulu Heart Program and the Honolulu‐Asia Aging Study.PARTICIPANTS: A total of 643 men who were evaluated for the incidence of Alzheimer's disease or other dementia between the fourth and the fifth examination of the Honolulu Heart Program.MEASUREMENTS: Driving history, diagnosis of dementia, grip strength, walking speed, standing balance test, interviewer's rating of vision status, and the neurologist's notes on mentions of driving behavior from informal interviews with a caregiver or family informant.RESULTS: The prevalence of driving declined dramatically with level of cognitive functioning. Among 162 men evaluated and found to have normal cognitive functioning, 78% still drove, compared with 62% of 287 men with poor cognitive functioning but no clinical dementia, 46% of 96 men with a new diagnosis of very mild dementia (Clinical Dementia Rating = 0.5), and 22% of 98 men with a new diagnosis of mild dementia (CDR = 1). Only one of 23 men diagnosed with moderate or more severe staged incident dementia (CDR > 1) was driving. About 10% of the 59 demented persons still driving relied on co‐pilots, and only one driver was reported as involved in a crash according to a review of the neurologists' notes.CONCLUSIONS: Incident dementia is a major cause of driving cessation. Based on these data, we estimate that approximately 4% of male drivers aged 75 years and older nationwide (about 175,000 men) have dementia. This number will increase with the projected growth of drivers aged 75 years and older.J Am Geriatr Soc 48:928–930, 2000.