Longitudinal study of self-imposed driving restrictions and deficit awareness in patients with Alzheimer disease
Longitudinal study of self-imposed driving restrictions and deficit awareness in patients with Alzheimer disease
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DOI：
10.1097/00002093-199907000-00007
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发表时间：
1999-07-01
影响因子：
2.1
通讯作者：
Wild, K
中科院分区：
文献类型：
--
作者：
Cotrell, V;Wild, K
35例阿尔茨海默病（AD）患者，包括19例仍在驾驶的患者，进行了意识水平和驾驶状态评估。驾驶状态与简易精神状态检查（MMSE）评分之间无显著相关性。只有注意力分项得分的意识问卷产生了显着差异的司机和nondrivers。12-18个月后对仍在驾驶的患者进行随访。除4名患者外，所有患者均已停止驾驶。护理人员回答了一份调查问卷，评估自AD发病以来患者的驾驶行为。MMSE与驾驶状态无相关性。在10例病例中，有7例是护理人员或患者决定患者应该停止驾驶。然而，护理人员报告说，护理人员认为患者应该停止驾驶和实际停止驾驶之间的时间较长（0.5-48个月）。结果表明，AD患者确实自愿限制了他们驾驶的几个领域，如果不这样做，可能与意识缺陷有关。特别是，缺乏注意力的意识与缺乏限制驾驶行为（如避免不熟悉的路线）显着相关。意识到与驾驶性能相关的缺陷可能对限制驾驶行为至关重要，并且这种行为变化可能使患者能够延长他或她作为驾驶员的状态。
Thirty-five patients with Alzheimer disease (AD), including 19 who were still driving, were evaluated for level of awareness and driving status. There was no significant correlation between driving status and Mini-Mental State Examination (MMSE) scores. Only the attention subscore of the awareness questionnaire yielded a statistically significant difference between drivers and nondrivers. Follow-up of the patients who were still driving was conducted 12-18 months later. All but 4 patients had stopped driving. Caregivers responded to a questionnaire assessing the patient's driving behaviors since the onset of AD. There was no correlation between MMSE and driving status. In 7 of 10 cases, caregivers or patients made the decision that the patient should stop driving. However, caregivers reported long periods between the caregiver's perception that the patient should stop driving and actual cessation (0.5-48 months). Results suggest that AD patients do restrict several areas of their driving voluntarily and that a failure to do so may be associated with an awareness deficit. In particular, a deficit of awareness for attention was significantly associated with an absence of restricted driving behaviors such as avoiding unfamiliar routes. Awareness of a deficit that is related to driving performance may be critical to restricted driving behavior, and this change in behavior may enable the patient to prolong his or her status as a driver.