Car Accidents Associated with Physical Frailty and Cognitive Impairment
Car Accidents Associated with Physical Frailty and Cognitive Impairment
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DOI：
10.1159/000508823
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发表时间：
2020-12-01
期刊：
影响因子：
3.5
通讯作者：
Shimada, Hiroyuki
中科院分区：
文献类型：
--
作者：
Doi, Takehiko;Ishii, Hideaki;Shimada, Hiroyuki
导言：与年龄相关的功能衰退会增加发生车祸的风险。具体的认知障碍和身体虚弱是否会增加车祸的风险尚不清楚。目的：本研究探讨车祸、虚弱和认知功能之间的关系，因为车祸与老年人有关。方法：数据收集自国家老年病学和老年学中心(NCGG) -老年综合征研究的12013名老年人（45.4%为女性，平均年龄：71.7岁[min: 60， max: 96]）。研究人员对两年内自述的车祸史进行了评估。使用日本心血管健康研究指数作为标准，包括以下虚弱成分：萎缩，虚弱，疲惫，低活动和缓慢。基于这些组件，“脆弱性”被赋值为1或更多。使用NCGG功能评估工具评估认知功能，使用标准化值评估认知障碍。结果：在参与者中，1117人（9.3%）有车祸史。与非车祸组相比，车祸组虚弱成分的适用性比例为收缩（p = 0.006），疲惫（p = 0.031），低活动（p = 0.034）和缓慢（p = 0.030），但没有虚弱（p = 0.452）。车祸组执行功能认知障碍比例也较高（p = 0.011）。logistic回归分析显示，身体虚弱（OR 1.26, 95% CI 1.11-1.43, p < 0.001）和认知障碍（OR 1.26, 95% CI 1.11-1.43, p < 0.001）与车祸有关。讨论：本研究的发现有助于提高老年司机风险评估的效用。需要进一步的研究来阐明车祸的危险性。
Introduction: Age-related functional decline elevates the risk of car accidents. Whether specific cognitive impairments and physical frailty increase the risk of car accidents is still unclarified. Objective: This study examines the association between car accidents, frailty, and cognitive function, owing to an increase in car accidents related to older adults. Methods: Data were collected from 12,013 older adults (45.4% women, mean age: 71.7 years [min: 60, max: 96]) enrolled in the National Center for Geriatrics and Gerontology (NCGG) - Study of Geriatric Syndromes. A 2-year self-reported history of car accidents was assessed. The Japanese cardiovascular health study index was used as the criterion and included the following components of frailty: shrinking, weakness, exhaustion, low activity, and slowness. "Frailty" was assigned a value of 1 or more based on these components. Cognitive function was assessed using the NCGG Functional Assessment Tool, and cognitive impairment was assessed using a standardized value. Results: Of the participants, 1,117 (9.3%) had a car accident history. The proportions of the frailty components' applicability were observed in the car accidents group compared to the non-car accidents group: shrinking (p = 0.006), exhaustion (p = 0.031), low activity (p = 0.034), and slowness (p = 0.030), but not weakness (p = 0.452). The proportion of cognitive impairment in executive function was also higher in the car accidents group (p = 0.011). A logistic regression analysis showed that both frailty (OR 1.26, 95% CI 1.11-1.43; p < 0.001) and cognitive impairment (OR 1.26, 95% CI 1.11-1.43, p < 0.001) are associated with car accidents. Discussion: This study's findings contribute to enhancing the utility of risk assessments for older drivers. Further study is required to clarify the risk of car accidents.