The Medical Referral Process and Motor-Vehicle Crash Risk for Drivers with Dementia.
The Medical Referral Process and Motor-Vehicle Crash Risk for Drivers with Dementia.
复制标题
患有痴呆的驾驶员的医疗转诊过程和汽车撞车风险。
DOI：
10.3390/geriatrics5040091
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发表时间：
2020-11-13
期刊：
影响因子：
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通讯作者：
Peek-Asa C
中科院分区：
文献类型：
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作者：
Davis J;Hamann C;Butcher B;Peek-Asa C
认知和身体障碍可发生痴呆症，并降低驾驶能力。在美国，个别州有程序转介和评估可能不再适合驾驶的司机。对于患有痴呆症的司机来说，执照审查过程并不很好理解。这项研究使用了来自爱荷华州交通部的综合数据，比较了2014年1月至2019年11月期间患有和不患有痴呆症的司机的转诊过程。未通过评估测试的可能性进行了比较驾驶员与非痴呆使用逻辑回归。使用考克斯比例风险模型比较转诊后驾驶能力审查的机动车碰撞风险。分析控制了被推荐司机的年龄和性别。痴呆驾驶员在所有测试中的表现都较差，除了视觉筛查测试。在转诊过程之后，患有和没有痴呆症的人之间的撞车风险相似。患有痴呆症的司机比没有痴呆症的司机更经常被拒绝驾驶执照。然而，与其他被推荐的驾驶员相比，由于驾驶执照审查过程而成功保留驾驶执照的痴呆症驾驶员的撞车风险并没有增加。
Cognitive and physical impairment can occur with dementia and reduce driving ability. In the United States, individual states have procedures to refer and evaluate drivers who may no longer be fit to drive. The license review process is not well understood for drivers with dementia. This study uses comprehensive data from the Iowa Department of Transportation to compare the referral process for drivers with and without dementia from January 2014 through November 2019. The likelihood of failing an evaluation test was compared between drivers with and without dementia using logistic regression. The risk of motor-vehicle crash after referral for review of driving ability was compared using a Cox proportional hazard model. Analysis controlled for the age and sex of the referred driver. Drivers with dementia performed worse on all tests evaluated except the visual screening test. After the referral process, the risk of crash was similar between those with and without dementia. Drivers with dementia were denied their license more frequently than referred drivers without dementia. However, drivers with dementia who successfully kept their license as a result of the license review process were not at an increased risk of crash compared to other referred drivers.