A LONGITUDINAL STUDY OF HAZARDOUS DRIVERS WITH DEMENTIA

对患有痴呆症的危险驾驶员的纵向研究

• 批准号: 6266731
• 负责人: BRIAN R OTT
• 金额: $ 40.2万
• 依托单位: MEMORIAL HOSPITAL OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-15 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6266731
• 关键词: Alzheimer's disease; aging; attention; behavioral /social science research tag; clinical research; cognition; computer data analysis; computer human interaction; diagnosis design /evaluation; disease /disorder onset; disease /disorder proneness /risk; functional ability; geriatrics; human old age (65+); human subject; language; longitudinal human study; memory; neuropsychological tests; neuropsychology; psychomotor function; statistics /biometry; vehicular accident; visual perception

This protocol describes a longitudinal research project which will examine changes in on-road driving performance and changes in {cognition} among actively driving subjects with Alzheimer's disease. It is well recognized that dementia is a risk factor among the elderly for motor vehicle crashes and fatalities. Degenerative dementias such as Alzheimer's disease, because of their progressive nature, eventually lead to driving incompetence in all cases. A critical question that faces clinicians in everyday practice is when to advise patients with early disease to abstain from driving. Because patients with Alzheimer's disease may still be competent to drive if their dementia is in its earliest and mildest stage, and because driving is an important factor in maintaining autonomy for elders, licenses should not be revoked based on arbitrary decisions about one's memory ability. Annual road testing for driving competence of all elders or even all elders with dementia is neither practical nor economical. Therefore, an effective screening instrument is badly needed. Knowledge about the actual driving impairments that occur in dementia patients that lead to hazardous driving and how they relate to changes in neuropsychological function over time is critical to the development of a valid screening tool. Drivers with early stage Alzheimer's disease will be enrolled in this study and followed every six months over {two to} three years. A recently validated road test protocol will be administered by a professional driving instructor. {Computerized} neuropsychological tests of visual perception, visual attention, and executive function will be administered concurrently. It is predicted that the earliest evidence of driving impairment will be associated with disturbances {in visual perception and attention.} In more advanced stages of dementia, when subjects are most likely to be judged as incompetent drivers, there will be prominent deficits in executive function as well. The longitudinal design of this study will give important insights into the evolution of driving impairment among AD patients and assist in the future development of screening tests to identify hazardous drivers who would be likely to fail a performance based road test.

这项协议描述了一个纵向研究项目，该项目将检查阿尔茨海默病患者在道路上驾驶性能的变化和认知能力的变化。众所周知，痴呆症是老年人发生车祸和死亡的一个危险因素。退化性痴呆，如阿尔茨海默病，由于其渐进性，最终在所有情况下都会导致驾驶能力低下。临床医生在日常工作中面临的一个关键问题是，何时建议早期疾病患者放弃驾驶。由于阿尔茨海默病患者在痴呆症最早和最轻微的阶段可能仍然有能力驾驶，而且驾驶是维持老年人自主性的重要因素，不应该因为一个人的记忆能力的武断决定而吊销执照。每年为所有老年人，甚至所有患有痴呆症的老年人进行驾驶能力道路测试既不实用，也不划算。因此，迫切需要一种有效的筛查工具。了解痴呆症患者实际发生的导致危险驾驶的驾驶障碍，以及它们与随着时间的推移神经心理功能变化的关系，对于开发有效的筛查工具至关重要。患有早期阿尔茨海默病的司机将被登记在这项研究中，并在两到三年内每六个月跟踪调查一次。最近经过验证的道路测试方案将由专业驾驶教练执行。视觉感知、视觉注意力和执行功能的神经心理测试将同时进行。据预测，驾驶障碍的最早证据将与(视觉感知和注意力)障碍有关。在痴呆症更严重的阶段，当受试者最有可能被判断为不称职的司机时，执行功能也会出现明显的缺陷。这项研究的纵向设计将为AD患者中驾驶损害的演变提供重要的见解，并有助于未来筛查测试的发展，以识别可能无法通过基于性能的道路测试的危险司机。