Naturalistic Assessment of the Driving ability of Cognitively Impaired Elders

认知障碍老年人驾驶能力的自然评估

• 批准号: 7424013
• 负责人: BRIAN R OTT
• 金额: $ 36.58万
• 依托单位: RHODE ISLAND HOSPITAL
• 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 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7424013
• 关键词: Alzheimer' s Disease; Attention; Automobile Driving; Caregivers; Classification; Cognitive; Competence; Condition; Dementia; Detection; Deterioration; Development; Disease; Elderly; Environment; Family member; Goals; Gold; Hybrids; Impaired cognition; Impairment; Knowledge; Licensing; Longitudinal Studies; Measures; Motor Vehicles; Neighborhoods; Neurocognitive; Numbers; Outcome; Patients; Perception; Performance; Population; Predisposition; Process; Protocols documentation; Public Health; Rate; Research; Research Personnel; Resources; Rhode Island; Risk; Safety; Score; Screening procedure; Sensory; Short-Term Memory; Solutions; Standards of Weights and Measures; Structure; Technology; Testing; Time; Universities; Video Recording; Visit; Visual attention; Visuospatial; Washington; Work; cognitive impairment no dementia; computerized; day; digital; executive function; experience; follow-up; insight; instructor; older driver; programs; research study; response; visual motor; visual search

DESCRIPTION (provided by applicant): This protocol describes research that will examine the driving abilities of elderly drivers with and without cognitive impairment related to probable or possible Alzheimer's disease. This research will expand our knowledge about cognitively impaired older drivers and extend the observations made during our present research studies from RO1#AG16335, entitled "A Longitudinal Study of Hazardous Drivers With Dementia." Specifically, we will examine 150 older drivers with mild Alzheimer's disease (N=50), questionable or mild dementia (N=50), and no cognitive impairment (N=50). We will compare performance on specific computerized measures of visual attention and executive function to digital camera recordings of subjects in their own cars, driving in their natural environments. We will perform a similar analysis of the computerized measures for the same subjects completing an extended version of the Rhode Island adaptation of the Washington University Road Test. Driving outcomes will be scored on continuous rating scales as well as global assessments of safety. These assessments will be done at baseline and repeated at one year. This will be the first study of its kind to directly examine cognitively impaired elders in their natural driving environments. We will compare driving performance in the structured road test setting to performance in the unstructured natural setting. This comparison will help us to understand the validity of the road test as a "gold standard" for driving assessment in this population. Furthermore, we will characterize and quantify the types of errors made in driving, by use of a reliable rating scale of the video recordings in both familiar and unfamiliar driving environments. We predict that video recordings in the natural environment will be more sensitive for detection of driver errors. Secondary goals of this research will include examination of the accuracy of family members and caregivers in predicting driving performance ratings by a professional driving instructor in the natural and road test settings. Relevance to public health: Ultimately, this research seeks to develop selected computerized measures for pilot testing as a screening measure in the clinician's office practice or in a department of motor vehicles. Also, we will gain much needed insight into the relevance of formal road tests to actual day to day driving performance by cognitively impaired older drivers. In this way, knowledge gained from the longitudinal study will further advance our understanding of the very important and vexing problem of drivers with early dementia, producing some potential solution to the identification of those at greatest risk for hazardous driving.

描述（由申请人提供）：本方案描述了一项研究，该研究将检查老年驾驶员的驾驶能力，这些驾驶员有和没有与可能或可能的阿尔茨海默病相关的认知障碍。这项研究将扩大我们对认知受损的老年司机的了解，并扩展我们目前从RO1#AG16335进行的研究中所做的观察，题为“痴呆症危险司机的纵向研究”。“具体来说，我们将检查150名患有轻度阿尔茨海默病（N=50），可疑或轻度痴呆（N=50）和无认知障碍（N=50）的老年司机。我们将比较视觉注意力和执行功能的特定计算机测量与数字相机记录的受试者在自己的汽车中在自然环境中驾驶的表现。我们将对完成华盛顿大学道路测试的罗得岛改编版的相同受试者进行类似的计算机化测量分析。驾驶结果将在连续评级量表以及全球安全评估中进行评分。这些评估将在基线时进行，并在一年后重复进行。这将是第一个直接研究认知受损的老年人在自然驾驶环境中的研究。我们将比较结构化道路测试设置中的驾驶性能和非结构化自然环境中的驾驶性能。这一比较将有助于我们理解路试作为这一人群驾驶评估的“金标准”的有效性。此外，我们将通过使用在熟悉和不熟悉的驾驶环境中的视频记录的可靠评级量表来表征和量化驾驶中所犯错误的类型。我们预测，在自然环境中的视频记录将更敏感的检测驾驶员的错误。本研究的次要目标将包括家庭成员和照顾者在自然和道路测试环境中由专业驾驶教练预测驾驶性能评级的准确性。与公共卫生的相关性：最终，本研究旨在开发选定的计算机化的措施试点测试作为筛选措施，在临床医生的办公室的做法或在一个部门的机动车辆。此外，我们将获得急需的洞察力的相关性，正式的道路测试，以实际的日常驾驶性能的认知受损的老年司机。通过这种方式，从纵向研究中获得的知识将进一步促进我们对早期痴呆症驾驶员非常重要和令人烦恼的问题的理解，为识别那些危险驾驶风险最大的人提供一些潜在的解决方案。