Predicting Long-Term Mobility Outcomes for Older Adults

描述（由申请人提供）：为了确定老年驾驶员的不良移动结果的功能能力风险因素，1998年，马里兰州机动车管理局（MVA）， NHTSA和nia资助的UAB Roybal应用老年学研究中心发起了一项合作研究。在这项研究中，在几个MVA外地办事处完成驾照更新后，用一系列基于绩效的措施对大样本（N=2000+）的老年司机进行了评估。此外，这些参与者的子样本（n=850+）每年通过电话采访跟踪三年，以监测他们整体流动性的变化。通过这项研究，马里兰州医疗管理局认为一套有限的功能能力测试对进一步评估和在许可过程中可能实施有用。此外，这些相同的措施被发现可以预测通过自我报告获得的更普遍的流动性下降。本申请建议在五年后的下一个许可证更新周期中重新检查原始参与者的改良版筛选电池，并通过电话调查在另外三年期间监测整个样本的流动性。继续跟踪这一独特且特征明确的样本的主要优势是，已经确定的风险因素的影响可以进行纵向检查，并且可以比较最初表现出认知和身体困难的个体与没有表现出认知和身体困难的个体随时间的运动功能轨迹。更清楚地了解风险因素如何随时间变化，可以作为制定干预措施的基础，以促进老年人的行动能力，并为负责评估驾驶能力的国家机构制定评估、转诊和许可指南提供信息。

DESCRIPTION (provided by applicant): In order to identify functional ability risk factors for adverse mobility outcomes among older drivers, a collaborative study was initiated in 1998 between the Maryland Motor Vehicle Administration (MVA), NHTSA, and the NIA-funded UAB Roybal Center for Research on Applied Gerontology. In this study, a large sample (N=2000+) of older drivers was evaluated with a brief battery of performance-based measures after completing license renewal at several MVA field offices. In addition, a sub-sample (n=850+) of these participants was followed annually by telephone interview for a three year period to monitor changes in their overall mobility. Through that study, a limited set of functional ability tests were deemed useful by the Maryland MVA for further evaluation and potential implementation in the licensing process. In addition, these same measures were found to be predictive of more general declines in mobility obtained through self-report. The present application proposes to re-examine the original participants on a modified version of the screening battery administered five years later during their next license renewal cycle and to monitor, via telephone survey, the mobility of the entire sample over an additional three year period. The primary advantage for continuing to follow this unique and well-characterized sample is that the impact of already identified risk factors can be examined longitudinally, and the trajectory of mobility function over time can be compared for individuals who initially evidenced cognitive and physical difficulties relative to those who did not. A clearer understanding of how risk factors change over time can serve as a basis for developing interventions to promote mobility for older adults, as well as providing information for the development of assessment, referral, and licensing guidelines for state agencies charged with the task of evaluating driving competence.