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: 6533806
• 负责人: BRIAN R OTT
• 金额: $ 40.18万
• 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/6533806
• 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.

该协议描述了一个纵向研究项目，该项目将检查患有阿尔茨海默病的主动驾驶受试者的道路驾驶表现的变化和{认知}的变化。 众所周知，痴呆症是老年人发生机动车事故和死亡的一个危险因素。 诸如阿尔茨海默病之类的退行性痴呆症，由于其进行性，最终会导致所有情况下的驾驶能力下降。 临床医生在日常实践中面临的一个关键问题是何时建议早期疾病患者戒酒。因为如果阿尔茨海默病患者的痴呆症处于最早、最轻微的阶段，他们仍然可能有能力开车，而且驾驶是老年人维持自主权的一个重要因素，因此不应根据一个人的记忆能力做出武断的决定来吊销驾照。 每年对所有长者甚至所有痴呆症长者进行驾驶能力道路测试既不实际也不经济。 因此，急需一种有效的筛查仪器。 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神经心理功能随时间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参加这项研究，并在{两到}三年内每六个月进行一次随访。 最近验证的道路测试协议将由专业驾驶教练进行管理。将同时进行视觉感知、视觉注意力和执行功能的{计算机化}神经心理学测试。 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。在痴呆症的更晚期阶段，当受试者最有可能被判断为不称职的驾驶员时，执行功能将出现明显的缺陷以及。这项研究的纵向设计将为了解 AD 患者驾驶障碍的演变提供重要见解，并有助于未来筛选测试的开发，以识别可能无法通过基于性能的道路测试的危险驾驶员。