"Naturalistic Assessment of the Driving ability of Cognitively Impaired Elders

《认知障碍长者驾驶能力的自然评估》

• 批准号: 7265728
• 负责人: BRIAN R OTT
• 金额: $ 37.45万
• 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/7265728
• 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）：本协议描述了一项研究，该研究将检查老年驾驶员的驾驶能力，这些驾驶员是否患有或不患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障碍老年驾驶员的了解，并扩展我们在 RO1#AG16335 的当前研究中所做的观察，题为“痴呆症危险驾驶员的纵向研究”。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) 以及无认知障碍 (N=50) 的老年驾驶员。我们将比较视觉注意力和执行功能的特定计算机化测量结果与受试者在自己的汽车中在自然环境中驾驶的数码相机记录的性能。我们将对相同受试者的计算机化测量进行类似的分析，完成华盛顿大学路考的罗德岛改编的扩展版本。驾驶结果将根据连续评级量表以及全球安全评估进行评分。这些评估将在基线上进行，并每年重复一次。这将是第一项在自然驾驶环境中直接检查认知障碍老年人的此类研究。我们将比较结构化道路测试环境中的驾驶性能与非结构化自然环境中的性能。这种比较将有助于我们了解路考作为该人群驾驶评估“黄金标准”的有效性。此外，我们将通过在熟悉和不熟悉的驾驶环境中使用视频记录的可靠评级量表来描述和量化驾驶错误的类型。我们预测自然环境中的视频录制对于检测驱动程序错误将更加敏感。这项研究的次要目标将包括检查家庭成员和护理人员在自然和道路测试环境中由专业驾驶教练预测驾驶表现评级的准确性。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试点测试措施，作为临床医生办公室实践或机动车辆部门的筛查措施。此外，我们还将深入了解正式道路测试与认知障碍老年驾驶员的实际日常驾驶表现的相关性。通过这种方式，从纵向研究中获得的知识将进一步加深我们对早期痴呆症驾驶员这一非常重要且令人烦恼的问题的理解，为识别危险驾驶风险最大的人提供一些潜在的解决方案。