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: 6637827
• 负责人: BRIAN R OTT
• 金额: $ 31.91万
• 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/6637827
• 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，该项目将研究在患有阿尔茨海默氏病的主体驾驶受试者中，在道路上驾驶绩效的变化和{认知}的变化。 众所周知，痴呆症是老年人撞车和死亡的老年人中的危险因素。 退化性痴呆症（例如阿尔茨海默氏病）由于其渐进性而最终导致在所有情况下驱动无能。 在日常实践中面临临床医生的一个关键问题是何时建议早期疾病的患者戒烟。因为如果阿尔茨海默氏病的患者处于最早和最温和的阶段，并且驾驶是维持长者自治的重要因素，则可能仍然有能力开车，因此不应根据对自己的记忆能力的任意决策来撤销许可证。 年度的道路测试，以驱动所有长者甚至所有患有痴呆症的长老的能力既不是实际也不是经济的。 因此，急需有效的筛选工具。 有关导致危险驾驶的痴呆症患者实际驾驶障碍的知识以及随着时间的推移与神经心理功能的变化有关的知识对于开发有效的筛查工具至关重要。患有早期阿尔茨海默氏病的驾驶员将参加这项研究，每六个月{两年至}三年。 最近经过验证的道路测试协议将由专业驾驶教练管理。 {计算机化}视觉感知，视觉关注和执行功能的神经心理学测试将同时管理。 据预测，最早的驾驶障碍证据将与扰动有关（在视觉感知和关注中。}在痴呆症的更高级阶段，当受试者最有可能被视为无能的驱动因素时，在执行功能中也会出现明显的缺陷。这项研究的纵向设计将为AD患者驾驶障碍的演变提供重要的见解，并协助未来开发筛查测试，以识别有害驾驶员，而这些危险驾驶员可能会失败基于性能的道路测试。