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: 7595158
• 负责人: BRIAN R OTT
• 金额: $ 37.99万
• 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/7595158
• 关键词: Alzheimer' s Disease; Attention; Automobile Driving; Caregivers; Classification; Cognitive; Competence; Dementia; Detection; Deterioration; Development; Disease; Elderly; Environment; Family member; Goals; Gold; Hybrids; Impaired cognition; Impairment; Knowledge; Licensing; Longitudinal Studies; Measures; Motor Vehicles; Neighborhoods; Neurocognitive; Outcome; Patients; Perception; Performance; Population; Predisposition; Process; Protocols documentation; Public Health; Research; Research Personnel; Resources; Rhode Island; Risk; Safety; Screening procedure; Sensory; Short-Term Memory; Solutions; Structure; Technology; Testing; Time; Universities; Video Recording; Visit; Visual attention; Visuospatial; Washington; Work; cognitive impairment no dementia; computerized; 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）：本协议描述了研究，该研究将检查有或没有与可能或可能的阿尔茨海默氏病有关的认知障碍的老年人驾驶能力。这项研究将扩大我们对认知受损驱动因素的知识，并扩展了我们从RO1＃AG16335的研究期间进行的观察结果，该研究名为“对痴呆症的有害驱动因素的纵向研究”。具体而言，我们将检查150名患有轻度阿尔茨海默氏病（n = 50），可疑或轻度痴呆（n = 50）的老年驱动因素，并且没有认知障碍（n = 50）。我们将将视觉关注和执行功能的特定计算机评估的性能与自己的汽车中的受试者的数码相机记录，在自然环境中驾驶。我们将对同一受试者的计算机措施进行类似的分析，该措施完成了华盛顿大学道路测试的罗德岛改编版的扩展版本。驾驶结果将在连续的评分量表以及全球安全评估上进行评分。这些评估将在基准时进行，并在一年中重复进行。这将是同类研究，直接在自然驾驶环境中直接检查认知受损的长者。我们将在结构化的道路测试环境中比较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理解道路测试作为该人群驾驶评估的“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可靠的视频记录评级量表来表征和量化驾驶错误的类型。我们预测，自然环境中的视频录制将对检测驾驶员错误更为敏感。这项研究的次要目标将包括检查家庭成员和看护人在预测自然和道路测试环境中专业驾驶教练驾驶绩效评级方面的准确性。与公共卫生有关：最终，这项研究旨在制定针对试点测试的计算机化措施，作为临床医生办公室实践或汽车部门的筛查措施。此外，我们将急需了解正式的道路测试与认知受损的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提高我们对早期痴呆症驾驶员非常重要且令人烦恼的问题的理解，从而为确定危险驾驶风险最大的人提供了一些潜在的解决方案。