Foley D J, Masaki K H, Ross G W, White L R
Epidemiology, Demography and Biometry Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA.
J Am Geriatr Soc. 2000 Aug;48(8):928-30. doi: 10.1111/j.1532-5415.2000.tb06889.x.
To determine the prevalence and cessation of driving among older men with incident dementia in the Honolulu-Asia Aging Study.
Retrospective cohort data from a community-based study of incident dementia.
The Honolulu Heart Program and the Honolulu-Asia Aging Study.
A total of 643 men who were evaluated for the incidence of Alzheimer's disease or other dementia between the fourth and the fifth examination of the Honolulu Heart Program.
Driving history, diagnosis of dementia, grip strength, walking speed, standing balance test, interviewer's rating of vision status, and the neurologist's notes on mentions of driving behavior from informal interviews with a caregiver or family informant.
The prevalence of driving declined dramatically with level of cognitive functioning. Among 162 men evaluated and found to have normal cognitive functioning, 78% still drove, compared with 62% of 287 men with poor cognitive functioning but no clinical dementia, 46% of 96 men with a new diagnosis of very mild dementia (Clinical Dementia Rating = 0.5), and 22% of 98 men with a new diagnosis of mild dementia (CDR = 1). Only one of 23 men diagnosed with moderate or more severe staged incident dementia (CDR > 1) was driving. About 10% of the 59 demented persons still driving relied on co-pilots, and only one driver was reported as involved in a crash according to a review of the neurologists' notes.
Incident dementia is a major cause of driving cessation. Based on these data, we estimate that approximately 4% of male drivers aged 75 years and older nationwide (about 175,000 men) have dementia. This number will increase with the projected growth of drivers aged 75 years and older.
在檀香山亚洲老年研究中确定患有新发痴呆症的老年男性的驾驶普及率及停止驾驶情况。
基于社区的新发痴呆症研究的回顾性队列数据。
檀香山心脏项目和檀香山亚洲老年研究。
在檀香山心脏项目的第四次和第五次检查之间接受阿尔茨海默病或其他痴呆症发病率评估的643名男性。
驾驶史、痴呆症诊断、握力、步行速度、站立平衡测试、访视员对视力状况的评分，以及神经科医生从与照顾者或家庭 informant 的非正式访谈中提及的驾驶行为记录。
驾驶普及率随认知功能水平显著下降。在评估发现认知功能正常的162名男性中，78%仍在开车；相比之下，认知功能较差但无临床痴呆症的287名男性中这一比例为62%，新诊断为极轻度痴呆症（临床痴呆评定量表=0.5）的96名男性中为46%，新诊断为轻度痴呆症（CDR=1）的98名男性中为22%。在诊断为中度或更严重分期的新发痴呆症（CDR>1）的23名男性中，只有1人仍在开车。根据神经科医生的记录回顾，仍在开车的59名痴呆症患者中约10%依赖副驾驶，且仅报告有1名司机发生过撞车事故。
新发痴呆症是停止驾驶的主要原因。基于这些数据，我们估计全国75岁及以上男性司机中约4%（约17.5万名男性）患有痴呆症。随着75岁及以上司机预计数量的增加，这一数字也会上升。
