Uc Ergun Y, Rizzo Matthew, Anderson Steven W, Shi Qian, Dawson Jeffrey D
Division of Neuroergonomics, Department of Neurology, College of Medicice, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
J Neurol Sci. 2006 Dec 21;251(1-2):35-43. doi: 10.1016/j.jns.2006.08.011. Epub 2006 Oct 16.
Drivers with cognitive impairment are at increased odds for vehicular crashes. Rear-end collisions (REC) are among the most common crash types. We tested REC avoidance in 61 drivers with mild Alzheimer's disease (AD) and 115 elderly controls using a high-fidelity interactive driving simulator. After a segment of uneventful driving, each driver suddenly encountered a lead vehicle stopped at an intersection, creating the potential for a collision with lead vehicle or with another vehicle following closely behind the driver. Eighty-nine percent of drivers with AD had unsafe outcomes, either an REC or an risky avoidance behavior (defined as slowing down abruptly or prematurely, or swerving out of the traffic lane) compared to 65% of controls (P=0.0007). Crash rates were similar in AD (5%) and controls (3%), yet a greater proportion of drivers with AD slowed down abruptly (70% vs. 37%, P<0.0001) or prematurely (66% vs. 45%, P=0.0115). Abrupt slowing increased the odds of being struck from behind by the following vehicle (P=0.0262). Unsafe outcomes were predicted by tests of visual perception, attention, memory, visuospatial/constructional abilities, and executive functions, as well as vehicular control measures during an uneventful driving segment. Drivers with AD had difficulty responding to driving conditions that pose a hazard for a REC. Some cognitive and visual tests were predictive of unsafe outcomes even after adjusting for disease status.
认知功能受损的驾驶员发生车祸的几率更高。追尾碰撞是最常见的碰撞类型之一。我们使用高保真交互式驾驶模拟器，对61名患有轻度阿尔茨海默病（AD）的驾驶员和115名老年对照组进行了追尾碰撞规避测试。在一段平稳驾驶之后，每位驾驶员突然遇到一辆在十字路口停下的前车，这就产生了与前车或紧跟在驾驶员后面的另一辆车发生碰撞的可能性。89%的AD患者出现了不安全结果，即追尾碰撞或危险的规避行为（定义为突然或过早减速，或驶出行车道），而对照组为65%（P=0.0007）。AD患者（5%）和对照组（3%）的碰撞率相似，但更多的AD患者突然（70%对37%，P<0.0001）或过早（66%对45%，P=0.0115）减速。突然减速增加了被后车追尾的几率（P=0.0262）。不安全结果可通过视觉感知、注意力、记忆、视觉空间/构建能力和执行功能测试以及平稳驾驶阶段的车辆控制措施来预测。患有AD的驾驶员在应对可能导致追尾碰撞的驾驶情况时存在困难。即使在调整疾病状态后，一些认知和视觉测试仍可预测不安全结果。
