Marshall Shawn C
SCO Health Service, Elisabeth Bruyere Research Institute, Ottawa, Ontario, Canada.
Traffic Inj Prev. 2008 Aug;9(4):291-8. doi: 10.1080/15389580801895244.
Medical conditions and associated impairments are known to be more prevalent with aging and can potentially impact the function and crash risk of older drivers.
To evaluate the impact of specific medical conditions and associated impairments on older driver crash risk.
A search identified reports and peer-reviewed publications evaluating the risk for medical conditions and associated crash risk. Medical conditions associated with older persons were reviewed to determine the associated relative risk of crash.
The review identified three recent comprehensive reviews of medical conditions or chronic illnesses and crash risk: Dobbs (2005); Vaa (2003); Charlton et al. (2004). Comparison of the reviews reveals a relatively high agreement where medical conditions considered to be at slightly to moderately increased relative risk of crash include alcohol abuse and dependence, cardiovascular disease, cerebrovascular disease/TBI, depression, dementia, diabetes mellitus, epilepsy, use of certain medications, musculoskeletal disorders, schizophrenia, obstructive sleep apnea, and vision disorders. However, determining fitness to drive at the individual level based on diagnosis has significant limitations related to factors such as multiple medical conditions as well as varying severity of disease and associated functional impairments. Medical conditions that may affect driving can serve as "red flags" to assist health care professionals and driving administrators to identify drivers who may need further evaluation.
Medical conditions overall, do impact the fitness to drive of older drivers; however, the crash risk tends to be only slightly to moderately increased. The conditions can serve as potential warnings for reduced fitness to drive, but many persons with these medical conditions would still be considered safe to continue driving.
已知医疗状况及相关损伤随着年龄增长更为普遍，并且可能影响老年驾驶员的功能和撞车风险。
评估特定医疗状况及相关损伤对老年驾驶员撞车风险的影响。
通过检索确定评估医疗状况风险及相关撞车风险的报告和同行评审出版物。对与老年人相关的医疗状况进行审查，以确定相关的撞车相对风险。
该综述确定了三项近期关于医疗状况或慢性病与撞车风险的综合综述：多布斯（2005年）；瓦阿（2003年）；查尔顿等人（2004年）。对这些综述的比较显示出相对较高的一致性，其中被认为撞车相对风险略有至中度增加的医疗状况包括酒精滥用和依赖、心血管疾病、脑血管疾病/创伤性脑损伤、抑郁症、痴呆症、糖尿病、癫痫、某些药物的使用、肌肉骨骼疾病、精神分裂症、阻塞性睡眠呼吸暂停和视力障碍。然而，基于诊断在个体层面确定驾驶适宜性存在重大局限性，这些局限性与多种医疗状况以及疾病严重程度和相关功能损伤的差异等因素有关。可能影响驾驶的医疗状况可作为“警示信号”，以协助医疗保健专业人员和驾驶管理部门识别可能需要进一步评估的驾驶员。
总体而言，医疗状况确实会影响老年驾驶员的驾驶适宜性；然而，撞车风险往往仅略有至中度增加。这些状况可作为驾驶适宜性降低的潜在警示，但许多患有这些医疗状况的人仍可能被认为继续驾驶是安全的。
