Department of Psychology, Kent State University, Kent, OH, USA.
BMC Geriatr. 2013 Jun 12;13:58. doi: 10.1186/1471-2318-13-58.
Cognitive impairment is prevalent in older adults with heart failure (HF) and associated with reduced functional independence. HF patients appear at risk for reduced driving ability, as past work in other medical samples has shown cognitive dysfunction to be an important contributor to driving performance. The current study examined whether cognitive dysfunction was independently associated with reduced driving simulation performance in a sample of HF patients.
18 persons with HF (67.72; SD = 8.56 year) completed echocardiogram and a brief neuropsychological test battery assessing global cognitive function, attention/executive function, memory and motor function. All participants then completed the Kent Multidimensional Assessment Driving Simulation (K-MADS), a driving simulator scenario with good psychometric properties.
The sample exhibited an average Mini Mental State Examination (MMSE) score of 27.83 (SD = 2.09). Independent sample t-tests showed that HF patients performed worse than healthy adults on the driving simulation scenario. Finally, partial correlations showed worse attention/executive and motor function were independently associated with poorer driving simulation performance across several indices reflective of driving ability (i.e., centerline crossings, number of collisions, % of time over the speed limit, among others).
The current findings showed that reduced cognitive function was associated with poor simulated driving performance in older adults with HF. If replicated using behind-the-wheel testing, HF patients may be at elevated risk for unsafe driving and routine driving evaluations in this population may be warranted.
认知障碍在老年心力衰竭（HF）患者中很常见，并且与功能独立性降低有关。HF 患者的驾驶能力似乎存在风险，因为过去在其他医学样本中的研究表明，认知功能障碍是驾驶表现的一个重要影响因素。本研究考察了认知功能障碍是否与 HF 患者样本中的驾驶模拟表现下降独立相关。
18 名 HF 患者（67.72；SD=8.56 岁）完成了超声心动图和一个简短的神经心理学测试组合，评估整体认知功能、注意力/执行功能、记忆和运动功能。所有参与者随后完成了 Kent 多维驾驶模拟评估（K-MADS），这是一个具有良好心理测量特性的驾驶模拟器场景。
该样本的平均简易精神状态检查（MMSE）得分为 27.83（SD=2.09）。独立样本 t 检验显示，HF 患者在驾驶模拟场景中的表现逊于健康成年人。最后，偏相关显示，注意力/执行功能和运动功能较差与几项反映驾驶能力的驾驶模拟表现较差指标独立相关（即，中心线交叉次数、碰撞次数、超过限速的时间百分比等）。
目前的研究结果表明，认知功能下降与 HF 老年患者的模拟驾驶表现不佳有关。如果使用路考测试进行复制，HF 患者可能面临不安全驾驶的风险，因此在该人群中进行常规驾驶评估可能是必要的。
