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老年人的驾驶与功能受限发生率:一项基于人群的前瞻性研究。

Driving and Incidence of Functional Limitation in Older People: A Prospective Population-Based Study.

作者信息

Shimada Hiroyuki, Makizako Hyuma, Tsutsumimoto Kota, Hotta Ryo, Nakakubo Sho, Doi Takehiko

机构信息

Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.

出版信息

Gerontology. 2016;62(6):636-643. doi: 10.1159/000448036. Epub 2016 Aug 18.

Abstract

BACKGROUND

Many studies have examined the negative social and health consequences of driving cessation in later life. However, whether the transition to driving cessation results in the incidence of functional limitation in older people remains unclear.

OBJECTIVE

The aim of this study was to examine whether driving cessation was associated with the incidence of functional limitation in older Japanese individuals.

METHODS

The study included 3,556 participants (mean age: 71.5 ± 5.3 years, 50.2% women) enrolled in the 'Obu Study of Health Promotion for the Elderly' cohort study between August 2011 and February 2012. The participants were classified into three groups according to their driving status: driving, driving cessation, and nondriving. We assessed new incidence of functional limitation over a 24- month period and examined several confounding factors.

RESULTS

The incidence rates for functional limitation in the driving, driving cessation, and nondriving groups were 0.9, 10.8, and 5.6%, respectively (p < 0.001). The fully adjusted Cox proportional hazard model showed that hazard ratios (HRs) for functional limitation in nondrivers [HR: 2.37, 95% confidence interval (CI): 1.27-4.44] and those who had ceased driving (HR: 7.80, 95% CI: 2.61-23.36) were significantly higher relative to those observed in current drivers.

CONCLUSION

Driving cessation exerted a strong impact on the risk of functional limitation. Further study is required to determine appropriate intervention strategies to help older people to maintain the abilities required for safe driving and delay the functional limitation associated with driving cessation.

摘要

背景

许多研究探讨了晚年停止驾车带来的负面社会和健康后果。然而,向停止驾车的转变是否会导致老年人出现功能受限的情况仍不明确。

目的

本研究旨在探讨停止驾车是否与日本老年人功能受限的发生率相关。

方法

该研究纳入了2011年8月至2012年2月期间参加“大府老年人健康促进研究”队列研究的3556名参与者(平均年龄:71.5±5.3岁,女性占50.2%)。参与者根据其驾车状态分为三组:驾车、停止驾车和不驾车。我们评估了24个月期间功能受限的新发病例,并考察了几个混杂因素。

结果

驾车组、停止驾车组和不驾车组功能受限的发生率分别为0.9%、10.8%和5.6%(p<0.001)。完全调整后的Cox比例风险模型显示,相对于当前驾车者,不驾车者(风险比:2.37,95%置信区间:1.27 - 4.44)和停止驾车者(风险比:7.80,95%置信区间:2.61 - 23.36)功能受限的风险比显著更高。

结论

停止驾车对功能受限风险有强烈影响。需要进一步研究以确定合适的干预策略,帮助老年人维持安全驾驶所需的能力,并延缓与停止驾车相关的功能受限。

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