Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, Bron, France.
USR 3413 CNRS/Université Bordeaux Segalen, Bordeaux cedex, France.
Int J Geriatr Psychiatry. 2017 Oct;32(10):1049-1058. doi: 10.1002/gps.4565. Epub 2016 Aug 23.
Aging entails deterioration in sensory, physical, and cognitive functions, raising doubt in the driving capacity of older drivers, especially when the deficits are severe, as in dementia. Many older drivers, especially women, adapt their driving habits in order to compensate for these deficits and eventually stop driving. The present prospective study assessed driving cessation in men and women throughout the dementia process, including a 2-year pre-dementia phase.
The study was based on a three-city cohort of subjects who were aged 65 years and older in 2000 and followed for more than 10 years. Active dementia detection was conducted at each follow-up. The probability of driving cessation was assessed in men and women during the 2-year pre-dementia phase and until 5 years after diagnosis.
In the 2-year pre-dementia phase, both men and women ceased driving earlier than drivers with no central nervous system pathology (p < 0,001), and women ceased driving earlier than men. A total of 45% of men and 74% of women had already ceased driving at dementia diagnosis. In contrast, the probability of cessation within 3 years after diagnosis was similar between men and women.
The study showed that, in this French urban population, few demented drivers, especially women, were still driving after diagnosis. Those who continued to drive 3 years after the diagnosis all had Alzheimer-type dementia. There is certainly a need for physicians to help these drivers to adapt their driving activity to their deficits and to prepare them to stop driving. Copyright © 2016 John Wiley & Sons, Ltd.
衰老会导致感觉、身体和认知功能的退化,这使人们对老年驾驶员的驾驶能力产生了怀疑,尤其是在认知功能障碍(如痴呆)等严重缺陷的情况下。为了弥补这些缺陷,许多老年驾驶员(尤其是女性)会调整他们的驾驶习惯,最终停止驾驶。本前瞻性研究评估了男性和女性在整个痴呆过程中的驾驶停止情况,包括 2 年的痴呆前期。
该研究基于一个由三个城市组成的队列,其中受试者在 2000 年时年龄在 65 岁及以上,并随访了 10 年以上。在每次随访时都进行主动痴呆检测。评估了男性和女性在痴呆前期 2 年期间以及诊断后 5 年内的驾驶停止概率。
在痴呆前期 2 年期间,男性和女性停止驾驶的时间均早于无中枢神经系统疾病的驾驶员(p<0.001),且女性停止驾驶的时间早于男性。在诊断为痴呆时,男性中有 45%,女性中有 74%的人已经停止驾驶。相比之下,男性和女性在诊断后 3 年内停止驾驶的概率相似。
该研究表明,在法国城市人群中,在诊断为痴呆后,很少有痴呆驾驶员(尤其是女性)仍在驾驶。那些在诊断后 3 年内仍继续驾驶的人都患有阿尔茨海默病型痴呆。医生确实需要帮助这些驾驶员调整其驾驶活动以适应他们的缺陷,并为他们停止驾驶做好准备。