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驾驶与痴呆症:家庭医疗中解决驾驶安全问题的有效方法。

Driving and dementia: Efficient approach to driving safety concerns in family practice.

作者信息

Lee Linda, Molnar Frank

机构信息

Family physician at the Center for Family Medicine Family Health Team in Kitchener, Ont, Schlegel Research Chair in Primary Care for Elders at the Schlegel-UW Research Institute for Aging, and Associate Clinical Professor in the Department of Family Medicine at McMaster University in Hamilton, Ont.

Geriatrician in Ottawa, Ont, Medical Director of the Regional Geriatric Program of Eastern Ontario, and Associate Professor in the Department of Medicine at the University of Ottawa.

出版信息

Can Fam Physician. 2017 Jan;63(1):27-31.

PMID:28115437
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5257216/
Abstract

OBJECTIVE

To provide primary care physicians with an approach to driving safety concerns when older persons present with memory difficulties.

SOURCES OF INFORMATION

The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Primary Care Collaborative Memory Clinic.

MAIN MESSAGE

One of the most challenging aspects of dementia care is the assessment of driving safety. Drivers with dementia are at higher risk of motor vehicle collisions, yet many drivers with mild dementia might be safely able to continue driving for several years. Because safe driving is dependent on multiple cognitive and functional skills, clinicians should carefully consider many factors when determining if cognitive concerns affect driving safety. Specific findings on corroborated history and office-based cognitive testing might aid in the physician's decisions to refer for comprehensive on-road driving evaluation and whether to notify transportation authorities in accordance with provincial reporting requirements. Sensitive communication and a person-centred approach are essential.

CONCLUSION

Primary care physicians must consider many factors when determining if cognitive concerns might affect driving safety in older drivers.

摘要

目的

为基层医疗医生提供一种方法,以便在老年人出现记忆困难时处理驾驶安全问题。

信息来源

该方法基于家庭医学中心基层医疗协作记忆诊所制定的一项经认可的记忆诊所培训计划。

主要信息

痴呆症护理最具挑战性的方面之一是对驾驶安全的评估。患有痴呆症的司机发生机动车碰撞的风险更高,但许多轻度痴呆症患者可能在数年内仍能安全驾驶。由于安全驾驶取决于多种认知和功能技能,临床医生在确定认知问题是否影响驾驶安全时应仔细考虑诸多因素。经证实的病史和基于办公室的认知测试的具体结果可能有助于医生决定是否转诊进行全面的上路驾驶评估,以及是否根据省级报告要求通知交通管理部门。敏感的沟通和以人为本的方法至关重要。

结论

基层医疗医生在确定认知问题是否可能影响老年司机的驾驶安全时必须考虑诸多因素。

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本文引用的文献

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Cognitive Tests and Determining Fitness to Drive in Dementia: A Systematic Review.认知测试与痴呆患者驾驶适宜性的判定:一项系统综述
J Am Geriatr Soc. 2016 Sep;64(9):1904-17. doi: 10.1111/jgs.14180. Epub 2016 Jun 2.
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Driving Cessation and Health Outcomes in Older Adults.老年人停止驾驶与健康结果
J Am Geriatr Soc. 2016 Feb;64(2):332-41. doi: 10.1111/jgs.13931. Epub 2016 Jan 19.
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Person-Centered Care: A Definition and Essential Elements.以患者为中心的护理:定义与基本要素
J Am Geriatr Soc. 2016 Jan;64(1):15-8. doi: 10.1111/jgs.13866. Epub 2015 Dec 2.
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"Are you still driving?" Metasynthesis of patient preferences for communication with health care providers.“你还在开车吗?”患者对与医疗服务提供者沟通的偏好的元综合研究。
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Clinical Utility of the Trail-Making Test as a Predictor of Driving Performance in Older Adults.连线测验作为老年人驾驶性能预测指标的临床效用
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Validity of the mini-mental state examination and the montreal cognitive assessment in the prediction of driving test outcome.简易精神状态检查表和蒙特利尔认知评估对驾驶考试结果预测的有效性。
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Comparing caregiver and clinician predictions of fitness to drive in people with Alzheimer's disease.比较照顾者与临床医生对阿尔茨海默病患者驾驶适宜性的预测。
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Predicting on-road driving performance and safety in healthy older adults.预测健康老年人的道路驾驶性能和安全性。
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