Mielenz Thelma J, Durbin Laura L, Cisewski Jodi A, Guralnik Jack M, Li Guohua
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY, 10032, USA.
Center for Injury Epdemiology and Prevention, Columbia University Medical Center, New York, NY, USA.
Inj Epidemiol. 2017 Dec;4(1):14. doi: 10.1186/s40621-017-0110-2. Epub 2017 May 8.
Improving physical functioning may be a future intervention to keep older adults driving safely longer as it can help maintain both physical and cognitive health longer. This systematic review assesses the evidence on the association between three physical functioning measures: the Short Physical Performance Battery, the Timed Up-and-Go test, and the Rapid Pace Walk with driving outcomes in older adults.
Older adult studies published between 1994 and 2015 that included the Short Physical Performance Battery, the Timed Up-and-Go test, or the Rapid Pace Walk as a measure of physical functioning and included a driving-related outcome were identified through a comprehensive search and reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Thirteen studies involving 5,313 older adults met the inclusion criteria. Lower Short Physical Performance Battery scores were associated with reduced driving exposure and increased cessation in all three Short Physical Performance Battery studies. The Timed Up-and-Go test was not associated with the driving outcomes (cessation, ability, crashes, and citations) in either of the two Timed Up-and-Go studies. Poorer Rapid Pace Walk scores were associated with decreased driving ability in two studies and with reduced driving exposure in one study, but not associated with driving ability, crashes, citations, or cessation in the remaining five Rapid Pace Walk studies.
The Timed Up-and-Go test measure appears not to be a useful measure of physical functioning for the driving outcomes included here. The Rapid Pace Walk may be useful in studies of driving ability and exposure. More driving studies should consider using the Short Physical Performance Battery to determine if it may be useful as a risk factor assessment for identifying individuals at risk of certain driving outcomes.
改善身体机能可能是未来一种能让老年人更长时间安全驾驶的干预措施，因为它有助于更长时间地维持身体和认知健康。本系统评价评估了三项身体机能测量指标之间关联的证据：简短体能测试电池组、定时起立行走测试以及快速步行与老年人驾驶结果之间的关联。
通过全面检索，确定了1994年至2015年间发表的老年研究，这些研究将简短体能测试电池组、定时起立行走测试或快速步行作为身体机能的一项测量指标，并包含与驾驶相关的结果，且按照系统评价和Meta分析的首选报告项目指南进行了审查。
13项涉及5313名老年人的研究符合纳入标准。在所有三项简短体能测试电池组研究中，较低的简短体能测试电池组得分与驾驶暴露减少和驾驶停止增加有关。在两项定时起立行走研究中，定时起立行走测试与驾驶结果（停止、能力、撞车和罚单）均无关联。在两项研究中，较差的快速步行得分与驾驶能力下降有关，在一项研究中与驾驶暴露减少有关，但在其余五项快速步行研究中与驾驶能力、撞车、罚单或驾驶停止均无关联。
定时起立行走测试指标似乎并非此处所纳入驾驶结果的身体机能有用测量指标。快速步行可能在驾驶能力和驾驶暴露研究中有用。更多驾驶研究应考虑使用简短体能测试电池组，以确定其是否可作为识别有特定驾驶结果风险个体的风险因素评估指标。
