Dementia Centre for Research Collaboration, UNSW Sydney.
Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW.
Alzheimer Dis Assoc Disord. 2018 Jan-Mar;32(1):57-61. doi: 10.1097/WAD.0000000000000212.
A diagnosis of dementia implies the eventual need to relinquish driving. This is associated with significant morbidity and anticipating when it will need to occur can be important for planning. Patients, however, vary in the course of their disease. We sought to identify predictors of driving cessation in patients with dementia, including both baseline characteristics and changes in cognition and function over time as indicators of disease trajectory. A total of 779 patients with dementia were recruited from 9 memory clinics around Australia. Patients and their carers reported their driving status and completed measures of dementia severity, cognition, function, neuropsychiatric symptoms, and medication use at regular intervals over a 3-year period. Of the 247 patients still driving at baseline, 147 (59.5%) stopped driving during the study. Variables that predicted driving cessation included older age; female sex; greater dementia severity and cognitive and functional impairments at baseline; and greater increases in dementia severity and cognitive and functional impairments over 3 and 6 month periods. The findings confirm that easily assessable characteristics, including changes over time, predict future driving status. The findings underscore the value of regularly assessing patients with standardized measures to determine disease trajectory and likely prognosis.
痴呆症的诊断意味着最终需要放弃驾驶。这与显著的发病率有关,预测何时需要发生这种情况对于规划很重要。然而,患者的疾病进程存在差异。我们试图确定痴呆症患者驾驶停止的预测因素,包括基线特征以及认知和功能随时间的变化,这些都是疾病轨迹的指标。共有 779 名痴呆症患者从澳大利亚的 9 个记忆诊所招募。患者及其照顾者报告了他们的驾驶状况,并在 3 年内定期完成了痴呆严重程度、认知、功能、神经精神症状和药物使用的测量。在基线时仍在开车的 247 名患者中,有 147 名(59.5%)在研究期间停止了驾驶。预测驾驶停止的变量包括年龄较大;女性;基线时痴呆严重程度和认知及功能障碍程度较高;以及在 3 个月和 6 个月期间痴呆严重程度和认知及功能障碍程度的增加幅度更大。这些发现证实了容易评估的特征,包括随时间的变化,可预测未来的驾驶状况。这些发现强调了定期使用标准化测量方法评估患者以确定疾病轨迹和可能的预后的价值。