评估不同类型痴呆患者的驾驶能力。
Assessing Fitness to Drive in Patients With Different Types of Dementia.
机构信息
Departments of Clinical and Developmental Neuropsychology, University of Groningen, Groningen.
SWOV Institute for Road Safety Research, The Hague.
出版信息
Alzheimer Dis Assoc Disord. 2018 Jan-Mar;32(1):70-75. doi: 10.1097/WAD.0000000000000221.
Dementia is a risk factor for unsafe driving. Therefore, an assessment strategy has recently been developed for the prediction of fitness to drive in patients with the Alzheimer disease (AD). The aim of this study was to investigate whether this strategy is also predictive of fitness to drive in patients with non-AD dementia, that is, vascular dementia, frontotemporal dementia, and dementia with Lewy bodies. Predictors were derived from 3 types of assessment: clinical interviews, neuropsychological tests, and driving simulator rides. The criterion was the pass-fail outcome of an official on-road driving assessment. About half of the patients with non-AD dementia (n=34) failed the on-road driving assessment. Neuropsychological assessment [area under the curve (AUC)=0.786] was significantly predictive of fitness to drive in patients with non-AD dementia, however, clinical interviews (AUC=0.559) and driving simulator rides (AUC=0.404) were not. The fitness-to-drive assessment strategy with the 3 types of assessment combined (AUC=0.635) was not found to significantly predict fitness to drive in non-AD dementia. Different types of dementia require different measures and assessment strategies.
痴呆是不安全驾驶的一个风险因素。因此，最近为预测阿尔茨海默病（AD）患者的驾驶能力制定了一项评估策略。本研究的目的是调查该策略是否也可预测非 AD 痴呆（即血管性痴呆、额颞叶痴呆和路易体痴呆）患者的驾驶能力。预测因素来自 3 种评估类型：临床访谈、神经心理学测试和驾驶模拟器测试。标准是官方路考评估的通过/失败结果。大约一半的非 AD 痴呆患者（n=34）未能通过路考。神经心理学评估（AUC=0.786）对非 AD 痴呆患者的驾驶能力具有显著预测作用，然而，临床访谈（AUC=0.559）和驾驶模拟器测试（AUC=0.404）则不然。结合 3 种评估类型的驾驶能力评估策略（AUC=0.635）并未发现对非 AD 痴呆患者的驾驶能力有显著预测作用。不同类型的痴呆需要不同的措施和评估策略。
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