24 年内停止驾驶：痴呆严重程度与脑脊液生物标志物。
Driving cessation over a 24-year period: Dementia severity and cerebrospinal fluid biomarkers.
机构信息
Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
出版信息
Alzheimers Dement. 2018 May;14(5):610-616. doi: 10.1016/j.jalz.2017.11.011. Epub 2018 Jan 10.
INTRODUCTION
With 36 million older adult U.S. drivers, safety is a critical concern, particularly among those with dementia. It is unclear at what stage of Alzheimer's disease (AD) older adults stop driving and whether preclinical AD affects driving cessation.
METHODS
Time to driving cessation was examined based on Clinical Dementia Rating (CDR) and AD cerebrospinal fluid biomarkers. 1795 older adults followed up to 24 years received CDR ratings. A subset (591) had cerebrospinal fluid biomarker measurements and was followed up to 17 years. Differences in CDR and biomarker groups as predictors of time to driving cessation were analyzed using Kaplan-Meier curves and Cox proportional models.
RESULTS
Higher CDR scores and more abnormal biomarker measurements predicted a shorter time to driving cessation.
DISCUSSION
Higher levels of AD biomarkers, including among individuals with preclinical AD, lead to earlier driving cessation. Negative functional outcomes of preclinical AD show a nonbenign phase of the disease.
简介
美国有 3600 万老年驾驶员，安全是一个关键问题，特别是对于痴呆症患者而言。目前尚不清楚老年人在阿尔茨海默病（AD）的哪个阶段停止驾驶，以及临床前 AD 是否会影响驾驶停止。
方法
根据临床痴呆评定量表（CDR）和 AD 脑脊液生物标志物来检查停止驾驶的时间。1795 名接受随访长达 24 年的老年人接受了 CDR 评分。其中一部分（591 名）进行了脑脊液生物标志物测量，并随访了长达 17 年。使用 Kaplan-Meier 曲线和 Cox 比例模型分析 CDR 和生物标志物组作为预测停止驾驶时间的差异。
结果
更高的 CDR 评分和更多异常的生物标志物测量预示着停止驾驶的时间更短。
讨论
更高水平的 AD 生物标志物，包括在临床前 AD 患者中，导致更早地停止驾驶。临床前 AD 的负面功能结果显示出疾病的非良性阶段。
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