Alosco Michael L, Penn Marc S, Spitznagel Mary Beth, Cleveland Mary Jo, Ott Brian R, Gunstad John
Department of Psychological Sciences, Kent State University, Kent, OH 44242, USA.
Summa Cardiovascular Institute, Akron, OH 44309, USA.
Geriatrics (Basel). 2015 Dec 23;1(1):2. doi: 10.3390/geriatrics1010002.
Heart failure (HF) patients commit many errors on driving simulation tasks and cognitive dysfunction appears to be one important contributor to impaired driving in HF. Clinical modifiers of cognition may also play a key role. In particular, depression is common in HF patients, linked with cognitive dysfunction, and contributes to reduced driving fitness in non-HF samples. However, the associations among depressive symptoms, cognition, and driving in HF are unclear. Eighteen HF patients completed a validated simulated driving scenario, the Beck Depression Inventory-II (BDI-II), and a cognitive test battery. Partial correlations controlling for demographic and medical confounds showed higher BDI-II score correlated with greater number of collisions, centerline crossings, and % time out of lane. Increased depressive symptoms correlated with lower attention/executive function, and reduced performance in this domain was associated with a greater number of collisions, centerline crossing, and % time out of lane. Depressive symptoms may be related to poorer driving performance in HF, perhaps through association with cognitive dysfunction. However, larger studies with on-road testing are needed to replicate our preliminary findings before recommendations for clinical practice can be made.
心力衰竭（HF）患者在驾驶模拟任务中会犯很多错误，认知功能障碍似乎是导致HF患者驾驶能力受损的一个重要因素。认知的临床调节因素也可能起关键作用。特别是，抑郁症在HF患者中很常见，与认知功能障碍有关，并导致非HF样本的驾驶适应性降低。然而，HF患者中抑郁症状、认知和驾驶之间的关联尚不清楚。18名HF患者完成了一个经过验证的模拟驾驶场景、贝克抑郁量表第二版（BDI-II）和一组认知测试。控制人口统计学和医学混杂因素的偏相关分析显示，BDI-II得分越高，碰撞次数、越中心线次数和偏离车道时间百分比越高。抑郁症状增加与注意力/执行功能降低相关，该领域表现的降低与更多的碰撞次数、越中心线次数和偏离车道时间百分比相关。抑郁症状可能与HF患者较差的驾驶性能有关，可能是通过与认知功能障碍的关联。然而，在能够提出临床实践建议之前，需要进行更大规模的道路测试研究来重复我们的初步发现。
