Falkenstein Michael, Karthaus Melanie, Brüne-Cohrs Ute
Institute for Work Learning and Aging (ALA), Hiltroper Landwehr 136, 44805 Bochum, Germany.
Leibniz Institute for Working Environment and Human Factors (IfADo), 44139 Dortmund, Germany.
Geriatrics (Basel). 2020 Oct 19;5(4):80. doi: 10.3390/geriatrics5040080.
Due to demographic changes, the number of older drivers is steadily increasing. Mobility is highly relevant for leading an independent life in the elderly. It largely depends on car driving, which is a complex task requiring a multitude of cognitive and motor skills vulnerable to age- related functional deterioration. The almost inevitable effects of senescence may be potentiated by age-related diseases, such as stroke or diabetes mellitus. Respective pharmacological treatment may cause side effects, additionally affecting driving safety. The present article reviews the impact of age-related diseases and drug treatment of these conditions on driving fitness in elderly drivers. In essence, we focus on diseases of the visual and auditory systems, diseases of the central nervous system (i.e., stroke, depression, dementia and mild cognitive disorder, and Parkinson's disease), sleep disorders, as well as cardiovascular diseases, diabetes mellitus, musculoskeletal disorders, and frailty. We will outline the role of functional tests and the assessment of driving behavior (by a driving simulator or in real traffic), as well as the clinical interview including questions about frequency of (near) accidents, etc. in the evaluation of driving fitness of the elderly. We also address the impact of polypharmacy on driving fitness and end up with recommendations for physicians caring for older patients.
由于人口结构的变化，老年驾驶员的数量在稳步增加。出行能力对于老年人独立生活至关重要。这在很大程度上依赖于汽车驾驶，而汽车驾驶是一项复杂的任务，需要多种认知和运动技能，这些技能容易受到与年龄相关的功能衰退的影响。衰老几乎不可避免的影响可能会因中风或糖尿病等与年龄相关的疾病而加剧。相应的药物治疗可能会产生副作用，进而影响驾驶安全。本文综述了与年龄相关的疾病及其药物治疗对老年驾驶员驾驶适宜性的影响。实质上，我们关注视觉和听觉系统疾病、中枢神经系统疾病（即中风、抑郁症、痴呆和轻度认知障碍以及帕金森病）、睡眠障碍，以及心血管疾病、糖尿病、肌肉骨骼疾病和身体虚弱。我们将概述功能测试的作用以及对驾驶行为的评估（通过驾驶模拟器或在实际交通中），以及在评估老年人驾驶适宜性时的临床访谈，包括关于（近期）事故频率等问题。我们还将探讨多重用药对驾驶适宜性的影响，并最终为照顾老年患者的医生提出建议。
