长期驾驶技能训练对轻度认知障碍老年人安全驾驶的影响。
Long-Term Effects of Driving Skill Training on Safe Driving in Older Adults with Mild Cognitive Impairment.
机构信息
Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
出版信息
J Am Geriatr Soc. 2021 Feb;69(2):506-511. doi: 10.1111/jgs.16888. Epub 2020 Nov 12.
BACKGROUND/OBJECTIVE: A driving skill program had positive effects on safe driving performance in older adults, even those with cognitive impairment. However, the long-term effects of the program remain unclear. The purpose of this study was to examine whether such effects were maintained at 1 year after the intervention in older adults with cognitive impairment who had low driving skills.
DESIGN
A secondary analysis of single-blind randomized controlled trial.
SETTING
Community setting in Japan.
PARTICIPANTS
Community-living adults, aged 65 years or older (n = 159), with mild cognitive impairment (MCI).
INTERVENTION
The intervention group completed 10 classroom sessions of 1 hour and 10 on-road sessions of 50 minutes, focusing on common problem areas of older drivers. The control group received one education class about safety driving.
MEASUREMENTS
On-road driving performance was assessed by certified driving school instructors in a driving school at preintervention and postintervention, and 1-year follow-up.
RESULTS
A total of 159 community-living older drivers participated in this study and were randomized to either an intervention group (n = 71) or a control group (n = 88). One year after the intervention, 104 of 159 community-living older drivers completed the follow-up assessment (intervention group, n = 58). Regarding the safe driving skill score, there was a significant group × time interaction (P < .01), indicating benefits of the intervention over time. Although the intervention group showed a significant decline in the safe driving skill score from postintervention (score = 38.9 ± 46.1) to 1-year follow-up (score = -0.3 ± 55.2), there was a significant difference between the groups at 1-year follow-up (control group score = -148.5 ± 46.4) (P < .05), and between preintervention (score = -132.0 ± 54.6) and 1-year follow-up in the intervention group (P < .05).
CONCLUSION
The driving skill program maintained safe driving performance that had been improved by the intervention in older adults with MCI.
背景/目的：驾驶技能计划对老年人的安全驾驶表现有积极影响，即使是认知障碍者也是如此。然而，该计划的长期效果尚不清楚。本研究的目的是在认知障碍且驾驶技能较低的老年人中，检查干预 1 年后是否仍能保持这种效果。
设计
单盲随机对照试验的二次分析。
地点
日本社区。
参与者
年龄在 65 岁或以上的社区居住成年人（n=159），患有轻度认知障碍（MCI）。
干预
干预组完成了 10 节 1 小时的课堂课程和 10 节 50 分钟的道路课程，重点关注老年驾驶员常见的问题区域。对照组接受了一节关于安全驾驶的教育课程。
测量
在干预前、干预后和 1 年随访时，由认证驾驶学校的教练在驾驶学校评估道路驾驶表现。
结果
共有 159 名社区居住的老年驾驶员参加了这项研究，并被随机分配到干预组（n=71）或对照组（n=88）。干预 1 年后，159 名社区居住的老年驾驶员中有 104 名完成了随访评估（干预组，n=58）。关于安全驾驶技能评分，存在显著的组×时间交互作用（P<0.01），表明随着时间的推移，干预措施有获益。尽管干预组在干预后（评分=38.9±46.1）到 1 年随访（评分=-0.3±55.2）期间的安全驾驶技能评分显著下降，但两组在 1 年随访时仍存在显著差异（对照组评分=-148.5±46.4）（P<0.05），并且与干预前（评分=-132.0±54.6）相比，干预组在 1 年随访时的评分也有显著差异（P<0.05）。
结论
驾驶技能计划维持了认知障碍老年人因干预而改善的安全驾驶表现。
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