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有和无轻度认知障碍的老年驾驶员的驾驶暴露、模式和安全关键事件:自然驾驶研究的结果。

Driving exposure, patterns and safety critical events for older drivers with and without mild cognitive impairment: Findings from a naturalistic driving study.

机构信息

Western Australian Centre for Road Safety Research, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.

Western Australian Centre for Road Safety Research, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.

出版信息

Accid Anal Prev. 2021 Mar;151:105965. doi: 10.1016/j.aap.2020.105965. Epub 2021 Jan 8.

Abstract

OBJECTIVE

The aim of the study is to compare driving exposure, patterns and factors associated with safety critical events between drivers with MCI and a comparison group without cognitive impairment.

DESIGN, SETTING, PARTICIPANTS: Naturalistic driving data using an in-vehicle monitoring device were collected from 36 older drivers with MCI and 35 older drivers without cognitive impairment over a two-week period in Western Australia.

MEASUREMENTS

Naturalistic driving exposure, patterns (eg. night-time trips, peak-hour trips) and safety critical events (harsh acceleration, harsh braking and harsh cornering).

RESULTS

Drivers with MCI had a lower number of safety critical events (mean = 7.20, SD = 11.44) compared to drivers without cognitive impairment (mean = 10.89, SD = 23.30) however, this was not statistically significantly. There were also no statistically significant differences between drivers with and without MCI for measures of driving exposure or any of the driving patterns including weekday trips, night-time trips and trips on highways/freeways. The results of the multivariable modelling found only binocular contrast sensitivity was associated with the rate of safety critical events. For every increase of 0.1 log units in contrast sensitivity (better contrast sensitivity) the rate of safety critical events significantly decreased by 30 % (IRR = 0.70, 95 % CI = 0.50-0.98, p = 0.04).

CONCLUSION

Drivers with MCI were found to have similar driving exposure and patterns compared to older drivers without cognitive impairment, however drivers with better contrast sensitivity experienced fewer safety critical events. Future research should consider a longitudinal study design with an extended driving monitoring period and a larger sample with a clinical diagnosis of MCI to assess changes in cognition and its impact on driving.

摘要

目的

本研究旨在比较轻度认知障碍(MCI)患者与无认知障碍的对照组驾驶员在驾驶暴露、模式和与安全相关的事件方面的差异。

设计、地点和参与者:在澳大利亚西部,使用车内监测设备收集了 36 名患有 MCI 的老年驾驶员和 35 名无认知障碍的老年驾驶员在两周内的自然驾驶数据。

测量

自然驾驶暴露、模式(例如夜间出行、高峰时段出行)和安全相关事件(急加速、急刹车和急转弯)。

结果

与无认知障碍的驾驶员相比(平均值=10.89,标准差=23.30),患有 MCI 的驾驶员发生安全相关事件的次数较少(平均值=7.20,标准差=11.44),但差异无统计学意义。在驾驶暴露或任何驾驶模式(包括工作日出行、夜间出行和高速公路出行)方面,患有 MCI 和无认知障碍的驾驶员之间也没有统计学上的显著差异。多变量模型的结果发现,只有双眼对比敏感度与安全相关事件的发生率相关。对比敏感度每增加 0.1 个对数单位(对比敏感度提高),安全相关事件的发生率显著降低 30%(IRR=0.70,95%CI=0.50-0.98,p=0.04)。

结论

与无认知障碍的老年驾驶员相比,患有 MCI 的驾驶员的驾驶暴露和模式相似,但对比敏感度较好的驾驶员发生安全相关事件的次数较少。未来的研究应考虑采用纵向研究设计,延长驾驶监测时间,并增加患有 MCI 的临床诊断样本量,以评估认知变化及其对驾驶的影响。

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