Ott Brian R, Papandonatos George D, Burke Erin M, Erdman Donna, Carr David B, Davis Jennifer D
Department of Neurology Warren Alpert Medical School of Brown University Rhode Island Hospital Providence Rhode Island USA.
Department of Biostatistics Brown University Providence Rhode Island USA.
Alzheimers Dement (N Y). 2021 Mar 3;7(1):e12140. doi: 10.1002/trc2.12140. eCollection 2021.
This clinical trial aimed to determine whether in-car video feedback about unsafe driving events (UDE) to cognitively impaired older drivers and family members leads to a reduction in such driving behaviors.
We randomized 51 cognitively impaired older drivers to receive either (1) a weekly progress report with recommendations and access to their videos, or (2) video monitoring alone without feedback over 3 months.
UDE frequency/1000 miles was reduced by 12% in feedback (rate ratio [RR] = 0.88, 95% confidence interval [CI] = .58-1.34), while remaining constant with only monitoring (RR = 1.01, 95% CI = .68-1.51). UDE severity/1000 miles was reduced by 37% in feedback (RR = 0.63, 95% CI = .31-1.27), but increased by 40% in monitoring (RR = 1.40, 95% CI = .68-2.90). Cognitive impairment moderated intervention effects ( = .03) on UDE frequency.
Results suggest the potential to improve driving safety among mild cognitively impaired older drivers using a behavior modification approach aimed at problem behaviors detected in their natural driving environment.
本临床试验旨在确定向认知障碍老年驾驶员及其家庭成员提供关于不安全驾驶事件（UDE）的车内视频反馈是否会减少此类驾驶行为。
我们将51名认知障碍老年驾驶员随机分为两组，一组（1）每周收到一份带有建议的进度报告并可查看其视频，另一组（2）仅进行视频监控，为期3个月且无反馈。
反馈组每1000英里的UDE频率降低了12%（率比[RR]=0.88，95%置信区间[CI]=0.58 - 1.34），而仅监控组保持不变（RR = 1.01，95% CI = 0.68 - 1.51）。反馈组每1000英里的UDE严重程度降低了37%（RR = 0.63，95% CI = 0.31 - 1.27），但监控组增加了40%（RR = 1.40，95% CI = 0.68 - 2.90）。认知障碍对UDE频率干预效果有调节作用（P = 0.03）。
结果表明，采用行为修正方法针对在自然驾驶环境中检测到的问题行为，有可能提高轻度认知障碍老年驾驶员的驾驶安全性。
