College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.
Australas J Ageing. 2022 Jun;41(2):282-292. doi: 10.1111/ajag.13024. Epub 2021 Dec 23.
To describe current practice and outcomes relating to fitness to drive for people with mild cognitive impairment (MCI) attending a specialist driving clinic.
Retrospective medical record audit from a driving fitness assessment clinic at a tertiary medical centre, South Australia, from 2015 to 2019.
Of 100 notes audited, n = 40 had a documented diagnosis of MCI and n = 60 had subjective cognitive concerns characteristic of MCI. Participants mean age was 80.0 years (SD 6.7), and mean Mini-Mental State Examination score was 26.1 (SD 2.1). Medical practitioners completed a comprehensive initial assessment relating to medical fitness to drive, considering scores from a cognitive assessment battery and non-cognitive factors (driving history, current driving needs, vision, physical abilities and collateral from family). After the initial assessment, most participants (84%) were referred for a practical on-road assessment, before receiving a final driving recommendation. Over half of participants continued driving (51%), most with conditions, while 35% ceased driving. Outcomes for the remaining 14% are unknown as we were unable to determine whether the practical assessment (11%) or lessons (3%) were completed.
Driving outcomes for people with MCI with questionable driving capabilities are variable, with both cognitive and non-cognitive factors important in guiding medical fitness to drive recommendations. There is a need for more driving clinics to provide in-depth assessment for people with MCI who demonstrate uncertain driving capabilities and improved support for decision-making in other non-driving specialist settings.
描述在专门驾驶诊所就诊的轻度认知障碍（MCI）患者的驾驶适能现状和结果。
对 2015 年至 2019 年期间在南澳大利亚州一家三级医疗中心的驾驶适能评估诊所进行回顾性病历审核。
在所审核的 100 份病历中，n=40 份病历记录了 MCI 的诊断，n=60 份病历记录了有 MCI 特征的主观认知问题。参与者的平均年龄为 80.0 岁（标准差 6.7），平均简易精神状态检查评分为 26.1（标准差 2.1）。医疗从业者完成了与医学驾驶适能相关的综合初始评估，评估考虑了认知评估工具包和非认知因素（驾驶史、当前驾驶需求、视力、身体能力以及来自家庭的证明）的分数。初始评估后，大多数参与者（84%）被转介进行实际的路考评估，然后再收到最终的驾驶建议。超过一半的参与者继续驾驶（51%），大多数有条件，而 35%的参与者停止驾驶。其余 14%的参与者的结果未知，因为我们无法确定是否完成了实际评估（11%）或课程（3%）。
有可疑驾驶能力的 MCI 患者的驾驶结果是可变的，认知和非认知因素对指导医学驾驶适能建议都很重要。需要更多的驾驶诊所为表现出不确定驾驶能力的 MCI 患者提供深入评估，并为其他非驾驶专科环境中的决策制定提供更好的支持。
