Keefer Anne, Dehler Maren, Kolominsky-Rabas Peter L, Gräßel Elmar, Saam Nicole J, Drasch Katrin
Friedrich-Alexander-Universität Erlangen-Nürnberg, Interdisziplinäres Zentrum für Health Technology Assessment (HTA) und Public Health (IZPH), Erlangen, Deutschland.
Friedrich-Alexander-Universität Erlangen-Nürnberg, Interdisziplinäres Zentrum für Health Technology Assessment (HTA) und Public Health (IZPH), Erlangen, Deutschland; Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Soziologie, Lehrstuhl für Methoden der empirischen Sozialforschung, Erlangen, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2025 Jun;195:85-92. doi: 10.1016/j.zefq.2025.03.007. Epub 2025 Apr 24.
In Germany, the number of drivers aged 65 and over is increasing. However, the risk of physical and cognitive impairments that affect the ability to drive rises with increasing age. Those who give up driving are often confronted with constraints of their autonomy and quality of life. The study aims to identify socio-demographic and health-related determinants of non-driving in people with mild cognitive impairment (MCI) or mild to moderate dementia.
The data basis is the baseline survey of the multicentre, prospective registry study "Digital Dementia Register Bavaria - digiDEM Bayern". The categorisation of people with MCI and people with mild to moderate dementia is based on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). A diagnosis may exist but is not a requirement. In addition to descriptive analyses, a binary logistic regression was conducted, and average marginal effects (AMEs) were interpreted.
Out of 1,005 participants with a valid driving license, 410 people (40.8%) participate in road traffic as drivers. The probability that people use a car increases with age, peaking at around 70 years and then decreasing. Being female, living in an urban environment, and having a care degree are associated with a lower probability of driving a car, whilst no existing MCI or dementia diagnosis, higher cognitive abilities, and better independence in everyday life (ADLs) are associated with a higher probability.
The decision to continue driving a car depends on several factors, including age, sex, place of residence, and cognitive and physical abilities. Regular assessments of the fitness to drive should take place, and alternative mobility options should be offered to ensure road safety and maintain the quality of life of people with cognitive impairments for as long as possible. The professional and private environment of people with cognitive impairments plays a crucial role in dealing appropriately with these issues.
在德国，65岁及以上的驾驶员数量正在增加。然而，影响驾驶能力的身体和认知障碍风险会随着年龄的增长而上升。那些放弃驾驶的人往往面临自主性和生活质量受限的问题。本研究旨在确定轻度认知障碍（MCI）或轻度至中度痴呆患者不驾驶的社会人口学和健康相关决定因素。
数据基础是多中心前瞻性登记研究“巴伐利亚数字痴呆登记册 - digiDEM Bayern”的基线调查。MCI患者和轻度至中度痴呆患者的分类基于简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）。可能存在诊断，但并非必需条件。除描述性分析外，还进行了二元逻辑回归，并解释了平均边际效应（AMEs）。
在1005名持有有效驾驶执照的参与者中，有410人（40.8%）作为驾驶员参与道路交通。人们使用汽车的概率随年龄增长而增加，在70岁左右达到峰值，然后下降。女性、生活在城市环境以及有护理需求与较低的驾驶汽车概率相关，而不存在MCI或痴呆诊断、较高的认知能力以及在日常生活活动（ADL）方面更好的独立性与较高的驾驶概率相关。
继续驾驶汽车的决定取决于几个因素，包括年龄、性别、居住地点以及认知和身体能力。应定期进行驾驶适宜性评估，并提供替代出行选择，以确保道路安全，并尽可能长时间维持认知障碍患者的生活质量。认知障碍患者的专业和私人环境在妥善处理这些问题方面起着至关重要的作用。
