Fox G K, Bowden S C, Bashford G M, Smith D S
Rehabilitation Studies Unit, University of Sydney, Royal Rehabilitation Centre Sydney, Ryde, New South Wales, Australia.
J Am Geriatr Soc. 1997 Aug;45(8):949-53. doi: 10.1111/j.1532-5415.1997.tb02965.x.
To examine driving competence in a group of drivers diagnosed with probable Alzheimer's Disease (AD) in terms of a standardized open road evaluation and expert judgments. To examine the validity of a standardized medical examination, including administration of the Mini-Mental Status Exam (MMSE), and a standardized neuropsychological assessment as predictors of open road driving performance.
A prospective investigation with consecutively referred subjects.
Coorabel Driver Assessment Centre, Royal Rehabilitation Centre Sydney, Australia.
Nineteen subjects with a diagnosis of probable AD.
A standardized clinical medical examination, a standardized neuropsychological assessment, and a standardized open road driving evaluation. The driving evaluation provided a correct driving actions score. The outcome measure was the expert judges' rating of overall driving competence, which was termed the final on-road result.
Seven subjects passed the on-road driving evaluation, and 12 failed. MMSE was found to be a significant predictor of final on-road result. The physician's prediction, the neuropsychology test scores, and the neuropsychologist's prediction were not found to be significantly associated with the final on-road result. The on-road driving evaluation was a reliable test.
Inasmuch as all subjects except one were still driving and all wished to continue to drive, it is important to note that 63.2% of subjects failed the on-road evaluation. Conversely, 36.8% were judged safe to drive, suggesting that AD diagnosis alone may be insufficient criteria for cessation of driving. A standardized road test may be the only appropriate means of determining driving competence in people diagnosed with AD.
通过标准化的开放道路评估和专家判断，研究一组被诊断为可能患有阿尔茨海默病（AD）的驾驶员的驾驶能力。研究标准化医学检查（包括简易精神状态检查表（MMSE）的实施）和标准化神经心理学评估作为开放道路驾驶表现预测指标的有效性。
对连续转诊的受试者进行前瞻性调查。
澳大利亚悉尼皇家康复中心库拉贝尔驾驶员评估中心。
19名被诊断为可能患有AD的受试者。
标准化临床医疗检查、标准化神经心理学评估和标准化开放道路驾驶评估。驾驶评估给出正确驾驶行为得分。结果指标是专家对整体驾驶能力的评分，即最终道路测试结果。
7名受试者通过道路驾驶评估，12名未通过。发现MMSE是最终道路测试结果的重要预测指标。未发现医生的预测、神经心理学测试分数和神经心理学家的预测与最终道路测试结果有显著关联。道路驾驶评估是一项可靠的测试。
由于除一名受试者外所有受试者仍在驾驶且都希望继续驾驶，需要注意的是63.2%的受试者道路测试未通过。相反，36.8%的受试者被判定驾驶安全，这表明仅AD诊断可能不足以作为停止驾驶的标准。标准化道路测试可能是确定AD患者驾驶能力的唯一合适方法。
