Marottoli R A, Richardson E D, Stowe M H, Miller E G, Brass L M, Cooney L M, Tinetti M E
VA Connecticut Healthcare System, West Haven 06516, USA.
J Am Geriatr Soc. 1998 May;46(5):562-8. doi: 10.1111/j.1532-5415.1998.tb01071.x.
The purposes of this study were (1) to develop a battery of tests that assessed a wide range of functional abilities relevant to driving yet could be performed in a clinician's office and (2) to determine which of these tests were most closely associated with self-reported adverse driving events.
A cohort study.
An urban community.
Participants were drawn from the Project Safety cohort, a probability sample of noninstitutionalized older persons in New Haven, Connecticut, initiated in 1989. The current study included surviving, active drivers in the cohort (N=125).
The test battery assessed visual, cognitive, and physical abilities potentially relevant to driving, and was administered in participants' homes by trained interviewers between October 1994 and July 1995. Outcome measures included the self-report of a crash, moving violation, or being stopped by police in any Project Safety interview since the inception of the cohort. Analyses compared performance on the elements of the test battery with participants' histories of adverse driving events.
Of the 125 drivers, 50 (40%) had reported an adverse event in a mean period of 5.76 (+/-.25) years before the current interview. The elements of the test battery independently associated with a history of events, adjusting for driving frequency, included near visual acuity worse than 20/40 (adjusted odds ratio 11.90), limited neck rotation (OR 6.10), and poor performance on a test of visual attention, the number cancellation task (OR 3.00). The resulting regression equation yielded a sensitivity of 80%, a specificity of 55%, and an area under the curve of .75 by receiver operating characteristic analysis.
These findings suggest it may be possible to identify individuals potentially at risk for self-reported adverse driving events using simple tests of functional ability. If validated, such an approach could be used to identify individuals who need a more detailed assessment of functional abilities to determine the severity and etiology of impairments, and their effect on driving performance, as well as possible interventions to correct or compensate for the impairments.
本研究的目的是：（1）开发一套测试，以评估与驾驶相关的广泛功能能力，且这些测试可在临床医生办公室进行；（2）确定这些测试中哪些与自我报告的不良驾驶事件最密切相关。
队列研究。
城市社区。
参与者来自“项目安全”队列，这是1989年在康涅狄格州纽黑文市对非机构化老年人进行的概率抽样。本研究纳入了该队列中仍在世的活跃驾驶员（N = 125）。
测试组评估了与驾驶潜在相关的视觉、认知和身体能力，由经过培训的访谈员于1994年10月至1995年7月在参与者家中进行测试。结果测量包括自队列开始以来在任何“项目安全”访谈中自我报告的撞车、交通违规或被警察拦下的情况。分析将测试组各项测试的表现与参与者的不良驾驶事件历史进行了比较。
在125名驾驶员中，50名（40%）报告在当前访谈前平均5.76（±0.25）年期间发生过不良事件。在调整驾驶频率后，与事件历史独立相关的测试组各项测试包括近视力低于20/40（调整后的优势比为11.90）、颈部旋转受限（优势比为6.10）以及视觉注意力测试（数字划消任务）表现不佳（优势比为3.00）。通过受试者操作特征分析，所得回归方程的灵敏度为80%，特异度为55%，曲线下面积为0.75。
这些发现表明，使用简单的功能能力测试有可能识别出自我报告不良驾驶事件的潜在风险个体。如果得到验证，这种方法可用于识别那些需要对功能能力进行更详细评估以确定损伤的严重程度和病因、其对驾驶表现的影响以及纠正或补偿损伤的可能干预措施的个体。
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