Stutts J C
Highway Safety Research Center, University of North Carolina, Chapel Hill 27599-3430, USA.
J Am Geriatr Soc. 1998 Jul;46(7):854-61. doi: 10.1111/j.1532-5415.1998.tb02719.x.
To determine whether older drivers with poorer cognitive and/or visual function drive fewer miles or avoid driving in situations that pose higher crash risks, such as at nighttime, in rush hour traffic, or when weather conditions are bad.
A cross-sectional data analysis conducted as part of a larger prospective study.
A total of 3238 drivers aged 65 and older applying for renewal of their driver's license at one of eight participating North Carolina driver's license offices.
Subjects were administered a battery of brief tests of cognitive and visual function, which included the Trail Making Test Parts A and B, the Short Blessed Orientation-Memory-Concentration test, and measures of high and low contrast visual acuity, contrast sensitivity, and peripheral vision. Participants were also asked to complete a brief driving survey containing questions about the number of miles they drove and whether they avoided driving under certain conditions, such as after dark or on busy, multi-lane roadways. Driver age and gender were covariates in the analyses.
Results of multivariate logistic regression models show a clear pattern of reduced driving exposure--lower annual miles and greater avoidance of high-risk driving situations--associated with lower levels of cognitive and visual function. In general, the prevalence odds of reduced driving exposure were higher for the cognitive function variables than for the visual function variables, and higher for males than for females. Men who scored in the lowest quartile of performance on one of the cognitive tests were six to seven times more likely to report driving fewer than 3000 miles a year than were men scoring in the highest quartile, and women with low scores were one-and-one-half to two times more likely to report driving less than 3000 miles than women with higher scores.
While the findings of this study are reassuring, they do not guarantee that all drivers with cognitive and visual impairments are limiting their driving exposure appropriately, and geriatricians and other health professionals should be encouraged to evaluate their patients' cognitive and visual fitness for driving and provide counsel where indicated.
确定认知和/或视觉功能较差的老年驾驶员是否行驶里程较少，或者是否避免在碰撞风险较高的情况下驾驶，如夜间、交通高峰期或天气恶劣时。
作为一项更大规模前瞻性研究的一部分进行的横断面数据分析。
在北卡罗来纳州八个参与研究的驾照办公室之一申请更新驾照的3238名65岁及以上的驾驶员。
对研究对象进行了一系列认知和视觉功能的简短测试，包括连线测验A和B、简易精神状态检查表，以及高低对比度视力、对比敏感度和周边视力的测量。参与者还被要求完成一份简短的驾驶调查，其中包含有关他们行驶里程数以及是否避免在某些条件下驾驶的问题，如天黑后或在繁忙的多车道道路上。驾驶员年龄和性别是分析中的协变量。
多变量逻辑回归模型的结果显示出一种明显的模式，即驾驶暴露减少——年行驶里程较低且更多地避免高风险驾驶情况——与较低的认知和视觉功能水平相关。一般来说，认知功能变量导致驾驶暴露减少的患病率比值高于视觉功能变量，男性高于女性。在一项认知测试中得分处于最低四分位数的男性报告每年行驶里程少于3000英里的可能性是得分处于最高四分位数男性的六至七倍，得分低的女性报告行驶里程少于3000英里的可能性是得分高的女性的一又二分之一至两倍。
虽然本研究的结果令人放心，但并不能保证所有认知和视觉受损的驾驶员都适当地限制了他们的驾驶暴露，应鼓励老年病医生和其他健康专业人员评估其患者的认知和视觉驾驶适宜性，并在必要时提供咨询。
