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Kurita S, Doi T, Harada K, Morikawa M, Nishijima C, Fujii K, Kakita D, Shimada H. Subjective memory concerns and car collisions: A cross-sectional cohort study among older Japanese drivers. Heliyon 2024; 10:e33080. [PMID: 39021989 PMCID: PMC11253256 DOI: 10.1016/j.heliyon.2024.e33080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 07/20/2024] Open
Abstract
Background A previous study suggested older drivers with subjective memory concerns (SMC) had increased odds of experiencing car collisions, but whether SMC in different contexts and the number of SMC applicable items change this association is unknown. The aim of this study was to examine the association between SMC and car collisions among older drivers in Japan. Methods This cross-sectional study was conducted using data from a Japanese community-based cohort study. Participants were community-dwelling older adults aged ≥60 years. SMC was assessed using five questions: 1) "Do you feel you have more problems with memory than most?" 2) "Do you have any difficulty with your memory?" 3) "Do you forget where you have left things more than you used to?" 4) "Do you forget the names of close friends or relatives?" and 5) "Do other people find you forgetful?" Participants were asked about their experiences with car collisions during the previous two years. Results A total of 13,137 older drivers (72.1 ± 5.5 years old, and 43.6 % female) were analyzed. Cochran-Armitage trend test showed that as the number of SMC applicable items increased, the percentage of the experiences of car collisions significantly increased (6.8 %-15.8 %, P < 0.001). Logistic regression models showed each SMC question was associated with an increased odds ratio (OR) of car collisions (OR 1.26 to 1.71, all P < 0.001) after adjusting for confounding factors. As the number of SMC applicable items increased, the OR of car collisions significantly increased (OR 1.19 to 2.28, all P < 0.05, P for trend <0.001). Conclusions This cross-sectional study among community-dwelling older drivers in Japan suggested each SMC question and the number of applicable items were associated with car collisions. SMC may be a sign of increased risk of traffic incidents for older drivers.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- School of Psychology, Faculty of Science, The University of New South Wales, Sydney, Australia
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Daisuke Kakita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Tsouvala A, Katsouri IG, Moraitou D, Papantoniou G, Sofologi M, Nikova A, Vlotinou P, Tsiakiri A, Tsolaki M. Metacognitive Awareness of Older Adult Drivers with Mild Cognitive Impairment: Relationships with Demographics, Subjective Evaluation of Cognition, and Driving Self-Efficacy. Behav Sci (Basel) 2024; 14:483. [PMID: 38920815 PMCID: PMC11200804 DOI: 10.3390/bs14060483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Self-regulation of driving is a means of maintaining one's driving identity. The purpose of this study was to investigate the extent to which older drivers with Mild Cognitive Impairment (MCI) are metacognitively aware of the requirements of specific demanding driving conditions and whether this awareness is linked to subjective assessments of cognition. (2) One hundred seventeen (117) older MCI drivers participated in a telephone survey in which they reported their metacognitive experiences in nine driving conditions, listed as an aim of self-regulation. The analyses included the participants' subjective cognitive assessments, both in terms of their cognitive state and their perceived driving self-efficacy. (3) The analyses pointed out a direct and negative effect of age on the formation of the metacognitive feeling of certainty. Furthermore, an indirect effect of sex through driving self-efficacy was established. This effect was negative in the case of the metacognitive feeling of difficulty and the estimation of effort and positive in the case of the metacognitive feeling of certainty. (4) This position points out the need to establish appropriate levels of the perceived self-efficacy of older drivers with MCI, and it raises issues when it moves to fictitious levels.
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Affiliation(s)
- Anastasia Tsouvala
- School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | | | - Despina Moraitou
- Laboratory of Psychology, School of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece; (D.M.); (M.T.)
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI—AUTh), 54124 Thessaloniki, Greece
| | - Georgia Papantoniou
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
| | - Maria Sofologi
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
| | | | - Pinelopi Vlotinou
- Department of Occupational Therapy, University of West Attica, 12243 Athens, Greece;
| | - Anna Tsiakiri
- Neurology Department, Democritus University of Thrace, 67100 Xanthi, Greece;
| | - Magdalini Tsolaki
- Laboratory of Psychology, School of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece; (D.M.); (M.T.)
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI—AUTh), 54124 Thessaloniki, Greece
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Spargo C, Laver K, Berndt A, Adey-Wakeling Z, George S. Australian medical practitioners' perspectives about current practice relating to fitness to drive assessment for older people with dementia and mild cognitive impairment: A qualitative study. Australas J Ageing 2024; 43:323-332. [PMID: 38343276 DOI: 10.1111/ajag.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 06/28/2024]
Abstract
OBJECTIVES To describe the perspectives of Australian medical practitioners about current practice, and the potential benefit of tools and resources to support fitness to drive assessment for older people with dementia and mild cognitive impairment (MCI). METHODS Semi-structured interviews with 22 medical practitioners from cognitive/memory clinics, hospitals, general practice and driving fitness assessment services in Australia. Reflexive thematic analysis was conducted. RESULTS Two overarching themes were generated: (1) Uncomfortable decisions, describing feelings of discomfort expressed by practitioners about making fitness to drive recommendations, with two subthemes: (a) 'Feeling uncertain' and (b) 'Sticking your neck on the line'; and (2) Easing the discomfort, describing participants' desire for tools/resources to support practitioners to increase comfort with fitness to drive recommendations, with two subthemes: (a) 'Seeking certainty' and (b) 'Focusing on the process' conveying two different perspectives about how this may be achieved. There was a desire for a new in-office assessment tool capable of accurately predicting fitness to drive outcomes and views that an evidence-based clinical pathway could improve practitioners' confidence in decision-making. CONCLUSIONS Perceptions of discomfort relating to fitness to drive assessment of older people with dementia and MCI exist amongst medical practitioners from health-care settings across Australia. In the absence of a well-validated in-office assessment tool, practitioners may benefit from an evidence-based clinical pathway to guide driving recommendations.
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Affiliation(s)
- Claire Spargo
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Kate Laver
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Rehabilitation Aged and Palliative Care, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Angela Berndt
- University of South Australia, Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Zoe Adey-Wakeling
- Rehabilitation Aged and Palliative Care, Flinders Medical Centre, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Stacey George
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
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Chanmas G, Taveekitworachai P, Paliyawan P, Thawonmas R, Thawonmas R, Nukoolkit C, Dajpratham P. Driving scenarios and environmental settings in simulator-based driving assessment systems for stroke: a systematic review. Top Stroke Rehabil 2023; 30:872-880. [PMID: 36617424 DOI: 10.1080/10749357.2023.2165273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 01/02/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Driving simulators are effective tools to evaluate the driving abilities of patients with stroke. They can introduce various driving scenarios which will greatly benefit both the assessors and drivers. However, there is still no guidelines by which driving scenarios should be introduced in the driving assessment. OBJECTIVES We conducted a systematic review to examine the utilization of driving scenarios and environments in the simulator-based driving assessment for patients with stroke. METHODS A systematic review was conducted following PRISMA. We searched PubMed, Web of Science, ScienceDirect, ACM Digital Library, and IEEE Xplore Digital Library databases in January and June 2022 to identify eligible articles published since 2010. RESULTS Our searches identified 1,614 articles. We included 12 studies that applied driving simulators to assess the driving performance of patients with stroke. The driving scenarios were categorized into three categories - vehicle controls scenarios, hazard perception scenarios, and trajectory planning scenarios - based on a certain set of driving abilities. The most common driving scenarios are simple navigation (n = 8) and emergency stop (n = 8). The most frequently used driving area is urban (n = 9), and a variety of roads and traffic conditions were found in the included studies. Only 2 studies applied weather conditions, such as the clear and sunny condition or the windy condition. CONCLUSION It is recommended for future research to consider covering scenarios from the aforementioned three categories and further investigate the benefits of introducing complex weather conditions and localized traffic conditions in the driving assessment.
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Affiliation(s)
- Gunt Chanmas
- Graduate School of Information Science and Engineering, Ritsumeikan University, Shiga, Japan
| | | | - Pujana Paliyawan
- Ritsumeikan Center for Game Studies, Ritsumeikan University, Kyoto, Japan
| | - Ramita Thawonmas
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ruck Thawonmas
- College of Information Science and Engineering, Ritsumeikan University, Shiga, Japan
| | - Chakarida Nukoolkit
- School of Information Technology, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
| | - Piyapat Dajpratham
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Krasniuk S, Crizzle AM, Toxopeus R, Mychael D, Prince N. Clinical Tests Predicting On-Road Performance in Older Drivers with Cognitive Impairment. Can J Occup Ther 2023; 90:44-54. [PMID: 35950229 PMCID: PMC9923206 DOI: 10.1177/00084174221117708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. The Trail Making Test Part B (Trails B) and Useful Field of View® (UFOV) can predict on-road outcomes in drivers with cognitive impairment (CI); however, studies have not included drivers referred for comprehensive driving evaluations (CDEs), who typically have more severe CI. Purpose. We determined the predictive ability of Trails B and UFOV on pass/fail on-road outcomes in drivers with CI (Montreal Cognitive Assessment <26) referred for CDEs. Method. Retrospective data collection from two driving assessments centers (N = 100, mean age = 76.2 ± 8.8 years). Findings. The Trails B (area under the curve [AUC] = .70) and UFOV subtests 2 (AUC = .73) and 3 (AUC = .76) predicted pass/fail outcomes. A cut-point ≥467 ms on UFOV subtest 3 better-predicted pass/fail outcomes with 78.9% sensitivity and 73.5% specificity. In comparison, a cut-point ≥3.58 min on Trails B had lower sensitivity (73.7%) and specificity (61.8%). Implications. The UFOV subtest 3 may be more useful than the Trails B for predicting pass/fail outcomes in drivers with more severe CI referred for CDEs.
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Affiliation(s)
| | - Alexander M. Crizzle
- Alexander Crizzle, School of Public Health,
University of Saskatchewan, Saskatoon, SK, Canada.
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Krasniuk S, Mychael D, Crizzle AM. Driving Errors Predicting Pass/Fail On-Road Assessment Outcomes Among Cognitively Impaired Older Drivers. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:144-153. [PMID: 35337241 PMCID: PMC9729977 DOI: 10.1177/15394492221076494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Older drivers with cognitive impairment (CI)/dementia make significantly more driving errors than healthy controls; however, whether driving errors are predictive of pass/fail outcomes in older drivers with CI/dementia are unclear. This study determined the driving errors that predicted failing an on-road assessment in drivers with CI. We retrospectively collected comprehensive driving evaluation data of 80 participants (76.1 ± 9.3 years) from an Ontario driving assessment center. Adjustment to stimuli (area under the curve [AUC] = 0.88), lane maintenance (AUC = 0.84), and speed regulation errors (AUC = 0.85) strongly predicted pass/fail outcomes. Worse performance on the Trails B (time) and Useful Field of View® (Subtest 2, Subtest 3, and risk index) were significantly correlated with adjustment to stimuli (p < .05), lane maintenance (p < .05), and speed regulation errors (p < .05). Adjustment to stimuli, lane maintenance, and speed regulation errors may be critical indicators of failing an on-road assessment in older drivers with CI. Prioritizing these errors may help identify at-risk drivers.
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Affiliation(s)
| | | | - Alexander M. Crizzle
- University of Saskatchewan, Saskatoon, Canada,Alexander M. Crizzle, Associate Professor and Director of the Driving Research & Simulation Laboratory, School of Public Health, University of Saskatchewan, 104 Clinic Road, Saskatoon, Saskatchewan, Canada S7N 2Z4.
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Delphin-Combe F, Coste MH, Bachelet R, Llorens M, Gentil C, Giroux M, Paire-Ficout L, Ranchet M, Krolak-Salmon P. An innovative therapeutic educational program to support older drivers with cognitive disorders: Description of a randomized controlled trial study protocol. Front Neurol 2022; 13:901100. [PMID: 35923824 PMCID: PMC9339957 DOI: 10.3389/fneur.2022.901100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Older drivers face the prospect of having to adjust their driving habits because of health problems, which can include neurocognitive disorders. Self-awareness of driving difficulties and the interaction between individual with neurocognitive disorders and natural caregiver seem to be important levers for the implementation of adaptation strategies and for the subsequent voluntary cessation of driving when the cognitive disorders become too severe. This study aims to evaluate an educational program for patient/natural caregiver dyads who wish to implement self-regulation strategies in driving activity, and to improve self-awareness of driving ability. The ACCOMPAGNE program is based on seven group workshops, which target the dyad. The workshops deal with the impact of cognitive, sensory and iatrogenic disorders on driving. They tackle questions about responsibility, and about autonomy and social life. They also provide alternative solutions aimed at maintaining outward-looking activities even if driving is reduced or stopped. A randomized controlled trial is planned to evaluate the effectiveness of the program 2 months and 6 months after inclusion, and to compare this to the effectiveness of conventional approaches. The main outcome of this trial (i.e., the implementation of self-regulated driving strategies), will be measured based on scores on the “Current Self-Regulatory Practices” subscale of the Driver Perception and Practices Questionnaire. The Driving Habits Questionnaire will be used to measure secondary outcomes (indicators of driving changes; indicators of changes in mood, quality of life and caregiver burden; and self-awareness of driving abilities). Indicators will be collected for both patients and natural caregivers. This cognitive, social and psychological program should allow older individuals with cognitive disorders to drive more safely, and help to maintain the quality of life and mood of both patient and natural caregiver despite driving limitations. The patient's care path would be optimized, as he/she would become an actor in the process of giving up driving, which will, most certainly, be needed at some point in the progress of neurocognitive disorders. This process ranges from becoming aware of driving difficulties, to implementing self-regulation strategies, through to complete cessation of driving when necessary.Clinical trial registration numberNCT04493957.
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Affiliation(s)
- Floriane Delphin-Combe
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
- *Correspondence: Floriane Delphin-Combe
| | - Marie-Hélène Coste
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | - Romain Bachelet
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | - Mélissa Llorens
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | - Claire Gentil
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | - Marion Giroux
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
| | | | - Maud Ranchet
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, Lyon, France
| | - Pierre Krolak-Salmon
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute for Elderly, Hospices Civils de Lyon, Lyon, France
- INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Brain Dynamics and Cognition Team, Lyon, France
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Spargo C, Laver K, Adey-Wakeling Z, Berndt A, George S. Mild cognitive impairment and fitness to drive: An audit of practice in a driving specialist clinic in Australia. Australas J Ageing 2021; 41:282-292. [PMID: 34939739 DOI: 10.1111/ajag.13024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/08/2021] [Accepted: 10/24/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe current practice and outcomes relating to fitness to drive for people with mild cognitive impairment (MCI) attending a specialist driving clinic. METHODS Retrospective medical record audit from a driving fitness assessment clinic at a tertiary medical centre, South Australia, from 2015 to 2019. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Claire Spargo
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Kate Laver
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Zoe Adey-Wakeling
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.,Flinders Medical Centre, Rehabilitation Aged and Palliative Care, Adelaide, South Australia, Australia
| | - Angela Berndt
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Stacey George
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
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Stanitsa E, Economou A, Beratis I, Kontaxopoulou D, Fragkiadaki S, Papastefanopoulou V, Pavlou D, Papantoniou P, Kroupis C, Papatriantafyllou J, Stefanis L, Yannis G, Papageorgiou SG. Effect of Apolipoprotein E4 on the Driving Behavior of Patients with Amnestic Mild Cognitive Impairment or Mild Alzheimer's Disease Dementia. J Alzheimers Dis 2021; 84:1005-1014. [PMID: 34602476 DOI: 10.3233/jad-210622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The driving behavior of patients with mild Alzheimer's disease dementia (ADD) and patients with mild cognitive impairment (MCI) is frequently characterized by errors. A genetic factor affecting cognition is apolipoprotein E4 (APOE4), with carriers of APOE4 showing greater episodic memory impairment than non-carriers. However, differences in the driving performance of the two groups have not been investigated. OBJECTIVE To compare driving performance in APOE4 carriers and matched non-carriers. METHODS Fourteen APOE4 carriers and 14 non-carriers with amnestic MCI or mild ADD underwent detailed medical and neuropsychological assessment and participated in a driving simulation experiment, involving driving in moderate and high traffic volume in a rural environment. Driving measures were speed, lateral position, headway distance and their SDs, and reaction time. APOE was genotyped through plasma samples. RESULTS Mixed two-way ANOVAs examining traffic volume and APOE4 status showed a significant effect of traffic volume on all driving variables, but a significant effect of APOE4 on speed variability only. APOE4 carriers were less variable in their speed than non-carriers; this remained significant after a Bonferroni correction. To further examine variability in the driving performance, coefficients of variation (COV) were computed. Larger headway distance COV and smaller lateral position COV were observed in high compared to moderate traffic. APOE4 carriers had smaller speed COV compared to non-carriers. CONCLUSION The lower speed variability of APOE4 carriers in the absence of neuropsychological test differences indicates reduced speed adaptations, possibly as a compensatory strategy. Simulated driving may be a sensitive method for detecting performance differences in the absence of cognitive differences.
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Affiliation(s)
- Evangelia Stanitsa
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Alexandra Economou
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ion Beratis
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Stella Fragkiadaki
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Vicky Papastefanopoulou
- Department of Clinical Biochemistry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimosthenis Pavlou
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Panagiotis Papantoniou
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Christos Kroupis
- Department of Clinical Biochemistry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - John Papatriantafyllou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aiginiteio University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Yannis
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
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Yang Y, Lee H. The Effects of Cognitive and Visual Functions of Korean Elderly Taxi Drivers on Safe Driving Behavior. Risk Manag Healthc Policy 2021; 14:465-472. [PMID: 33574720 PMCID: PMC7873031 DOI: 10.2147/rmhp.s280249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/15/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose In this study, we investigated the effect of visual and cognitive functions of elderly taxi drivers on safe driving behavior. We aimed to identify factors that interfere with safe driving in an aging Korean society in elderly taxi drivers. Participants and Methods A total of 203 elderly taxi drivers, aged >65, working at 3 companies in a single city were assessed over 4 weeks from December 1 to December 30, 2017, using the Motor-Free Visual Perception Test, Korean Montreal Cognitive Assessment, and Korean Safe Driving Behavior Measure. To examine the effects of cognitive and visual functions on driving behavior, we performed a stepwise multiple linear regression analysis (p<0.05). Results All 4 subdomains of safe driving behaviors were significantly correlated with the cognitive subdomains of attention and abstraction and the visual perception subdomains of visual closure 1 and figure-ground. Conclusion More systematic assessments of the relationship between driving behavior and cognitive and visual function in elderly individuals are needed.
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Affiliation(s)
- YeongAe Yang
- Department of Occupational Therapy, College of Biomedical Sciences and Engineering, Inje University, Gimhae, Republic of Korea.,Institute of Aged Life Redesign, Inje University, Gimhae, Republic of Korea
| | - HyeJin Lee
- Department of Occupational Therapy, Choonhae College of Health Sciences, Ulsan, Republic of Korea.,Department of Rehabilitation Science, Graduate School of Inje University, Gimhae, Republic of Korea
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