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Vito E, Barkla A, Coventry L. DriveSafe DriveAware: A systematic review. Australas J Ageing 2023; 42:53-63. [PMID: 36602154 DOI: 10.1111/ajag.13166] [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: 03/14/2022] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Driving is an activity of daily living that significantly affects independence, and driving cessation is associated with poor health, lower quality of life, cognitive decline and early entry into care facilities. There is no consensus regarding the best off-road tool to assess driving safety. Therefore, this review explored the diagnostic accuracy, reliability and clinical utility of DriveSafe DriveAware (DSDA) compared with an on-road driving assessment. METHODS This review adhered to the PRISMA guidelines. Electronic databases for all English language articles published prior to December 2021 were searched. Studies were assessed for methodological quality and results were synthesised using a narrative descriptive approach. RESULTS Six studies were reviewed, consisting of 1332 participants. Four studies assessed diagnostic accuracy, two studies assessed reliability and three were relevant to clinical utility since they used DSDA as a standalone tool. Some studies demonstrated high levels of diagnostic accuracy, with specificity and sensitivity above 90% for those who fall into the safe and unsafe categories (50% of those assessed). Inter-rater reliability showed substantial agreement, and test-retest reliability was demonstrated for all age groups. DSDA was assessed as having high clinical utility (as a standalone tool) based on time taken to conduct, cost effectiveness and equipment required to complete the assessment. CONCLUSIONS DriveSafe DriveAware appears to be an ideal tool for the subacute setting; however, at present, inadequate evidence exists to support its use as a standalone tool for directing driving decisions. Further research is required.
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Affiliation(s)
- Erin Vito
- Sir Charles Gairdner Osborne Park Health Care Group, Osborne Park Hospital, Stirling, Western Australia, Australia
| | - Anna Barkla
- Sir Charles Gairdner Osborne Park Health Care Group, Osborne Park Hospital, Stirling, Western Australia, Australia
| | - Linda Coventry
- Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.,Centre for Research in Aged Care, Edith Cowan University, Joondalup, Western Australia, Australia
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2
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Nasu S, Ishibashi Y, Ikuta J, Yamane S, Kobayashi R. Reliability and Validity of the Japanese Version of the Assessment of Readiness for Mobility Transition (ARMT-J) for Japanese Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13957. [PMID: 36360838 PMCID: PMC9656332 DOI: 10.3390/ijerph192113957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The Assessment of Readiness for Mobility Transition (ARMT) questionnaire assesses individuals' emotional and attitudinal readiness related to mobility as they age. This study aimed to examine the reliability and validity of the Japanese version of the ARMT (ARMT-J). The ARMT-J and related variables were administered to 173 patients and staff members undergoing rehabilitation at hospitals in Japan. Construct validity was first examined using confirmatory factor analysis (CFA) to confirm cross-cultural validity. For structural validity, the optimal number of factors was confirmed using a Velicer's minimum average partial test and parallel analysis, followed by exploratory factor analysis (EFA). Finally, a CFA was performed using the most appropriate model. Internal consistency, test-retest reliability, standard error of measurement (SEM), and smallest detectable change (SDC) were assessed for reliability. The CFA fit for the factor structure of the original ARMT was low. Therefore, the EFA was conducted with two to four factors. The optimal factor structure was three factors, with a Cronbach's alpha coefficient and Cohen's weighted kappa coefficient of 0.85 and 0.76, respectively. The intraclass correlation coefficient (ICC) of the test-retest was 0.93, the SEM was 0.72, and the SDC was 2.00. The model fit was good for the ARMT-J, with a three-factor structure.
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Affiliation(s)
- Satonori Nasu
- Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo 116-8551, Japan
- Department of Occupational Therapy, Nakaizu Rehabilitation Center, Shizuoka 410-2507, Japan
| | - Yu Ishibashi
- Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo 116-8551, Japan
| | - Junichi Ikuta
- Department of Occupational Therapy, Nakaizu Rehabilitation Center, Shizuoka 410-2507, Japan
| | - Shingo Yamane
- Department of Occupational Therapy, Faculty of Health Sciences, Aino University, Osaka 567-0012, Japan
| | - Ryuji Kobayashi
- Department of Occupational Therapy, Faculty of Health Sciences, Okayama Healthcare Professional University, Okayama 700-0913, Japan
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Peng Z, Shimosaka M, Nishimoto H, Kinoshita A. Speedometer-reading performance of senior drivers with cognitive impairment: a comparison of analogue and digital speedometers. Psychogeriatrics 2022; 22:621-630. [PMID: 35689401 DOI: 10.1111/psyg.12863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND With the deterioration of cognitive functions, the capability to obtain information with speed, one of the essential elements needed to perform safe driving, may be impacted. We aimed to compare the legibility of analogue and digital speedometers for senior drivers with cognitive impairment, and examined the demographic, cognitive, and driving-related variables that predict their speedometer-reading performance. METHODS A total of 50 senior drivers with cognitive impairment were investigated and asked to complete an office-based speedometer-reading test using an iPad. Two general types of speedometers (analogue and digital) were tested in this study. RESULTS The age of the participants ranged from 61 to 92 years (mean (SD), 79.10 (6.973)), and 29 were male. The mean (SD) score of the Mini-Mental State Examination was 22.48 (6.089). The median (QL , QU ) scores of the analogue and digital speedometer-reading tests were 4 (4, 5.25) and 6 (6), respectively. Based on the result of the Wilcoxon signed-rank test, the score of the digital speedometer-reading test was significantly higher than that of the analogue one (Z = 4.399, P < 0.001). The results of multiple linear regression analyses show that the scores of the Mini-Mental State Examination (β = 0.358, P = 0.025), and the trail-making test-A (β = -0.443, P = 0.006) predicted the digital speedometer-reading performance, and they together explain 54.7% of the total variance. CONCLUSIONS A digital speedometer was found to be easier for absolute value reading for senior drivers with cognitive impairment, compared to an analogue speedometer. Senior drivers with subjective cognitive decline may also have impairments in obtaining the speed information through an analogue speedometer. General cognitive function and attention may influence the speed-reading performance on the digital speedometer.
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Affiliation(s)
- Zhouyuan Peng
- School of Nursing, Health Science Center, Shenzhen University, Shenzhen, China.,Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Momoyo Shimosaka
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Nishimoto
- Integrated Center for Advanced Medical Technologies, Kochi University Hospital, Kochi, Japan
| | - Ayae Kinoshita
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Chang HCR, Ho MH, Traynor V, Tang LY, Liu MF, Chien HW, Chan SY, Montayre J. Mandarin version of dementia and driving decision aid (DDDA): Development and stakeholder evaluation in Taiwan. Int J Older People Nurs 2021; 16:e12370. [PMID: 33595919 DOI: 10.1111/opn.12370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/10/2021] [Accepted: 01/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dementia causes cognitive and memory difficulties which can reduce the driving safety of the individuals. The decision-making process for driving retirement is challenging, and yet limited guidance is available. OBJECTIVES This article reports the development of the Taiwanese version of dementia and driving decision aid (DDDA) and the evaluation from stakeholders through a dementia and driving education programme. METHODS A multi-method approach was adopted using a pre-test, post-test survey and focus group interviews. A total of 154 healthcare professionals, family caregivers and people with dementia participated education programme, and 12 experts attended the focus group discussion. The survey included demographics, knowledge, confidence, competence and awareness of using DDDA. Participants completed a survey prior and immediately after the education programme. We translated a 32-page interactive DDDA booklet from the original English version to Mandarin. The education programme consisted of three-hour dementia and driving education module delivered both face-to-face and online. RESULTS The majority of participants described the booklet as balanced (91.7%) with the information presented in a 'good' or 'excellent' manner (93.4%). Most participants (85.3%) felt that DDDA helps them in making decisions about driving. Five themes were extracted from the focus group interview: (1) approach targeted to people with dementia, (2) specific content and additional information, (3) culturally appropriate modification, (4) having the right to drive and (5) booklet dissemination. The knowledge, confidence, competence and awareness of using the DDDA increased significantly (p < 0.001) after the education programmes. CONCLUSION We anticipate that use of the DDDA booklet will raise awareness of this social and health issue among the general public and facilitate collaborations with clinicians, municipalities and related organisations in providing a decision-making resource material for those with people living with dementia and their families. This study was not a clinical trial and the focus of this study was development and evaluation of the DDDA booklet. As mentioned in the methods section, participants were invited to attend the education program and provided their thoughts on the DDDA booklet based on their satisfaction level. Moreover, the education program was a one-day, workshop type program. This study was neither "prospectively assigns human participants or groups of humans to one or more health-related interventions" nor "to evaluate the effects on health outcomes", according to the definition of clinical trial by WHO. Therefore, we did not consider this study was a clinical trial. IMPLICATIONS FOR PRACTICE There is an urgent need for supporting people with dementia and their families to negotiate the complex decision-making involved in deciding to change their approach to driving. The DDDA booklet can fill an important gap in service delivery to people with dementia who are adjusting to life without driving.
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Affiliation(s)
- Hui Chen Rita Chang
- Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Mu-Hsing Ho
- Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Victoria Traynor
- Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Li-Yu Tang
- Taiwan Alzheimer's Disease Association, Taipei City, Taiwan
| | - Megan F Liu
- School of Gerontology Health Management, Taipei Medical University, Taipei, Taiwan
| | - Hui-Wen Chien
- Department of Nursing, College of Medicine & Health Science, Asia University, Taichung, Taiwan
| | - Su-Yuan Chan
- Taiwan Alzheimer's Disease Association, Taipei City, Taiwan
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Campbelltown, NSW, Australia
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Bayer A. Next steps after diagnosing dementia: interventions to help patients and families. Pract Neurol 2020; 20:294-303. [PMID: 32444477 DOI: 10.1136/practneurol-2019-002416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2020] [Indexed: 11/03/2022]
Abstract
The way that a diagnosis of dementia is delivered to patients, what information is provided and what practical advice and support is arranged has a lasting impact and deserves at least as much attention as the process of assessment and investigation. Individuals and their families require an honest yet sensitive discussion about the nature and cause of their problems, using non-technical language and tailored to their priorities and needs. This should lead on to the provision of good-quality information in an accessible format. Priorities for intervention include medication review, attention to sensory deficits, appropriate pharmacological and nonpharmacological treatment, best use of memory aids and strategies and discussion of driving eligibility, financial entitlement and legal advice. Referral onwards should be made to an appropriate individual or service to provide ongoing emotional and practical support and signposting.
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Affiliation(s)
- Antony Bayer
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
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Holden A, Pusey H. The impact of driving cessation for people with dementia - An integrative review. DEMENTIA 2020; 20:1105-1123. [PMID: 32326750 DOI: 10.1177/1471301220919862] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
At the point of diagnosis of dementia many people will be driving and go on to experience the significant life transition from driver to non-driver. Driving plays an important role in society enhancing independence, quality of life and general health and well-being. Hence cessation from driving can be a very difficult life transition to make. The aim of this integrative review was to summarise what is known about the impact and experience for people with dementia and their carers in the 'post-cessation' phase of retiring from driving. Thematic analysis utilised themes identified in previous life transition research focusing on driving cessation and these included processes, influences, emotions, roles and programmes. Analysis revealed a lack of formal processes to follow in surrendering one's licence and that the medical professions and multi-disciplinary teams should take more responsibility for the legal processes of driving cessation and supporting individuals at the point of and following this disclosure. People with dementia and their carers experience a significant impact upon their life roles and considerable emotional and psychological consequences. The review also suggested that there are a variety of influences affecting the life transition period from driver to non-driver such as family support and access to alternative forms of transport and that there is a need for development for interventions/programmes to support individuals with dementia post-driving cessation.
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Affiliation(s)
- Alison Holden
- Research and Development, Lancashire and South Cumbria NHS Foundation Trust, UK
| | - Helen Pusey
- Division of Nursing, Midwifery and Social Work, University of Manchester, UK
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Velayudhan L, Baillon S, Urbaskova G, McCulloch L, Tromans S, Storey M, Lindesay J, Bhattacharyya S. Driving Cessation in Patients Attending a Young-Onset Dementia Clinic: A Retrospective Cohort Study. Dement Geriatr Cogn Dis Extra 2018; 8:190-198. [PMID: 29805385 PMCID: PMC5968244 DOI: 10.1159/000488237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/07/2018] [Indexed: 12/03/2022] Open
Abstract
Background Although driving by persons with dementia is an important public health concern, little is known about driving cessation in younger people with dementia. We aimed to determine the prevalence and factors affecting driving cessation in individuals with and without dementia aged under 65 years attending a memory clinic in a European setting. Methods Subjects were consecutive patients assessed at a specialist memory service at a university teaching hospital between 2000 and 2010. The data collected included demographic, clinical, standardized cognitive assessments as well as information on driving. Dementia diagnosis was made using ICD-10 criteria. Results Of the 225 people who were or had been drivers, 32/79 (41%) with young-onset dementia (YOD) stopped driving compared to 25/146 (17%) patients who had cognitive impairment due to other causes. Women were more likely to cease driving and voluntarily than men (p < 0.001). Diagnosis of YOD was associated with driving cessation (1.193, 95% CI 0.570–1.815, p ≤ 0.001), and was mediated by impairment in praxis with the highest indirect mediation effect (0.754, 95% CI 0.183–1.401, p = 0.009). Conclusions YOD diagnosis, female gender, and impairment in praxis have a higher probability for driving cessation in those under 65 years of age with cognitive impairment.
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Affiliation(s)
- Latha Velayudhan
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom.,Psychiatry for the Elderly, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Sarah Baillon
- Psychiatry for the Elderly, Department of Health Sciences, University of Leicester, Leicester, United Kingdom.,Mental Health Services for Older People, Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Gabriela Urbaskova
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Laura McCulloch
- Psychiatry for the Elderly, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Samuel Tromans
- Mental Health Services for Older People, Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Mathew Storey
- Psychiatry for the Elderly, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - James Lindesay
- Psychiatry for the Elderly, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Sagnik Bhattacharyya
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
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