Alzheimer's disease and driving : prediction and assessment of driving performance.
20060937 ST [electronic version only]
Fox, G.K. Bowden, S.C. Bashford, G.M. & Smith DS.
Journal of the American Geriatrics Society, Vol. 45 (1997), No. 8 (August), p. 949-953, 26 ref.
|Samenvatting||The objective of this study was 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. DESIGN: A prospective investigation with consecutively referred subjects. Setting was The Coorabel Driver Assessment Centre, Royal Rehabilitation Centre Sydney, Australia. Participants were nineteen subjects with a diagnosis of probable AD. A standardized clinical medical examination, a standardized neuropsychological assessment, and a standardized open road driving evaluation were performed. 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. (Author/publisher)|
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