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DOI: 10.1055/a-1690-6940
Aktuelle Evidenzlage zur Beurteilung der Fahrtauglichkeit von Menschen mit kognitiven Einschränkungen: Ein systematisches Review
Current Evidence for Assessing Fitness to Drive of People with Cognitive Impairment: A Systematic Review Förderung Das Projekt digiDEM Bayern wird durch das Bayerische Staatsministerium für Gesundheit und Pflege (StMGP) gefördert (Förderkennzeichen G42d-G8300–2017/1606–38).![](https://www.thieme-connect.de/media/gesu/202304/lookinside/thumbnails/16906940_10-1055-a-1690-6940-1.jpg)
Zusammenfassung
Einleitung Aufgrund der hohen Prävalenz demenzieller Erkrankungen handelt es sich bei der Überprüfung der Fahrtauglichkeit von Menschen mit kognitiven Beeinträchtigungen um ein Thema von großer gesellschaftlicher Relevanz.
Methodik Es wurde eine umfassende systematische Literaturrecherche zu der Forschungsfrage: „Welche evidenz-basierten Methoden eignen sich zur Beurteilung der Fahrtauglichkeit von Menschen mit Demenz (MmD) oder milden kognitiven Einschränkungen (MCI)?“ für den Zeitraum 2015–2020 durchgeführt. Die Recherche erfolgte in den Datenbanken Medline, PsycINFO, LIVIVO, PubPsych, Scopus, Cinahl und CENTRAL.
Ergebnisse 30 Studien wurden in die qualitative Analyse eingeschlossen. Die Fahrtauglichkeit kann mit praxisbasierten Testverfahren wie Praxisfahrtest (On-road), Fahrsimulator und Fahrverhaltensbeurteilung im natürlichen Umfeld (Naturalistic Driving) beurteilt werden. Theoriebasierte Methoden sind: neuropsychologische Tests, fahrspezifische Testungen und Fragebögen zur Selbsteinschätzung. Die Studienlage zeigt, dass einzelne neuropsychologische Tests nicht zur Bestimmung der Fahrtauglichkeit ausreichen. Eine höhere Aussagekraft haben praxisbasierte Testverfahren, fahrspezifische Testungen sowie Kombinationen aus evidenz-basierten Methoden.
Schlussfolgerungen Die Überprüfung der Fahrtauglichkeit von Menschen mit kognitiven Beeinträchtigungen sollte angesichts des progredienten Verlaufs demenzieller Erkrankungen engmaschig durch eine Kombination aus theorie- und praxisbasierter Methoden erfolgen.
Abstract
Background Assessment of driving ability in people with cognitive impairment is a topic of great social relevance due to the high prevalence of dementia.
Methods A comprehensive systematic literature review was conducted on the research question, “Which evidence-based methods are suitable for assessing the fitness to drive of people with dementia or mild cognitive impairment?” for the period 2015–2020. The search was conducted in the Medline, PsycINFO, LIVIVO, PubPsych, Scopus, Cinahl, and CENTRAL databases.
Results Thirty studies were included in the qualitative analysis. Driving ability can be assessed with practice-based testing procedures such as On-road Driving, Simulator, and Naturalistic Driving. Theory-based methods include neuropsychological testing, driving-specific testing, and self-assessment questionnaires. Studies show that single neuropsychological tests are not sufficient to determine fitness to drive. Practice-based test procedures, driving-specific tests, and combinations of evidence-based methods have a higher informative value.
Conclusions In view of the progressive course of dementia, the assessment of driving ability of people with cognitive impairment should be performed in a close-meshed way by a combination of theory- and practice-based methods.
Schlüsselwörter
Menschen mit Demenz - MCI - Überprüfung der Fahrtauglichkeit - Kognitive Beeinträchtigung - FahrperformanzPublikationsverlauf
Artikel online veröffentlicht:
24. Januar 2022
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Literatur
- 1 Bickel H. Informationsblatt 1. Die Häufigkeit von Demenzerkrankungen (06.2020). Im Internet: https://www.deutsche-alzheimer.de/fileadmin/alz/pdf/factsheets/infoblatt1_haeufigkeit_demenzerkrankungen_dalzg.pdf;Stand: 11.08.2021.
- 2 Qin W, Xiang X, Taylor H. Driving Cessation and Social Isolation in Older Adults. J Aging Health 2020; 32: 962-971
- 3 Bundesministerium für Familie, Senioren, Frauen und Jugend (BMFSFJ), Bundesministerium für Gesundheit (BMG). Nationale Demenzstrategie. Im Internet: https://www.nationale-demenzstrategie.de/fileadmin/nds/pdf/2020-07-01_Nationale_Demenzsstrategie.pdf; Stand:16.02.2021.
- 4 Kim YJ, An H, Kim B. et al. An International Comparative Study on Driving Regulations on People with Dementia. J Alzheimers Dis 2017; 56: 1007-1014
- 5 Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Deutsche Gesellschaft für Neurologie (DGN). S3-Leitlinie „Demenzen“: Langversion (01.2016). Im Internet: https://www.dgppn.de/_Resources/Persistent/ade50e44afc7eb8024e7f65ed3f44e995583c3a0/S3-LL-Demenzen-240116.pdf Stand: 25.07.2018.
- 6 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097-e1000097
- 7 Ziegler A, Antes G, König I. Bevorzugte Report Items für systematische Übersichten und Meta-Analysen: Das PRISMA-Statement. DMW – Deutsche Medizinische Wochenschrift 2011; 136: e9-e15
- 8 von Elm E, Altman DG, Egger M. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370: 1453-1457
- 9 von Elm E, Altman DG, Egger M. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 2014; 12: 1495-1499
- 10 Aksan N, Anderson SW, Dawson J. et al. Cognitive functioning differentially predicts different dimensions of older drivers’ on-road safety. Accident Analysis and Prevention 2015; 75: 236-244
- 11 Barco PP, Baum CM, Ott BR. et al. Driving errors in persons with dementia. Journal of the American Geriatrics Society 2015; 63: 1373-1380
- 12 Davis JD, Wang S, Festa EK. et al. Detection of risky driving behaviors in the naturalistic environment in healthy older adults and mild Alzheimer’s disease. Geriatrics (Switzerland) 2018; 3(2): 13
- 13 Duncanson H, Hollis AM, O’Connor MG. Errors versus speed on the Trail Making Test: Relevance to driving performance. Accident Analysis and Prevention 2018; 113: 125-130
- 14 Moharrer M, Wang S, Davis JD. et al. Driving Safety of Cognitively-Impaired Drivers Based on Near Collisions in Naturalistic Driving. Journal of Alzheimer’s disease reports 2020; 4: 1-7
- 15 O’Connor MG, Duncanson H, Hollis AM. Use of the MMSE in the Prediction of Driving Fitness: Relevance of Specific Subtests. Journal of the American Geriatrics Society 2019; 67: 790-793
- 16 Papandonatos GD, Ott BR, Davis JD. et al. Clinical utility of the trail-making test as a predictor of driving performance in older adults. Journal of the American Geriatrics Society 2015; 63: 2358-2364
- 17 Seelye A, Mattek N, Sharma N. et al. Passive Assessment of Routine Driving with Unobtrusive Sensors: A New Approach for Identifying and Monitoring Functional Level in Normal Aging and Mild Cognitive Impairment. Journal of Alzheimer’s Disease 2017; 59: 1427-1437
- 18 Stern RA, Abularach LM, Seichepine DR. et al. Office-Based Assessment of At-Risk Driving in Older Adults with and Without Cognitive Impairment. Journal of Geriatric Psychiatry and Neurology 2016; 29: 352-360
- 19 Venkatesan UM, Festa EK, Ott BR. et al. Differential Contributions of Selective Attention and Sensory Integration to Driving Performance in Healthy Aging and Alzheimer’s Disease. J Int Neuropsychol Soc 2018; 24: 486-497
- 20 Beratis IN, Andronas N, Kontaxopoulou D. et al. Driving in mild cognitive impairment: The role of depressive symptoms. Traffic injury prevention 2017; 18: 470-476
- 21 Beratis IN, Pavlou D, Papadimitriou E. et al. Mild Cognitive Impairment and driving: Does in-vehicle distraction affect driving performance?. Accident Analysis and Prevention 2017; 103: 148-155
- 22 Economou A, Pavlou D, Beratis I. et al. Predictors of accidents in people with mild cognitive impairment, mild dementia due to Alzheimer’s disease and healthy controls in simulated driving. International Journal of Geriatric Psychiatry 2020; 35: 859-869
- 23 Fragkiadaki S, Beratis IN, Kontaxopoulou D. et al. Self-awareness of Driving Ability in the Healthy Elderly and Patients With Mild Cognitive Impairment (MCI). Alzheimer Disease & Associated Disorders 2018; 32: 107-113
- 24 Pavlou D, Papadimitriou E, Antoniou C. et al. Comparative assessment of the behaviour of drivers with Mild Cognitive Impairment or Alzheimer’s disease in different road and traffic conditions. Transportation Research Part F: Traffic Psychology and Behaviour 2017; 47: 122-131
- 25 Vardaki S, Dickerson AE, Beratis I. et al. Simulator Measures and Identification of Older Drivers With Mild Cognitive Impairment. American Journal of Occupational Therapy 2016; 70: p1-p10
- 26 Hird MA, Vesely KA, Fischer CE. et al. Investigating Simulated Driving Errors in Amnestic Single- and Multiple-Domain Mild Cognitive Impairment. J Alzheimers Dis 2017; 56: 447-452
- 27 Stinchcombe A, Paquet S, Yamin S. et al. Assessment of drivers with Alzheimer’s disease in high demand driving situations: Coping with intersections in a driving simulator. Geriatrics (Switzerland) 2016; 31;1(3): 21
- 28 Vanlaar WGM, Mainegra Hing M, Meister S. et al. Pilot study of a new road test to assess cognitive fitness to drive. Transportation Research Part F: Traffic Psychology and Behaviour 2019; 65: 258-267
- 29 Yamin S, Stinchcombe A, Gagnon S. Driving Competence in Mild Dementia with Lewy Bodies: In Search of Cognitive Predictors Using Driving Simulation. International Journal of Alzheimer’s Disease 2015; 806024 : 1-8
- 30 Yamin S, Stinchcombe A, Gagnon S. Deficits in Attention and Visual Processing but not Global Cognition Predict Simulated Driving Errors in Drivers Diagnosed with Mild Alzheimer’s Disease. American Journal of Alzheimer’s Disease and other Dementias 2016; 31: 351-360
- 31 Fuermaier ABM, Piersma D, De Waard D. et al. Driving difficulties among patients with Alzheimer’s disease and other neurodegenerative disorders. Journal of Alzheimer’s Disease 2019; 69: 1019-1030
- 32 Piersma D, Fuermaier AB. Waard et al. Prediction of Fitness to Drive in Patients with Alzheimer’s Dementia. PLoS ONE, Vol 11 p e 2016 0149566
- 33 Piersma D, Fuermaier ABM, de Waard D. et al. The MMSE should not be the sole indicator of fitness to drive in mild Alzheimer’s dementia. Acta neurologica Belgica 2018; 118: 637-642
- 34 Anstey KJ, Eramudugolla R, Chopra S. et al. Assessment of Driving Safety in Older Adults with Mild Cognitive Impairment. Journal of Alzheimer’s Disease 2017; 57: 1197-1205
- 35 Eramudugolla R, Huque MH, Wood J. et al. On-Road Behavior in Older Drivers With Mild Cognitive Impairment. Journal of the American Medical Directors Association 2020; 22(2): 399-405.e1
- 36 Crivelli L, María Julieta R, Farez MF. et al. Driving and alzheimer’s disease: A neuropsychological screening battery for the elderly. Dementia e Neuropsychologia 2019; 13: 312-320
- 37 Kurzthaler l, Kemmler G, Defrancesco M. et al Executive dysfunctions predict self-restricted driving habits in elderly people with or without Alzheimer’s dementia. Pharmacopsychiatry 2017; 50: 203-210
- 38 Paire-Ficout L, Lafont S, Conte F. et al. Naturalistic driving study investigating self-regulation behavior in early Alzheimer’s disease: A pilot study. Journal of Alzheimer’s Disease 2018; 63: 1499-1508
- 39 Schulz P, Spannhorst S, Beblo T. et al. Preliminary validation of a questionnaire covering risk factors for impaired driving skills in elderly patients. Geriatrics (Switzerland) 2016; 8;1(1): 5
- 40 Kay LG, Bundy AC, Clemson LM. Predicting fitness to drive in people with cognitive impairments by using DriveSafe and DriveAware. Arch Phys Med Rehabil 2009; 90: 1514-1522