인지기능 저하를 보이는 노인군에서 시각 주의력 및 운전수행 손상
Impairments of Visual Attention and Driving Performance in Older Adults with Declined Cognitive Functions
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초록
본 연구는 경도 인지 장애군과 경증 알츠하이머병 환자군에서 시각 주의력의 손상이 운전 수행과 관련이 있는지를 알아보고자 하였다. 이를 위해 경증 알츠하이머병 환자군과 경도 인지 장애군, 정상 노인 대조군을 대상으로 연속 수행 과제와 시각 탐색 과제, 변화 맹시 과제 등 전산화된 신경심리검사를 실시하여 시각 주의력을 측정하였으며, 운전시뮬레이터를 사용하여 운전 수행을 비교하였다. 그 결과, 시각 주의력 측정치에서 경증 알츠하이머병 환자군이 경도 인지 장애군과 정상 노인 대조군에 비해 유의하게 저조한 수행을 보이고 있었다. K-평균 군집분석으로 인지기능저하군(경증 알츠하이머병 환자군+경도 인지 장애군)을 운전을 잘한 집단과 못한 집단으로 분류하였다. 그리고 시각 주의과제 측정치로 판별 분석한 결과, 운전자 집단에서 사례의 81.8%를 정확하게 분류하여 성공적으로 분류할 수 있었다. 결론적으로, 경증 알츠하이머병 환자군과 경도 인지 장애군의 시각 주의력 손상이 운전 수행을 저조하게 할 수 있으며, 알츠하이머병 환자에서 시각 주의력의 측정이 운전적합성 여부의 판단을 위한 기초적인 선별검사로써 유용할 것으로 생각된다. 마지막으로 연구의 제한점과 추후 연구에 대한 방향을 제시하였다.
Abstract
This study examined impairments of visual attention and driving performance in mild cognitive impairment(MCI), mild Alzheimer's disease(AD), and control groups. All groups were subjected to several web-based neuropsychological tests, including a continuous performance test, a visual search task, and a change blindness task in order to measure impairments in visual attention. In addition, a driving simulator was employed to compare driving performances among the three groups. As a result, AD group showed poorer performances on the visual attention task compared to MCI and control groups. Using a K-means cluster analysis with five driving performance scales, the declined cognitive function group(AD+MCI) was divided into Good/Bad driver subgroups. Finally, a discriminant function analysis was conducted to test whether the five measures of visual attention could successfully classify the two groups. As a result, 81% of the members were correctly classified, suggesting that impairments on visual attention in AD and MCI may cause poor driving performances. Also, it was demonstrated that visual attention tests might be useful in determining the suitability of obtaining or keeping a driving license in AD patients. Several limitations of the present study and suggestions for further research were discussed.
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