치매환자들의 운전실태: 노인성치매임상연구센터 연구
Driving in Patients with Dementia: A CREDOS (Clinical Research Center for Dementia of South Korea) Study
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초록
Background: There are few studies about driving and dementia in Korea. The purpose of this study is to investigate the real condition of automobile driving in patients with dementia and the characteristics of those who continue to drive after diagnosis of dementia. Methods: A total of 4,377 patients including 3,792 with Alzheimer’s disease and 585 with vascular dementia were recruited from multiple nationwide hospitals. Clinical evaluations and neuropsychological tests were done in them according to the protocol of the Clinical Research Center for Dementia of South Korea study. Caregivers replied which patients drove an automobile, gave up driving, or has never driven. The same evaluations of them were followed after one year. Results: There were 272 (6.2%) drivers, 321 (7.3%) ex-drivers, and 3,784 (86.5%) non-drivers with dementia. Drivers with dementia were younger and had higher Korean Mini-Mental State Examination (K-MMSE) (21.5±4.3 vs 19.8±5.1 vs 17.4±5.2, p<0.001) and lower Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) scores (4.08±2.15 vs 5.80±3.41 vs 5.83±3.39, p<0.001) compared with ex-drivers and non-drivers with dementia. The drivers and ex-drivers with dementia had higher educational level and a higher proportion of male compared with non-drivers with dementia (77.6% vs 80.1% vs 23.3%, p<0.001). About 54.6% of the drivers with dementia continued to drive at one year after diagnosis of dementia. They had higher K-MMSE (23.2±3.6 vs 20.8±4.5, p=0.003) and lower CDR-SB scores (3.30±1.47 vs 4.40±1.85, p=0.001) at baseline compared with those who quitted driving after baseline. Conclusions: Male patients who were relatively young and had high educational level and mild dementia had a tendency to drive an automobile at that time of diagnosis of dementia. About half of them continued to drive after diagnosis of dementia.
Abstract
Background: There are few studies about driving and dementia in Korea. The purpose of this study is to investigate the real condition of automobile driving in patients with dementia and the characteristics of those who continue to drive after diagnosis of dementia. Methods: A total of 4,377 patients including 3,792 with Alzheimer’s disease and 585 with vascular dementia were recruited from multiple nationwide hospitals. Clinical evaluations and neuropsychological tests were done in them according to the protocol of the Clinical Research Center for Dementia of South Korea study. Caregivers replied which patients drove an automobile, gave up driving, or has never driven. The same evaluations of them were followed after one year. Results: There were 272 (6.2%) drivers, 321 (7.3%) ex-drivers, and 3,784 (86.5%) non-drivers with dementia. Drivers with dementia were younger and had higher Korean Mini-Mental State Examination (K-MMSE) (21.5±4.3 vs 19.8±5.1 vs 17.4±5.2, p<0.001) and lower Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) scores (4.08±2.15 vs 5.80±3.41 vs 5.83±3.39, p<0.001) compared with ex-drivers and non-drivers with dementia. The drivers and ex-drivers with dementia had higher educational level and a higher proportion of male compared with non-drivers with dementia (77.6% vs 80.1% vs 23.3%, p<0.001). About 54.6% of the drivers with dementia continued to drive at one year after diagnosis of dementia. They had higher K-MMSE (23.2±3.6 vs 20.8±4.5, p=0.003) and lower CDR-SB scores (3.30±1.47 vs 4.40±1.85, p=0.001) at baseline compared with those who quitted driving after baseline. Conclusions: Male patients who were relatively young and had high educational level and mild dementia had a tendency to drive an automobile at that time of diagnosis of dementia. About half of them continued to drive after diagnosis of dementia.
참고문헌 (26)
- Eby DW, "Driving behaviors in early stage dementia : a study using in-vehicle technology", Accid Anal Prev, 49, pp.330~337 (2012)
- Breen DA, "Driving and dementia", BMJ, 334, pp.1365~1369 (2007)
- Iverson DJ, "Practice parameter update : evaluation and management of driving risk in dementia : report of the Quality Standards Subcommittee of the American Academy of Neurology", Neurology, 74, pp.1316~1324 (2010)
- Dawson JD, "Predictors of driving safety in early Alzheimer disease", Neurology, 72, pp.521~527 (2009)
- Cutler SJ, "Transport changes in life satisfaction", Gerontologist, 15, pp.155~159 (1975)
- Marottoli RA, "Consequences of driving cessation: decreased out-of-home activity levels", J Gerontol B Psychol Sci Soc Sci, 55, pp.S334~S340 (2000)
- Ragland DR, "Driving cessation and increased depressive symptoms", J Gerontol A Biol Sci Med Sci, 60, pp.399~403 (2005)
- Adler G, "Driving cessation in older men with dementia", Alzheimer Dis Assoc Disord, 17, pp.68~71 (2003)
- Carmody J, "Driving with dementia: Equity, obligation, and insurance", Australas Med J, 7, pp.384~387 (2014)
- Carter K, "Driving and dementia: a clinical decision pathway", Int J Geriatr Psychiatry (2014)
- Choi SH, "Neurologic signs in relation to cognitive function in subcortical ischemic vascular dementia : a CREDOS(Clinical Research Center for Dementia of South Korea)study", Neurol Sci, 33, pp.839~846 (2012)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders" (1994), American Psychiatric Association
- McKhann G, "Clinical diagnosis of Alzheimer’s disease : report of the NINCDSADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease", Neurology, 34, pp.939~944 (1984)
- Román GC, "Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop", Neurology, 43, pp.250~260 (1993)
- Noh Y, "A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities", J Stroke Cerebrovasc Dis, 23, pp.636~642 (2014)
- 구형모, "일상활동평가-복합(Seoul-Instrumental Activities of Daily Living ; S-IADL)의 신뢰도 및 타당도 연구", 신경정신의학, 43(2), pp.189~199 (2004), 대한신경정신의학회
- Mahoney FI, "Functional evaluation : the Barthel Index", MdState Med J, 14, pp.61~65 (1965)
- Han C, "An adaptation of the Korean mini-mental state examination(K-MMSE)in elderly Koreans : demographic influence and population-based norms(the AGE study)", Arch Gerontol Geriatr, 47, pp.302~310 (2008)
- 안현정, "Seoul Neuropsychological Screening Battery-Dementia Version (SNSB-D): A Useful Tool for Assessing and Monitoring Cognitive Impairments in Dementia Patients", Journal of Korean Medical Science, 25(7), pp.1071~1076 (2010), 대한의학회
- Bae JN, "Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients", J Psychosom Res, 57, pp.297~305 (2004)
- Choi SH, "Interchanging scores between clinical dementia rating scale and global deterioration scale", Alzheimer Dis Assoc Disord, 17, pp.98~105 (2003)
- Hachinski VC, "Cerebral blood flow in dementia", Arch Neurol, 32, pp.632~637 (1975)
- 윤보라, "치매 환자는 누가 돌보는가: 독거 치매 노인 현황과 주부양자 조사 연구", Dementia and Neurocognitive Disorders(대한치매학회지), 11(1), pp.13~17 (2012), 대한치매학회
- 김성래, "알츠하이머병, 기억성 경도인지장애, 피질하 유형의 혈관성치매와 혈관성 경도인지장애에서 육체기능 저하가 도구일상생활능력에 미치는 영향", 대한신경과학회지, 27(4), pp.355~361 (2009), 대한신경과학회
- Marie Dit Asse L, "Automobile driving in older adults : factors affecting driving restriction in men and women", J Am Geriatr Soc, 62, pp.2071~2078 (2014)
- O’Bryant SE, "Validation of the new interpretive guidelines for the clinical dementia rating scale sum of boxes score in the national Alzheimer’s coordinating center database", Arch Neurol, 67, pp.746~749 (2010)