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Elderly Drivers with Cognitive Impairment

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21. Video Intervention to Enhance the Safety Of Cognitively Impaired Older Drivers

Video Intervention to Enhance the Safety Of Cognitively Impaired Older Drivers Video Intervention to Enhance the Safety Of Cognitively Impaired Older Drivers - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more (...) . Video Intervention to Enhance the Safety Of Cognitively Impaired Older Drivers The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02593552 Recruitment Status : Completed First Posted : November 2, 2015 Last Update Posted : May 27, 2016 Sponsor: Rhode Island Hospital Information provided by (Responsible

2015 Clinical Trials

22. Video Feedback Intervention for Cognitively Impaired Older Drivers

Video Feedback Intervention for Cognitively Impaired Older Drivers Video Feedback Intervention for Cognitively Impaired Older Drivers - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Video Feedback (...) Intervention for Cognitively Impaired Older Drivers The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT02600026 Recruitment Status : Recruiting First Posted : November 9, 2015 Last Update Posted : May 15, 2018 See Sponsor: Rhode

2015 Clinical Trials

23. Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru. Full Text available with Trip Pro

the "Encuesta de Salud y Bienestar del Adulto Mayor", a regional survey conducted in an extremely poor population of people older than 65 years old from 12 Peruvian cities in 2012. The outcome variable was cognitive impairment, determined by a score of ≤7 in the modified Mini-Mental State Examination. The exposure was self-reported hypertension status. Variables such as age, gender, controlled hypertension, education level, occupation, depression and area of living (rural/urban) were included (...) Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru. Previous studies have shown that hypertension is a risk factor for cognitive impairment, but whether this association is also present in extremely poor populations in Low Middle Income Countries settings remains to be studied. Understanding other drivers of cognitive impairment in this unique population also merits attention.We performed a secondary analysis using data from

2017 BMC Geriatrics

24. Assessment of Driving Safety in Older Adults with Mild Cognitive Impairment Full Text available with Trip Pro

Assessment of Driving Safety in Older Adults with Mild Cognitive Impairment With population aging, drivers with mild cognitive impairment (MCI) are increasing; however, there is little evidence available regarding their safety.We aimed to evaluate risk of unsafe on-road driving performance among older adults with MCI.The study was a cross-sectional observational study, set in Canberra, Australia. Participants were non-demented, current drivers (n = 302) aged 65 to 96 years (M = 75.7, SD = 6.18 (...) , 40% female) recruited through the community and primary and tertiary care clinics. Measures included a standardized on-road driving test (ORT), a battery of screening measures designed to evaluate older driver safety (UFOV®, DriveSafe, Multi-D), a neurocognitive test battery, and questionnaires on driving history and behavior.Using Winblad criteria, 57 participants were classified as having MCI and 245 as cognitively normal (CN). While the MCI group had a significantly lower overall safety rating

2017 Journal of Alzheimer's Disease

25. Age and the anaesthetist

, whereas only 1 in 16 of the population was aged 70-years-old. Less than 10% of the population lived to benefit. In Britain at the beginning of the 20th century, the only general support for old age was the Poor Law. None but a small number of people received a proper pension or had made private insurance provision. The consequent extent of poverty in the elderly resulted in Lloyd George’s Old Age Pensions Act (1908) [9], which paid a non- contributory, means-tested pension to each person aged over 70 (...) to keep people at work, but these are not necessarily in the public’s best interest, and this has been a regular topic of discussion in newspapers such as the Washington Post [49], in which continued employment of elderly medical staff has been questioned. It reports that 42% of physicians are > 55-years-old and 21% are > 65-years-old – a considerable contrast with the UK. Probably the oldest clinically practising living physician was Ephraim Engleman, who worked until his death at the age of 104 [50

2016 Association of Anaesthetists of GB and Ireland

26. Vision screening of older drivers for preventing road traffic injuries and fatalities. (Abstract)

among older drivers is referred to as "low mileage bias" in older driver mobility research. It is also important to note that older drivers are more vulnerable to serious injury and death in the event of a traffic crash due to changes in physiology associated with normal ageing. Vision, cognition, and motor functions or skills (e.g., strength, co-ordination, and flexibility) are three key domains required for safe driving. To drive safely, an individual needs to be able to see road signs, road side (...) Vision screening of older drivers for preventing road traffic injuries and fatalities. Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer generation passes retirement age. As older adults make up an increasing proportion of the population, they are an important consideration when designing future evidence-based traffic safety policies, particularly those that lead to restrictions

2014 Cochrane

27. Circulating mitochondrial DNA: New indices of type 2 diabetes-related cognitive impairment in Mexican Americans. Full Text available with Trip Pro

Circulating mitochondrial DNA: New indices of type 2 diabetes-related cognitive impairment in Mexican Americans. Mitochondrial function has been implicated and studied in numerous complex age-related diseases. Understanding the potential role of mitochondria in disease pathophysiology is of importance due to the rise in prevalence of complex age-related diseases, such as type 2 diabetes (T2D) and Alzheimer's disease (AD). These two diseases specifically share common pathophysiological (...) characteristics which potentially point to a common root cause or factors for disease exacerbation. Studying the shared phenomena in Mexican Americans is of particular importance due to the disproportionate prevalence of both T2D and AD in this population. Here, we assessed the potential role of mitochondria in T2D and cognitive impairment (CI) in a Mexican American cohort by analyzing blood-based indices of mitochondrial DNA copy number (mtDNACN) and cell-free mitochondrial DNA (CFmtDNA). These mitochondrial

2019 PLoS ONE

28. Predicting On-Road Driving Performance and Safety in Cognitively Impaired Older Adults (Abstract)

Predicting On-Road Driving Performance and Safety in Cognitively Impaired Older Adults To evaluate the ability to predict on-road driving in cognitively impaired older drivers.Cross-sectional observational study.Laboratory tests and on-road assessment.Drivers with cognitive impairment (Mini-Mental State Examination score < 26, N = 43, mean age 74).The Roadwise Review, a hazard perception test (HPT), several vision tests, and a standardized 18-km driving assessment.The best prediction of passing (...) or failing the on-road test was a combination of the HPT, leg strength, visual acuity, visual search and working memory, and number of medications taken (Nagelkerke coefficient of determination = 0.40). The sensitivity of the model was 71%, and the specificity was 75%.Further research is required to determine how these tests may be used or combined with other data (e.g., medical history) to assess fitness to drive of cognitively impaired older drivers.© 2015, Copyright the Authors Journal compilation ©

2015 EvidenceUpdates

29. Child Abuse, Elder Abuse, and Intimate Partner Violence

Guideline Gap Assessment Tool 108 Appendix A-3 Intimate Partner Violence Guideline Gap Assessment Tool 111 Appendix A-4 Sex Trafficking Guideline Gap Assessment Tool 114 Appendix B-1 Mary Bridge Children’s Hospital Screening Tool for Child Abuse 116 Appendix B-2 Emergency Department: Mistreatment Assessment Tool for Social Workers (ED-MATS), Comprehensive Assessment 118 Appendix B-3 Elder Abuse Suspicion Index (EASI © ) 119 Appendix B-4 Geriatric Injury Documentation Tool 120 Appendix C-1 Screening (...) for Intimate Partner Violence or Sex Trafficking 122 Appendix C-2 Trauma Coder’s Guide to Abuse Injury Coding 123 Expert Panel 127 3INTRODUCTION Child abuse, elder abuse, and intimate partner violence are serious, preventable public health problems that affect millions of people. This guideline seeks to help the trauma practitioner identify victims of abuse that present with physical injury and to initiate treatment and reporting. While this Best Practices Guideline (BPG) is not intended to focus

2019 American College of Surgeons

30. A neuropsychological instrument measuring age-related cerebral decline in older drivers: development, reliability, and validity of MedDrive. Full Text available with Trip Pro

A neuropsychological instrument measuring age-related cerebral decline in older drivers: development, reliability, and validity of MedDrive. When facing age-related cerebral decline, older adults are unequally affected by cognitive impairment without us knowing why. To explore underlying mechanisms and find possible solutions to maintain life-space mobility, there is a need for a standardized behavioral test that relates to behaviors in natural environments. The aim of the project described (...) in this paper was therefore to provide a free, reliable, transparent, computer-based instrument capable of detecting age-related changes on visual processing and cortical functions for the purposes of research into human behavior in computational transportation science. After obtaining content validity, exploring psychometric properties of the developed tasks, we derived (Study 1) the scoring method for measuring cerebral decline on 106 older drivers aged ≥70 years attending a driving refresher course

2014 Frontiers in human neuroscience Controlled trial quality: uncertain

31. Searching for a mitochondrial root to the decline in muscle function with ageing. Full Text available with Trip Pro

Searching for a mitochondrial root to the decline in muscle function with ageing. Sarcopenia, the age-related loss of muscle mass and strength, is linked to a range of adverse outcomes, such as impaired physical performance, cognitive function, and mortality. Preventing sarcopenia may reduce the burden of functional decline with aging and its impact on physiological and economic well-being in older adults. Mitochondria in muscle cells lose their intrinsic efficiency and capacity to produce (...) energy during aging, and it has been hypothesized that such a decline is the main driver of sarcopenia. Oxidative phosphorylation becomes impaired with aging, affecting muscle performance, and contributing to an age-associated decline in mobility. However, it is unclear whether this deterioration is due to a reduced mitochondria population, decreased mitochondrial energetic efficiency, or a reduced capacity to dynamically transport oxygen and nutrients into the mitochondria, and addressing

2018 Journal of cachexia, sarcopenia and muscle

32. Association of Functional Impairments and Co-Morbid Conditions with Driving Performance among Cognitively Normal Older Adults. Full Text available with Trip Pro

Association of Functional Impairments and Co-Morbid Conditions with Driving Performance among Cognitively Normal Older Adults. To examine the relationship between key functional impairments, co-morbid conditions and driving performance in a sample of cognitively normal older adults.Prospective observational study.The Knight Alzheimer's Disease Research Center, Washington University at St. Louis.Individuals with normal cognition, 64.9 to 88.2 years old (N = 129), with a valid driver's license (...) , who were currently driving at least once per week, and who had participated in longitudinal studies at the Knight Alzheimer's Disease Research Center.Static visual acuity, contrast sensitivity, physical frailty measures, motor skills, total medical conditions, and the modified Washington University Road Test.When controlling for age, race, gender, APOE, and education the total number of medical conditions was unassociated with both road test scores (pass vs. marginal + fail) and the total driver

2016 PLoS ONE

33. Working with Families to Promote Safe Sleep for Infants 0-12 Months of Age

been defined as the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness (Commission on Social Determinants of Health, 2008a, 2008b). According to the Commission, avoidable health inequities that exist within and between countries are largely attributable to such circumstances, which are shaped by economics, social policies and politics. Examples of social determinants that affect the health of Canadians include: ¦ income and social (...) for action, which may inform future directions (Commission on Social Determinants of Health, 2008a, 2008b):22 REGISTERED NURSES’ ASSOCIATION OF ONTARIO BACKGROUND Working with Families to Promote Safe Sleep for Infants 0-12 Months of Age 1. Improve daily living conditions – the circumstances in which people are born, grow, live, work, and age (e.g., promote access to affordable housing, fair employment, and primary health care); 2. Address the inequitable distribution of power, money, and resources

2014 Registered Nurses' Association of Ontario

34. How effective is the Trail Making Test (Parts A and B) in identifying cognitively impaired drivers? Full Text available with Trip Pro

How effective is the Trail Making Test (Parts A and B) in identifying cognitively impaired drivers? the medical community plays an important role in identifying drivers who may no longer be competent to drive due to illnesses such as dementia. Several office-based cognitive screening tools are currently used by the medical community, e.g. Mini-Mental State Examination, Trail Making Test (TMT), to assist in the identification of cognitively impaired (CI) at-risk drivers. However, the predictive (...) previous studies/guidelines were used to assess predictive power.a total of 134 older drivers (mean age = 75.30; SD = 7.83) participated: 87 healthy controls and 47 CI individuals. All predictor variables, with the exception of TMT-A errors, were significantly correlated with driving outcome. However, results from ROC curve analyses indicated that only TMT-A and -B total time had moderate discriminative abilities. Results also indicate that the power of the TMT is the lowest where physicians need

2013 EvidenceUpdates

35. Self-regulation of older drivers with cognitive impairment: a systematic review. (Abstract)

Self-regulation of older drivers with cognitive impairment: a systematic review. Cognitive decline contributes significantly to the safety risk of older drivers. Some drivers may be able to compensate for the increased crash risk by avoiding complex driving situations or restricting their driving.A comprehensive English-language systematic review was conducted to determine the level of evidence for older adult drivers with cognitive impairment engaging in self-regulation.Twelve studies were (...) included in the review. The majority of studies investigated driver avoidance, followed by driver restriction. Few studies ascertained the reasons for changing driving behaviour.The evidence supports the view that drivers with cognitive impairment do restrict their driving and avoid complex driving situations. However, it remains to be determined whether the drivers who engage in self-regulation have insight into their own driving abilities or whether external factors result in self-regulation

2014 Australasian journal on ageing

36. Predicting on-road assessment pass and fail outcomes in older drivers with cognitive impairment using a battery of computerized sensory-motor and cognitive tests. (Abstract)

-road tests previously found to be useful in other older populations, and a carefully constructed and tested prediction model, off-road measures have yet to be found that are sufficiently accurate to allow acceptable determination of on-road driving safety of cognitively impaired older drivers.© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society. (...) Predicting on-road assessment pass and fail outcomes in older drivers with cognitive impairment using a battery of computerized sensory-motor and cognitive tests. To generate a robust model of computerized sensory-motor and cognitive test performance to predict on-road driving assessment outcomes in older persons with diagnosed or suspected cognitive impairment.A logistic regression model classified pass–fail outcomes of a blinded on-road driving assessment. Generalizability of the model

2013 Journal of the American Geriatrics Society

37. Association between vision impairment and driving exposure in older adults aged 70 years and over: a population-based examination. Full Text available with Trip Pro

Association between vision impairment and driving exposure in older adults aged 70 years and over: a population-based examination. To examine the relationship between vision impairment and driving exposure (amount of driving one does) in a population-based sample of older drivers and to examine to what extent cognitive status impacts this relationship.Enrollees consisted of a population-based sample of older adults from Alabama who were ≥70 years old, held a current driver's license, and had (...) , and a decreased number of places and trips driven per week compared to those with normal contrast sensitivity, even after adjustment for other factors. Slowed visual processing speed was associated with reduced number of days driven per week after adjustment. Visual acuity deficit was not associated with changes in driving exposure. Cognitive status did not impact any of the associations between vision impairment and driving exposure.Older drivers with contrast sensitivity impairment exhibit reduced driving

2014 Acta ophthalmologica

38. Adherence to driving cessation advice given to patients with cognitive impairment and consequences for mobility. Full Text available with Trip Pro

Adherence to driving cessation advice given to patients with cognitive impairment and consequences for mobility. Driving is related to social participation; therefore older drivers may be reluctant to cease driving. Continuation of driving has also been reported in a large proportion of patients with cognitive impairment. The aim of this study is to investigate whether patients with cognitive impairment adhere to driving cessation advice after a fitness-to-drive assessment and what (...) their frequency of cycling and/or public transport use.Adherence to the recommendations given after the fitness-to-drive assessments was high. Female patients were in general more likely to cease driving. However, a minority of patients did not adhere to driving cessation advice. These drivers with dementia should be made aware of the progression of their cognitive impairment and general health decline to facilitate driving cessation. There are large differences in mobility between patients with cognitive

2018 BMC Geriatrics

39. General cognitive impairment as a risk factor for motor vehicle collision involvement: a prospective population-based study Full Text available with Trip Pro

General cognitive impairment as a risk factor for motor vehicle collision involvement: a prospective population-based study This study examined whether cognitive impairment and decline as assessed by a brief mental status screening test is associated with future crash risk in a cohort of older drivers. A three-year prospective study was conducted in a population-based sample of 2000 licensed drivers aged 70 years and older. At the baseline visit, cognitive impairment was defined as <24 (...) ; adjustment for potential confounders namely age and visual processing speed attenuated this relationship (adjusted RR=1.26, 95% CI 0.65-2.44). Drivers who experienced a pronounced decline in estimated MMSE scores in one year were 1.64 (95% CI 1.04-2.57) times more likely to have a future at-fault crash compared to those whose scores did not decline. Evaluation of MMSE over time may provide important insight in an older driver's future risk of at-fault crash involvement.

2018 Geriatrics (Basel, Switzerland)

40. Determining medical fitness to operate motor vehicles : CMA driver's guide

and accurate. Features in this edition include: Updated information in the Dementia and Mild Cognitive Impairment, Sleep Disorders, Nervous system and Aging sections Rewritten sections on Psychiatric, Alcohol and Drugs to conform to DSM-5 New information on medical marijuana and driving An updated section on Endocrine and Metabolic Disorders referencing the latest recommendations from the Canadian Diabetes Association (CDA) Several other sections underwent minor changes to bring them up to date with recent (...) Determining medical fitness to operate motor vehicles : CMA driver's guide CMA Driver's Guide (9th edition) | Joule, a CMA Company Utilities Search Search Main navigation Quantum Clinical Search Main navigation - conditional Quantum Clinical Search CMA Driver's Guide (9th edition) | 40+ years Length of time the CMA and Joule have been helping physicians keep Canadian highways, railways and skies safe. What's new? The guide is reviewed regularly to ensure that the information remains current

2017 CPG Infobase

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