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CC BY-NC-ND 4.0 · Gesundheitswesen 2023; 85(04): 354-363
DOI: 10.1055/a-1690-6940
Übersichtsarbeit

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
Linda Karrer
1   Interdisziplinäres Zentrum für Health Technology Assessment (HTA) und Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
,
Elisabeth Pfleger
1   Interdisziplinäres Zentrum für Health Technology Assessment (HTA) und Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
,
Peter Kolominsky-Rabas
1   Interdisziplinäres Zentrum für Health Technology Assessment (HTA) und Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
› Author Affiliations Förderung Das Projekt digiDEM Bayern wird durch das Bayerische Staatsministerium für Gesundheit und Pflege (StMGP) gefördert (Förderkennzeichen G42d-G8300–2017/1606–38).
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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 - Fahrperformanz

Key words

People with dementia - MCI - Fitness to drive - Driving performance


Publication History

Article published online:
24 January 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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