Using Implementation Science to Guide the Process of Adapting a Patient Engagement Intervention for Inpatient Spinal Cord Injury/Disorder Rehabilitation.

Objectives: This study aimed to describe the process of adapting an evidence-based patient engagement intervention, enhanced medical rehabilitation (E-MR), for inpatient spinal cord injury/disease (SCI/D) rehabilitation using an implementation science framework.

Design: We applied the collaborative intervention planning framework and included a community advisory board (CAB) in an intervention mapping process.

Setting: A rehabilitation hospital.

Older adult driving performance assessed under simulated and on-road conditions.

Simulated driving offers a convenient test of driving ability for older drivers, although the viability of using simulated driving with this population is mixed. The relative weighting of the relevant perceptual, cognitive, and physical factors may vary between simulated and on-road driving. The current study was designed to assess this possibility.

Caregiver Prediction of Driving Fitness in Older Adults with Dementia.

: To determine whether caregiver opinion of fitness to drive and the level of assistance needed for functional activities are useful in determining the need for a Comprehensive Driving Evaluation.: This study examined a sample (N = 179) of drivers with dementia. Caregivers completed a questionnaire that included caregiver opinion of driving fitness and the Functional Assessment Questionnaire (FAQ).

Validity and Reliability of the Traffic Sign Naming Test (TSNT) and Written Exam for Driving Decisions (WEDD) as Measures of Fitness to Drive Among Older Adults.

Importance: Occupational therapists need valid and reliable tools to help determine fitness to drive of older drivers with medical conditions such as dementia.

Objective: To establish the validity and reliability of the Traffic Sign Naming Test (TSNT) and Written Exam for Driving Decisions (WEDD) as measures of fitness to drive of adults with and without dementia.

Design: Cross-sectional.

Alzheimer Disease Biomarkers and Driving in Clinically Normal Older Adults: Role of Spatial Navigation Abilities.

Purpose: Older adults experience impaired driving performance, and modify their driving habits, including limiting amount and spatial extent of travel. Alzheimer disease (AD)-related pathology, as well as spatial navigation difficulties, may influence driving performance and driving behaviors in clinically normal older adults. We examined whether AD biomarkers [cerebrospinal fluid (CSF) concentrations of Aβ42, tau, and ptau181] were associated with lower self-reported spatial navigation abilities, and whether navigation abilities mediated the relationship of AD biomarkers with driving performance and extent.

Preclinical Alzheimer's disease and longitudinal driving decline.

Introduction: Links between preclinical AD and driving difficulty onset would support the use of driving performance as an outcome in primary and secondary prevention trials among older adults (OAs). We examined whether AD biomarkers predicted the onset of driving difficulties among OAs.

Methods: 104 OAs (65+ years) with normal cognition took part in biomarker measurements, a road test, clinical and psychometric batteries and self-reported their driving habits.

Amyloid Imaging, Cerebrospinal Fluid Biomarkers Predict Driving Performance Among Cognitively Normal Individuals.

Postmortem brain studies of older drivers killed in car accidents indicate that many had Alzheimer disease (AD) neuropathologic changes. We examined whether AD biomarkers are related to driving performance among cognitively normal older adults. Individuals with normal cognition, aged 65+ years, and driving at least once per week, were recruited.

Clinical Utility of the Trail-Making Test as a Predictor of Driving Performance in Older Adults.

Objectives: To assess the clinical utility of the Trail-Making Tests (TMTs) as screens for impaired road-test performance.

Design: Secondary analyses of three data sets from previously published studies of impaired driving in older adults using comparable road test designs and outcome measures.

Setting: Two academic driving specialty clinics.

Driving Errors in Persons with Dementia.

Objectives: To differentiate driving errors in persons with dementia who fail a performance- based road test from errors in persons who pass.

Design: Cross-sectional.

Setting: Community.

Interrater Reliability of the Record of Driving Errors (RODE).

The Record of Driving Errors (RODE) is a novel standardized tool designed to quantitatively document the specific types of driving errors that occur during a standardized performance-based road test. The purpose of this study was to determine interrater reliability between two occupational therapy driver rehabilitation specialists who quantitatively scored specific driving errors using the RODE in a sample of older adults diagnosed with dementia (n=24). Intraclass correlation coefficients of major driving error and intervention categories indicated almost perfect agreement between raters.

Predicting road test performance in drivers with stroke.

OBJECTIVE. The aim of this study was to develop a brief screening battery to predict the on-road performance of drivers who had experienced a stroke. METHOD.

Potentially driver-impairing (PDI) medication use in medically impaired adults referred for driving evaluation.

Background: Potentially driver-impairing (PDI) medications have been associated with poorer driving performance and increased risk of motor vehicle collision.

Objectives: To describe the frequency of medication use and to determine the association between routine use of PDI medications and performance on driving and cognitive tests.

Methods: A total of 225 drivers with medical impairment (mean age 68 ± 12.

Predictors of return to driving after stroke.

Objective: Although returning to driving is a major concern for many survivors of stroke, predicting who will return to driving after a stroke is often difficult for rehabilitation professionals. The primary aim of this study was to identify patient factors present at admission to an inpatient rehabilitation hospital that can be used to identify which patients who have had acute stroke will and will not return to driving.

Design: After comparing returners and nonreturners on demographic and clinical characteristics, a logistic regression model with return to driving as the outcome variable was built using the backward stepwise method.

Naturalistic validation of an on-road driving test of older drivers.

Objective: The objective was to compare a standardized road test to naturalistic driving by older people who may have cognitive impairment to define improvements that could potentially enhance the validity of road testing in this population.

Background: Road testing has been widely adapted as a tool to assess driving competence of older people who may be at risk for unsafe driving because of dementia; however, the validity of this approach has not been rigorously evaluated.

Method: For 2 weeks, 80 older drivers (38 healthy elders and 42 with cognitive impairment) who passed a standardized road test were video recorded in their own vehicles.

Physician input and licensing of at-risk drivers: a review of all-inclusive medical evaluation forms in the US and Canada.

This article details a systematic review of medical evaluation forms in support of licensing decisions for medically at-risk drivers. Comparisons were made between all-inclusive forms utilized by 52 State and Provincial Departments of Motor Vehicles (DMVs) in the US and Canada. Comparisons focused on length, format, content, instructional quality, medical coverage, ease of use, and other qualitative characteristics.

Predicting road test performance in drivers with dementia.

Objectives: To develop a cognitive and functional screening battery for the on-road performance of older drivers with dementia.

Design: Prospective observational study.

Setting: On-road driving evaluation clinic at an academic rehabilitation center.