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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
671

Investigating cognitive impairments in amyotrophic lateral sclerosis (ALS) using eye movements and functional magnetic resonance imaging (fMRI)

Witiuk, Kelsey 26 September 2011 (has links)
Patients with Amyotrophic lateral sclerosis (ALS) often experience cognitive impairment that accompanies degeneration of the motor system. A valuable tool for assessing cognitive control over behaviour is the antisaccade task which requires: 1) inhibition of the automatic response to look towards an eccentric visual stimulus (prosaccade) to instead 2) redirect gaze in the opposite direction of the stimulus (antisaccade). Psychometric tests were used to quantify the degree of impairment, while eye tracking, functional magnetic resonance imaging (fMRI) and structural MRI were combined to identify the neural correlates of cognitive impairment in ALS. We predict ALS patients will have executive dysfunction and grey matter loss in executive and oculomotor control areas that will affect antisaccade performance and will alter the corresponding brain activation. ALS patients and age-matched controls participated in a rapid-event-related fMRI design with interleaved pro- and antisaccade trials. Catch trials (no stimulus presented after instructional cue to prepare pro- or antisaccade) allowed us to discern the preparatory period from the execution period. ALS patients were biased towards automatic saccade responses, and had greater difficulty with antisaccades relative to controls in terms of correct and timely responses. We found that worsened antisaccade performance in ALS correlated with the degree of cognitive impairment. Generally, we found trends of increased brain activation during the preparatory period of antisaccades in ALS patients compared to controls in most oculomotor areas; meanwhile few differences were seen during execution. Structural analyses revealed ALS patients had decreased grey matter thickness in frontotemporal and oculomotor regions such as the frontal and supplementary eye fields (FEF, SEF) and the dorsolateral prefrontal cortex (DLPFC). These findings suggest that loss of structural integrity and executive dysfunction may elicit compensation mechanisms to improve functional and behavioural performance. Despite this compensation, ALS patients still performed worse on antisaccades than controls. Further investigation to expand the current data set should improve our ability to assuredly identify the neural correlates of cognitive decline in ALS, and may provide a model system to use for critical evaluation of future therapies and interventions for ALS. / Thesis (Master, Neuroscience Studies) -- Queen's University, 2011-09-22 14:20:39.704
672

FLEEING PREDATION: THE EFFECT OF COPPER EXPOSURE ON INDUCIBLE ANTIPREDATOR DEFENSES IN DAPHNIA PULICARIA CLONES FROM A HISTORICALLY METAL CONTAMINATED LAKE

BRESNEHAN, AMANDA 05 April 2012 (has links)
Antipredator defenses are ubiquitous in aquatic ecosystems. In the widely studied Chaoborus-Daphnia predator-prey system, Daphnia elicit a variety of phenotypically plastic responses to Chaoborus including: morphological, life history, and behavioral responses. While these inducible defenses benefit the prey, metal contaminants have been shown to interfere with chemosensory functions, thereby inhibiting antipredator defenses and decreasing survivorship. However, in lakes with a history of metal contamination, such as Kelly Lake in Sudbury, Ontario, there is evidence to suggest that Daphnia may have adapted to high, ambient copper concentrations. Using seven distinct Daphnia clones that were hatched from resting eggs from Kelly Lake, we examined morphological and life history traits when clones were exposed to either a nominal concentration of copper, kairomone, or a combination of both. As expected, clones displayed a variety of inducible responses in both kairomone-control and kairomone-copper treatments, which was attributed to genetic variability. Expected trade-offs in life history traits were not always observed, suggesting that inducible traits may be coupled. Furthermore, in contradiction to life history theory, one clone exhibited both increased somatic growth and increased reproductive output, indicating that clones likely adopted adaptive strategies to stressors rather than elicitng trade-offs in traditional traits. Our results indicate that environmentally relevant copper concentrations do not inhibit the induction of antipredator defenses in Daphnia from Kelly Lake, and we conclude that Kelly Lake Daphnia have developed an adaptive tolerance to copper. Adaptation to copper contamination may have implications for resilience in natural Kelly Lake populations. / Thesis (Master, Biology) -- Queen's University, 2012-04-03 19:33:59.137
673

Genetic epidemiology and phenotypic resolution of complex traits : studies in specific language impairment and alcoholism

Kovac, Ilija. January 2000 (has links)
Rationale. Definition of complex behavioral disorders is generally phenomenological in nature and guided by pragmatic, rather than genetic, concerns. Consequently, important aspect of genetic analysis is the search for novel phenotypic definitions from the familial/genetic perspective. SLI study 1. SLI denotes an inability to acquire normal language in the absence of peripheral hearing impairment, neurological disorder, and mental retardation. Sibling resemblance for several theoretically derived specific components of the SLI phenotype was examined in families of SLI children. In 38 sib-pairs from 10 French-speaking pedigrees, Verb Tense Morphology sub-tests (Real and Non-real Words) showed nonparametric correlations of 0.39 and 0.35, respectively (p < 0.05, 2-tailed). In a densely affected Anglophone pedigree, 41 sib-pair showed familial resemblance with respect to Derivational Morphology (r = 0.52, p < 0.01). SLI study 2. Family history study in 27 families examined the relationship between attention deficit/hyperactivity in SLI children and familial risk of speech/language disorders. Higher odds of speech/language disorders were observed in first-degree relatives of 13 SLI children who also had a medical record of attention deficit/hyperactivity (15/27 vs. 4/46, p = 0.001). Alcoholism study 1. Latent class analysis (LCA) including gender and 15 antisocial behaviors (>15yr) was performed in 236 broadly ascertained alcohol-dependent subjects (121 males, 115 females). Evidence for 3 qualitative behavioral classes was obtained: Socially Adjusted Adults, SAA; Antisocial Non-Aggressive Adults, ANAA; and Antisocial Aggressive Adults, AAA. In both, genders, the AAA class had the earliest age of onset for alcohol dependence (p = 0.001), more alcoholic first-degree relatives and more of other psychopathology. In females, the ANAA class was intermediate. In the ANAA males, socially adjusted childhood behavior differentiated the late onset from the intermediate ons
674

De la difficulté des enfants dysphasiques à décoder des émotions de base : éclairages sur un syndrome méconnu

Skhiri, Amina 05 1900 (has links)
On évoque souvent des difficultés à interagir socialement chez les enfants ayant une dysphasie. Ces difficultés sont généralement attribuées aux troubles du langage, mais elles pourraient aussi provenir d’un problème à décoder les émotions des autres. Le but de la présente recherche est d’explorer cette voie chez les enfants dysphasiques de 9 à 12 ans. Différents stimuli émotionnels leur ont été présentés sous forme de vidéos ainsi qu’à des enfants d’un groupe contrôle selon cinq conditions : parole non filtrée, parole filtrée, visage dynamique, visage dynamique accompagné de la parole non filtrée, et visage dynamique avec parole filtrée. Les enfants dysphasiques et les enfants du groupe contrôle ne se comportent pas différemment de manière significative en fonction des émotions présentées et des conditions testées. Par contre, un sous-groupe d’enfants ayant une dysphasie mixte commet significativement plus d’erreurs pour l’ensemble de la tâche que le sous-groupe d’enfants sans dysphasie de même âge chronologique. En fait une part seulement des enfants dysphasiques mixtes ont des scores plus faibles. Ces mêmes enfants présentent un QI non verbal faible tandis que leur compréhension du langage est équivalente à celle de leur sous-groupe (enfants dysphasiques mixtes). Malgré ces différences significatives, les scores des enfants dysphasiques mixtes restent relativement élevés et les difficultés observées sont subtiles. Sur le plan clinique, les praticiens (orthophonistes, psychologues, éducateur) devront systématiser l’évaluation des habiletés de décodage des émotions chez l’enfant dysphasique dont les difficultés ne sont pas forcément évidentes dans la vie quotidienne. La recherche devra développer un outil de dépistage sensible aux troubles de décodage émotionnel et des stratégies thérapeutiques adaptées. / Children with Specific Language Impairment (SLI) can have social problems that are often explained by their language disorders. However, the ability to identify other people’s emotions could be caused by their emotion processing difficulties. We explore this question in children with SLI aged 9 to 12 years old. Children with and without SLI were tested on five emotional stimuli presented in dynamic video and audio format: unfiltered speech, filtered speech, facial expressions, facial expressions with unfiltered speech, and facial expressions with filtered speech. The children with impaired language do not differ significantly from the unimpaired children across all modalities and emotions. However, a subgroup of SLI children with mixed (expressive-receptive) delay commits more errors on the task than their age-matched peers. In fact only a subgroup of these children shows lower scores. These same children also show low IQ scores but language comprehension as good as their subgroup. Despite these significant differences the mixed SLI group’s scores are quite high, showing that deficits are subtle. Clinical implications of this study militate for a systematization of the evaluation by health practitioners of these abilities in children with SLI who might not show obvious signs of deficits in this domain in their everyday activities. Research should pursue the development of a sensitive evaluation tool to identify emotional decoding difficulties and should evaluate therapeutic strategies adapted to this population.
675

Quality of Life in Adult Obsessive-Compulsive Disorder: The Role of Moderating and Mediating Variables

Speisman, Brittany Belle 01 January 2012 (has links)
Background: This study examined the contribution of various aspects of obsessive-compulsive disorder (OCD) on quality of life (QoL) in 102 adults with a principal diagnosis of OCD from an archival database. Method: Participants were assessed for DSM-IV diagnoses by trained clinicians using the Anxiety Disorders Interview Schedule, 4th Edition (ADIS-IV), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and an unstructured interview. Further information was attained using the Beck Depression Inventory II (BDI-II), the Obsessive Compulsive Inventory Revised (OCI-R) and the Medical Outcome Study-36 (MOS-36). Results: Results indicated that obsessive-compulsive symptom severity was positively correlated with diminished emotional health, social functioning and general health QoL, but not physical health QoL. Main effects were found for depression severity, the presence or absence of comorbid major depressive disorder and obsessive-compulsive symptom severity and QoL. Mediational analyses indicated that interference of obsessive-compulsive symptoms on the Y-BOCS mediated the relationship between obsessive-compulsive symptom severity and social functioning, emotional health and general health QoL. Mediational analyses further revealed that resistance to obsessive-compulsive symptoms on the Y-BOCS was a mediator between obsessive-compulsive symptom severity and social functioning QoL. Further analyses explained the role of each mediator in the relationship between obsessive-compulsive symptom severity and social functioning QoL. Across symptom dimensions, persons with OCD had a largely impacted QoL within multiple domains. Conclusions: Diminished QoL is common in persons with OCD and is essential in understanding the complete clinical picture of OCD. Results are discussed in terms of implications for assessment, treatment and future research.
676

Sutrikusios klausos mokinių verbalinės raiškos skatinimas dailės terapijos sesijose / Stimulation of verbal expression for pupil with impaired hearing by sessions of art therapy

Poškienė, Irena 07 September 2010 (has links)
Darbe atlikta teorinė analizė atskleidė, kad sutrikusios klausos mokiniai susiduria su verbalinės raiškos problemomis dėl turimo skurdaus žodyno ir paveikto gebėjimo priimti, suprasti, išreikšti lingvistinę informaciją. Šias problemas galima spręsti dailės terapijos sesijose, kurių metu, sudarant sąlygas, įgyjama dailinės ir verbalinės raiškos patirtis, lavinami įgūdžiai. Iškelta hipotezė, kad dailės terapijos sesijose yra skatinama klausos sutrikimų turinčių mokinių verbalinė raiška. Veiklos (veiksmo) metodu buvo atliktas tyrimas, kurio tikslas – ištirti dailės terapijos poveikį skatinant sutrikusios klausos mokinių verbalinę raišką. Panaudojus literatūros analizės rezultatus, organizuotos dailės terapijos sesijos, kuriose buvo stebimos dailinės raiškos inspiravimo ir verbalinės raiškos skatinimo apraiškos. Tyrime dalyvavo 5 (2 neprigirdintys ir 3 kurti) klausos sutrikimų turintys 10-14 metų amžiaus mokiniai. Empirinėje dalyje nagrinėti sutrikusios klausos mokinių verbalinės raiškos skatinimo rezultatai bei atliktos content ir fenomenografinės analizės atskleidė svarbiausias tyrimo išvadas: 1. Retrospektyvus dailės terapijos sesijų stebėjimas atskleidė, kad grupės dalyvių verbalinė raiška yra skatinama tiesioginiu poveikiu – sudarant sąlygas išsisakyti, papasakoti apie savo dailinės raiškos kūrinį, atsakyti į mokytojos ir kitų grupės dalyvių klausimus bei netiesioginiu poveikiu – stebint mokytojos bendravimą, kitų dalyvių pasisakymus, išreiškiant spontaniškai kilusias... [toliau žr. visą tekstą] / The theoretical research performed in the paper revealed that the pupils with hearing impairments confronted with the problems of verbal expression concerning their poor vocabulary and their affected ability to accept, perceive, and express linguistic information. These problems can be solved in sessions of art therapy, which capacitate acquiring experience of artistic and verbal expression and development of skills. We have hypothesized that the verbal expression of pupils with hearing impairments is stimulated during the sessions of art therapy. The research, which aim was the ascertainment of the effect of the art therapy on stimulation of the verbal expression of the pupils with hearing impairments, was performed by the method of activity (action). By using the results of the literature analysis, the sessions of art therapy were organised, during which we observed the manifestations of artistic activity inspiration and stimulation of verbal expression. 5 pupils with hearing impairments (2 hard of hearing and 3 deaf) of 10 – 14 years old participated in the research. The results of verbal expression stimulation of the pupils with hearing impairments analysed in the empirical part and the content and phenomenographic analyses revealed the following main conclusions of the research: 1. The retrospective observation of the art therapy sessions revealed that the verbal expression of the participants of the group was stimulated by the direct impact – by allowing opening... [to full text]
677

Sutrikusios klausos asmenų psichomotorinės reakcijos ypatumai / Peculiarities of psychomotor reactions of people with hearing impairment

Matulevičius, Kęstutis 20 June 2012 (has links)
Tyrimo objektas – greitų ir tikslių judesių mokymasis. Tyrimo tikslas – nustatyti ir palyginti merginų ir vaikinų greitų ir tikslių judesių greito mokymosi ypatumus atliekant uţduotį – 5 serijas po 20 kartojimų. Išvados: 1. Vaikinai atlikdami paprastą uţduotį reagavo greičiau nei merginos. 2. Merginos atlikdamos sudėtingą uţduotį ją išmoko atlikę pirmą seriją. Vaikinai atlikdami tą pačią sudėtingą uţduotį atliko nuosekliai maţėjant laiko intervalui. 3. Merginos pirmosios serijos metu išmokusios atlikti sudėtingą uţduotį likusias keturias serijas atliko panašiu laiku daugiau netobulėdamos. Vaikinai atlikdami tą pačią sudėtingą uţduotį atliko ją maţindami vidutinį reakcijos laiką ir didindami vidutinį reakcijos greitį. Uždaviniai: 1. Nustatyti ir įvertinti registruotų judesių rodiklių skirtumus tarp merginų ir vaikinų. 2. Įvertinti greito mokymosi poveikį merginoms ir vaikinams. 3. Ištirti ir palyginti merginų ir vaikinų greito mokymosi dinamiką. Tyrimo hipotezė – vaikinų greitų ir tikslių judesių mokymasis tobulės sparčiau nei merginų. Rezultatai. Nustatytas statistiškai reikšmingas skirtumas (p < 0,05, 1 obs ) tarp vaikinų ir merginų reakcijos laiko atliekant paprastą uţduotį Atliekant sudėtingą uţduotį, vaikinų ir merginų laiko iki taikinio rodiklių vidurkiai iš 5 serijų skyrėsi statistiškai nereikšmingai tik pirmojoje serijoje. Merginos greitai išmoko sudėtingą uţduotį ir ją atliko greičiau nei vaikinai. Vaikinų mokymasis vyko palaipsniui, su kiekviena serija vis gerėjant... [toliau žr. visą tekstą] / This Master thesis involves the analysis of psychomotor reactionsfor deaf people and people with hearing impairment using the analyzer of dynamic parameters of human hand and leg movements (DPA-1). The analyzer is intended for measuring dynamic parameters of qualitative hand or leg independent or coordinated movements when reacting to the target in the monitor. The target can be programmed by different geometric, chromatic and time parameters. DPA-1 analyzer enables analyzing psychomotor reaction, dynamic and kinematic peculiarities of movements. Research object – learning speed and accuracy movements. Research aim – to estimate and compare the peculiarities of men and women’sspeed and accuracy movement learning. Research objectives: 1. To estimate and evaluate the differences of registered results in movements between men and women. 2. To evaluate the influence of fast learning for men and women. 3. To analyze and compare the dynamics of fast learning between men and women. Research hypothesis: Learning speed and accuracy movements will improve more for men than for women. Results.The difference between men and women performing a complicated task is statistically significant (p < 0.05, 1 obs ). The difference in average indicesbetween men and women’s time to target in 5 exercise sessions performing the complicated task was statistically insignificant only in the first session. Women learned how to perform the complicated task faster and showed better speed results than men... [to full text]
678

Šokamųjų žaidimų atranka vidutinį intelekto sutrikimą turintiems vaikams / Selection of dancing games for children with moderate intellectual impairment

Mičiulytė, Evelina 02 August 2013 (has links)
Ne taip seniai intelekto sutrikimą turintys asmenys Lietuvoje vis dar buvo izoliuota, stigmuota visuomenės dalis. Šiandien jų padėtis pasikeitusi. Siekiama bei įstatymais garantuojama kiekvieno neįgalaus asmens teisė į visapusišką ugdymą(si), socializaciją ir jo galimybes atitinkančią gyvenimo kokybę. Priklausomai nuo intelekto sutrikimo laipsnio, proto negalia lemia didesnius ar mažesnius pažeidimus visose bendrųjų gebėjimų raidos srityse (kognityvinėje, emocinėje, fizinėje, socialinėje) ir tuo riboja žmogaus galimybes. Dėl vidutinio intelekto sutrikimo sukeltų pažeidimų vaikai patiria kalbos, motorikos, aplinkos pažinimo, bendravimo sunkumų. Šokamieji žaidimai – veikla, kurioje persipina poezija, muzika, drama ir choreografija. Neįgaliųjų ugdymo kontekste šie žaidimai turėtų būti grindžiami ne judesių atlikimo kokybe, o tapti viena iš ugdymo ir komunikavimo priemonių, kurios užtikrintų pilnavertį, praktinį mokinių funkcionavimą. Tyrimo objektas – šokamųjų žaidimų atranka vidutinį intelekto sutrikimą turintiems vaikams. Darbo tikslas – atskleisti šokamųjų žaidimų ypatumus pritaikant vidutinį intelekto sutrikimą turintiems vaikams. Uždaviniai: išanalizuoti sutrikimų specifiką ir pateikti vidutinį intelekto sutrikimą turinčių vaikų psichologinę ir pedagoginę charakteristiką; išryškinti šokamųjų žaidimų taikymo galimybes šokio ugdymo procese; atskleisti šokamųjų žaidimų taikymo ypatumus vidutinį intelekto sutrikimą turinčių vaikų šokio veikloje; pagrįsti šokamųjų žaidimų... [toliau žr. visą tekstą] / Not long ago people with intellectual impairment were an isolated and stigmatised part of society in Lithuania. The situation has changed. Depending on the degree of intellectual impairment, mental disability determines minor to serious impairment in all areas of development of general abilities (cognitive, emotional, physical and social), thus limiting human capabilities. Children suffering from moderate intellectual impairment experience linguistic, motor, cognitive and communication difficulties. Dancing games encompass poetry, music, drama and choreography. In the context of the education of disabled people, instead of being based on the quality of movements, these games should become a means of education and communication ensuring full practical functioning of students. The subject matter of the thesis is selection of dancing games for children with moderate intellectual impairment. The purpose of the thesis is to reveal the specific features of dancing games adapted for children with moderate intellectual impairment. Objectives: to analyse the specific features of this type of impairment and provide the psychological and educational characteristics of children with moderate intellectual impairment; to highlight the applicability of dancing games in the dance training process; to identify the specificity of the use of dancing games in the dancing activities of children with moderate intellectual impairment; to justify the criteria for the selection of dancing games for... [to full text]
679

Assessment and revision of a paediatric diagnostic audiology report

Donald, Ashleigh January 2015 (has links)
Optimising outcomes for children with hearing impairment (HI) requires a family centred approach that prioritises parent involvement. Families must be provided with information to encourage participation; and meet their need for emotional support and knowledge. Diagnostic audiology reports can help provide this information, but their delivery alone is insufficient. If these reports are not readable and comprehendible they cannot meet national and international legal standards, nor can they support the health literacy of parents. The majority of New Zealand adults have insufficient health literacy skills, a concerning fact given the strong association between poor health literacy and negative health outcomes. The aim of this study was to evaluate a paediatric diagnostic audiology report, revise it and verify the revision. A mock audiology report was evaluated via a readability analysis and semi-structured interviews with parent participants. Results confirmed that the report was difficult to read and understand. Next, the report was revised using best practice guidelines and parental recommendations. Verification of the revision process with 32 participants revealed that parents who read the revised report had significantly greater comprehension, self-efficacy and perception ratings than parents who read the unrevised report. Additionally, the report’s readability was markedly improved. These results may have critical implications for parents and their children with HI. Incomprehensible audiology reports fail to support parental health literacy, promote understanding, encourage participation or offer emotional support. Because knowledge is power for these families, it is hoped that the findings of this study will be recognised and implemented into clinical practice.
680

Prediction of Driving Ability in Healthy Older Adults and Adults with Alzheimer’s Dementia or Mild Cognitive Impairment

Hoggarth, Petra Ann January 2011 (has links)
Normal ageing is associated with decline in visual, cognitive, and physical functioning, with concurrent increases in the incidence of chronic medical conditions, including cognitive disorders. Determining when age-related changes have adversely affected a person’s ability to drive safely is a complex task, particularly when cognitive disorders such as mild cognitive impairment and dementia are present. The aim of this research was to assess the utility of a number of off-road measures in predicting Pass and Fail outcomes for older drivers on a blinded on-road driving assessment with a driving specialist occupational therapist and a driving instructor, which is considered the ‘gold standard’ measure of driving ability. The off-road measures included standardized cognitive tests, computerized sensory-motor & cognitive tests, medical conditions, and personality measures. The research project comprised three studies. In Study 1 (Healthy Older Drivers study), 60 drivers with no diagnosed cognitive disorder (‘cognitively-unimpaired’), aged 70-84 years (mean age 76.7, 50% male), completed standard cognitive tests, computerized sensory-motor and cognitive tests (SMCTests™), and measures of personality. Results were used to form classification models for on-road assessment Pass and Fail outcome. Sixteen participants failed the on-road assessment. A backwards stepwise binary logistic regression model selected a measure of executive function and a computerized measure of visuomotor planning and coordination as the best predictors. Following leave-one-out cross-validation, this model was estimated to correctly predict 60% of an independent group of cognitively-unimpaired older drivers into on-road Pass and Fail groups. In Study 2 (Healthy Driver Follow-up study), 56 participants from the Healthy Older Drivers study were followed for 24 months using annual telephone interviews to assess driving behaviour, driving attitudes, medical conditions, and the occurrence of crashes and receipt of traffic offences. Official data regarding crashes and traffic offences were also obtained. The aim was to determine whether either the on-road Pass/Fail classification or the off-road measures could predict subsequent crashes and offences. Failing the on-road assessment was not associated with higher crash or offence rates and there were only two baseline measures that predicted crashes or offences (i.e., distance driven at baseline testing and, paradoxically, a lower error score on a measure of visuomotor planning and coordination). However, drivers who reported more distress associated with their medical condition(s) were more likely to have had a crash or offence at 24 months. The outcomes of the Healthy Older Drivers and Healthy Driver Follow-up studies suggest that there is little value in off-road or on-road assessment of cognitively-unimpaired older drivers due to the weak relationship with future negative driving outcomes. However, distress associated with medical conditions may be a useful measure. Study 3 (Dementia and Driving study) recruited a sample of 60 driving assessment centre referrals with mild cognitive impairment or Alzheimer’s dementia. These participants, aged 58-92 years (mean age 77.9, 60% male), performed a computerized battery of sensory-motor and cognitive tests and a formal blinded on-road driving assessment. A backwards stepwise binary logistic regression model selected measures of reaction time and movement speed of the upper limbs, visuomotor planning and coordination, and sustained attention. Following leave-one-out cross-validation, this model was estimated to correctly predict 68% of an independent group of drivers with mild cognitive impairment and Alzheimer’s dementia into on-road Pass and Fail groups. A subsample of 32 participants completed additional standard cognitive tests and provided information on medical conditions. A binary logistic regression model in this subsample was formed which selected measures of verbal fluency, the presence of heart disease, and a comprehensive cognitive screen. Following leave-one-out crossvalidation, this model would be expected to correctly classify 75% of an independent group of drivers with mild cognitive impairment and Alzheimer’s dementia into on-road Pass and Fail groups. The three measures in this model could be performed in around 35-50 min in a primary health setting. It is concluded that off-road and on-road assessment of older drivers with no diagnosis of cognitive or neurological disorder is an inaccurate and inefficient use of driving assessment resources, both for the prediction of on-road driving performance and for predicting future crashes and traffic offences. The Dementia and Driving study found a model comprising three measures that could be performed in a primary health setting with reasonable accuracy for correctly classifying people with mild cognitive impairment and Alzheimer’s dementia who go on to Pass and Fail an on-road driving assessment.

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