Published

2018-05-01

Associação entre cognição e habilitação para direção veicular em idosos

Association between cognition and habilitation for vehicular direction in the elderly

Asociación entre cognición y habilitación para dirigir en los adultos mayores

Keywords:

Cognição, condução de veículo, exame para habilitação de motoristas, idoso (fonte, decs Bireme) (pt)
Cognición, Examen de Aptitud para la Conducción de Vehículos, Automobile Driving, Anciano (fuente, DeCS BIREME) (es)
Cognition, Automobile Driver Examination, Conducción de Automóvil, Aged (source, DeCS BIREME) (en)

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Objetivo: analisar a associação entre a cognição e os resultados dos exames de aptidão física e mental para habilitação veicular em idosos. Método: trata-se de estudo transversal realizado em clínicas de trânsito credenciadas para realizar exames de habilitação veicular. A amostra do tipo probabilística foi constituída por 421 idosos (≥ 60 anos). Os dados foram coletados, por meio do Miniexame do Estado Mental (Meem) e consulta no Registro Nacional de Condutores Habilitados. Para a análise dos dados, utilizou-se estatística descritiva e aplicação dos testes Kruskal-Wallis e Qui-quadrado. Valores de p ≤ 0,05 indicaram significância estatística. Resultados: para o Meem, o escore médio foi 27,13 ± 2,53 pontos; 92,2 % (n = 388) apresentaram cognição normal e 7,8 % (n = 33) comprometimento cognitivo. Quanto aos resultados dos testes de aptidão física e mental para habilitação veicular 71,5 % (n = 301), foram considerados aptos com restrição, 21,9 % (n = 92) aptos e 6,7 % (n = 28) inaptos temporariamente. Houve associação significativa entre os resultados da habilitação veicular e os escores cognitivos (p < 0,001) e não houve associação às categorias cognitivas (p = 0,172). Os escores mais baixos de cognição foram identificados em idosos aptos com restrição e inaptos temporariamente. Conclusão: os resultados evidenciam inconsistência do MEEM para avaliar a cognição. Recomenda-se às clínicas de trânsito a utilização do MEEM com cautela, enquanto ferramenta de rastreio cognitivo em motoristas idosos.

Objective: to analyze the association between cognition and the final results of physical and mental fitness tests for vehicular habilitation in the elderly. 

Method: This is a cross-sectional study carried out at accredited transit clinics to perform vehicle habilitation tests. The probabilistic sample consisted of 421 elderly (≥ 60 years). Data were collected through the Mini Mental State Examination (MMSE) and consultation in the National Registry of Qualified Drivers. Descriptive statistics and Kruskal-Wallis and Chi-square tests were used to analyze the data. Values of p≤0.05 indicated statistical significance.
Results: For the MMSE, the mean score was 27.13 ±2.53 points, 92.2 % (n =388) presented normal cognition and 7.8 % (n =33) cognitive impairment. Regarding the results of the physical and mental fitness tests for vehicle habilitation, 71.5 % (n =301) were considered fit with restriction, 21.9 % (n =92) fit and 6.7 % (n =28) temporarily unfit. There was a significant association between the results of vehicular habilitation and cognitive scores (p<0.001) and there was no association with cognitive categories (p =0.172). The lowest cognition scores were identified in fit elderly with restricted and temporarily unfit.
Conclusion: The results show inconsistency of the MMSE to evaluate cognition. It is recommended to the traffic clinics to use the MMSE with caution, as a tool of cognitive screening in elderly drivers.

Objetivo: analizar la asociación entre la cognición y los resultados finales de los exámenes de aptitud física y mental para habilitación vehicular en adultos mayores.Método: Se trata de un estudio transversal realizado en clínicas de tránsito acreditadas para realizar exámenes de habilitación vehicular. La muestra del tipo probabilística fue constituida por 421 adultos mayores (≥ 60 años). Los datos fueron colectados por medio de Mini Examen del Estado Mental (MEEM) y consulta en el Registro Nacional de Conductores Habilitados. Para el análisis de los datos se utilizó estadística descriptiva y aplicación de los testes Kruskal-Wallis y Qui-cuadrado. Los valores de p≤0,05 indicaron significancia estadística.Resultados: Para el MEEM el puntaje promedio fue de 27,13 ± 2,53 puntos, 92,2 % (n =388) presentaron cognición normal y 7,8 % (n =33) comprometimiento cognitivo. En cuanto a los resultados de las pruebas de aptitud física y mental para habilitación vehicular 71,5 % (n =301) se consideraron aptos con restricción, el 21,9 % (n =92) aptos y el 6,7 % (n =28) inaptos temporales. Se observó una asociación significativa entre los resultados de la habilitación vehicular y los escores cognitivos (p<0,001) y no hubo asociación a las categorías cognitivas (p =0,172). Los escores más bajos de cognición se identificaron en ancianos aptos con restricción e inaptos temporalmente. Conclusión: Los resultados evidencian la inconsistencia del MEEM para evaluar la cognición. Se recomienda a las clínicas de tránsito la utilización del MEEM con cautela, como herramienta de evaluación cognitivo en conductores adultos mayores. 

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