The effective operation of a motor vehicle encompasses a wide range of cognitive processes that can decline due to age-related changes in neuroanatomical structures and cognitive functionality. The increasing number of older adult drivers in our rapidly aging population heightens the public safety concern of unsafe driving associated with these changes. Nurses caring for older adults in public health settings are well positioned to make a difference in the management of older patients who may be at risk of endangering themselves or others on the roadways. In this article, information is provided for increasing nurses' awareness of the cognitive factors inhibiting effective driving, recognizing older adults who may be at risk for unsafe driving, and facilitating a patient/family to seek a driving evaluation.
Purpose
Parkinson's disease (PD) impacts language in multiple ways, though important questions remain. The current article explores 2 main issues: what type of everyday language difficulties (ELDs) are noted by care partners and how do ELDs relate to cognition, daily activities, and motor disability in PD.
Method
Care partner reports of ELD were collected in 42 community-dwelling individuals with PD. Descriptive information of ELD was tallied, and the relationship of cognitive decline, activities of daily living (ADLs), and motor disability with ELD was evaluated.
Results
Forty-two percent of patients were described by care partners as having at least 1 consistent ELD, and the frequency of ELD increased in the presence of dementia, χ
2
(2) = 14.37,
p
= .0008. The most commonly described ELDs by caregivers were related to comprehension of instructions and deriving the point of conversations. ELD was correlated with worse cognition (
r
s
= −.524,
p
< .001), increased difficulty with daily activities (
r
s
= .634,
p
< .001), and increased motor dysfunction (
r
s
= .554,
p
< .001). Mild ADL decline (Functional Assessment Questionnaire score of 4); an area under the curve of .81 (
SE
= .07) was highly specific to the presence of ELD (95.4%).
Conclusions
Care partners note a variety of ELDs in patients with PD, most commonly comprehension difficulties. These difficulties increase with overall cognitive decline but are described in 30%–40% of those without significant cognitive deficits. ADL difficulties correlate with functional, motoric, and cognitive status, with even mild functional declines predictive of the presence of ELD. Implications for research and practice in this population are discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.