{"created":"2023-06-19T10:30:45.968052+00:00","id":2906,"links":{},"metadata":{"_buckets":{"deposit":"9628b10f-cad3-493a-9bfb-ad33f6a09393"},"_deposit":{"created_by":31,"id":"2906","owners":[31],"pid":{"revision_id":0,"type":"depid","value":"2906"},"status":"published"},"_oai":{"id":"oai:kwmed.repo.nii.ac.jp:00002906","sets":["1709617079800:35:791"]},"author_link":["109901","109902","109903","109904","109905","109906","109907","109908","109909","109910","109911","109912","109913","109914"],"item_10001_alternative_title_1":{"attribute_name":"その他(別言語等)のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Current status and problems of elderly drivers in our outpatient clinic","subitem_alternative_title_language":"en"}]},"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"7","bibliographicPageStart":"1","bibliographicVolumeNumber":"46","bibliographic_titles":[{"bibliographic_title":"川崎医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kawasaki medical journal","bibliographic_titleLang":"en"}]}]},"item_10001_description_33":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"原著論文","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_10001_description_34":{"attribute_name":"記事種別(英)","attribute_value_mlt":[{"subitem_description":"Regular Article","subitem_description_language":"en","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"川崎医学会","subitem_publisher_language":"ja"}]},"item_10001_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.11482/KMJ-J202046001","subitem_relation_type_select":"DOI"}}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://igakkai.kms-igakkai.com/wp/wp-content/uploads/2020/KMJ-J202046001.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_relation_35":{"attribute_name":"医中誌ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"2021178663","subitem_relation_type_select":"ICHUSHI"}}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00045593","subitem_source_identifier_type":"NCID"},{"subitem_source_identifier":"AA12940574","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03865924","subitem_source_identifier_type":"PISSN"},{"subitem_source_identifier":"2758089X","subitem_source_identifier_type":"EISSN"}]},"item_10001_text_31":{"attribute_name":"著者所属(日)","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学神経内科学・川崎医科大学附属病院認知症疾患医療センター"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学附属病院認知症疾患医療センター"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学附属病院認知症疾患医療センター"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学附属病院認知症疾患医療センター"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学附属病院認知症疾患医療センター"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学神経内科学・川崎医科大学附属病院認知症疾患医療センター"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学神経内科学・川崎医科大学附属病院認知症疾患医療センター"}]},"item_10001_text_32":{"attribute_name":"著者所属(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School・Dementia-related disease medical center, Kawasaki Medical School Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School, Kawasaki Medical School Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School, Kawasaki Medical School Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School, Kawasaki Medical School Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School, Kawasaki Medical School Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School・Dementia-related disease medical center, Kawasaki Medical School Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurology, Kawasaki Medical School・Dementia-related disease medical center, Kawasaki Medical School Hospital"}]},"item_10001_textarea_5":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"　Following the revision of the Road Traffic Act, which obligates elderly drivers to undergo cognitive screening tests at license renewal, we established a new outpatient memory clinic specializing in issues surrounding elderly drivers’ driver licenses. In this new outpatient clinic, we provide guidance and information about supporting resources for life after returning their driver’s licenses and the usual medical care and education. In the past two years, 31 patients, with an average age of 80.1±3.9 years, visited this clinic. Among these, 19 were referred to our clinic because of impaired cognition by screening test (the first classification), three were referred us for traffic violations and the others visited voluntarily. Among these 31 patients, ten had already experienced car accidents and six had already been prescribed cholinesterase inhibitors. Neuropsychological examination revealed mildly impaired cognitive function including MMSE-J 22.3±3.9, Kohs IQ 66.4±11.9, DASC-21 29.5±7.1 and CDR 0.58 ±0.19. Brain MRI revealed significant brain atrophy in 20 patients and brain contusions in 12. 123I-IMP SPECT showed decreased cerebral blood flow in 14 patients. Although driving is necessary for most patients to maintain activities of daily living and quality of life, we recommended all to stop driving based on the revised Road Traffic Act, which restricts driving by people with dementia. However, only nine patients suspended their driving and returned their licenses voluntarily; most MCI patients continued driving even after diagnosis. More effort is necessary to persuade patients of the significance of the current system, as is a social system that offers alternative means of transportation and supports patients in their lives in their local community."}]},"item_10001_textarea_6":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_language":"ja","subitem_textarea_value":"　当院では平成29年３月12日の道路交通法改正を踏まえて平成29年４月より，もの忘れ外来とは別に「運転免許外来」を新設し，時間をかけた丁寧な診療と告知，指導，運転免許返納後の生活確保・支援ができるよう，多職種で受診者に対応している．平成31年４月までの運転免許外来受診者は31人で，平均年齢80.07±3.91歳．第一分類該当者19人，交通違反での紹介３人で，その他は自発的な受診であった．10例は既に事故を起こし，６例は既に抗認知症薬を内服していた . 受診者のほとんどが，通院，買い物，農作業など運転中止後の生活が困るとの理由から，運転継続を希望した．神経心理検査では，MMSE-J 22.32/30±3.87, Kohs IQ 66.42±11.87, DASC-21 29.53±7.07, CDR 0.58±0.19と比較的認知機能低下が軽度な者が多かった．頭部 MRI では20例に陳旧性脳梗塞や脳挫傷，12例に脳萎縮を認め，123I-IMP 脳血流 SPECT では14例にアルツハイマー病を示唆する脳血流低下を認めた．診断後，全例に運転免許返納を推奨したが，自発的に運転中止に至った例は９例のみであった．かかりつけ医による診断書作成が普及し自主返納事例も増加したためか，当院の受診者数ならびに運転免許取り消し処分となる事例は外来開設当初の予想より少なかった．認知機能低下は認めるものの明らかな認知症に至っていない MCI 症例については，診断書提出後も運転継続している事例が多かった．運転継続希望者に丁寧に現制度の意義を説明し，移動手段の確保や生活支援について地域で相談できる体制作りが必要である．"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"久德, 弓子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"吉武, 亜紀","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"赤松, 祐美","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"西橋, 佳花","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金島, 由佳","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"三原, 雅史","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"砂田, 芳秀","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"KUTOKU, Yumiko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YOSHITAKE, Aki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"AKAMATSU, Yumi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"NISHIBASHI, Yoshika","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"KANESHIMA, Yuka","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MIHARA, Masahito","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SUNADA, Yoshihide","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-10-18"}],"displaytype":"detail","filename":"KMJ-J202046001.pdf","filesize":[{"value":"2.6 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","objectType":"fulltext","url":"https://kwmed.repo.nii.ac.jp/record/2906/files/KMJ-J202046001.pdf"},"version_id":"7e32d1d7-61fd-483f-aa92-cdafcc39ae44"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"認知症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"改正道路交通法","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Dementia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Road Traffic Act","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"当科運転免許外来受診者の現状と課題","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"当科運転免許外来受診者の現状と課題","subitem_title_language":"ja"}]},"item_type_id":"10001","owner":"31","path":["791"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-10-18"},"publish_date":"2022-10-18","publish_status":"0","recid":"2906","relation_version_is_last":true,"title":["当科運転免許外来受診者の現状と課題"],"weko_creator_id":"31","weko_shared_id":-1},"updated":"2024-04-12T06:50:06.315488+00:00"}