Hillary Maxwell

Mindfulness-based cognitive therapy reduces symptoms of depression in people with a traumatic brain injury: results from a randomized controlled trial.

Objective:We sought to determine if we could reduce symptoms of depression in individuals with a traumatic brain injury using mindfulness-based cognitive therapy. Setting:The study was conducted in a community setting. Participants:We enrolled adults with symptoms of depression after a traumatic brain injury. Design:We conducted a randomized controlled trial; participants were randomized to the 10-week mindfulness-based cognitive therapy intervention arm or to the wait-list control arm. Main Measures:The primary outcome measure was symptoms of depression using the Beck Depression Inventory-II. Results:The parallel group analysis revealed a greater reduction in Beck Depression Inventory-II scores for the intervention group (6.63, n = 38,) than the control group (2.13, n = 38, P = .029). A medium effect size was observed (Cohen d = 0.56). The improvement in Beck Depression Inventory-II scores was maintained at the 3-month follow-up. Conclusion:These results are consistent with those of other researchers that use mindfulness-based cognitive therapy to reduce symptoms of depression and suggest that further work to replicate these findings and improve upon the efficacy of the intervention is warranted.

Visual-cognitive tools used to determine fitness-to-drive may reflect normal aging

Scores on many visual‐cognitive tools are proposed as indicators of fitness‐to‐drive. A purported feature of some tools and one believed to be important is that they are ‘age‐independent’. Specifically, scores are not correlated with age and poor scores represent a pathological process rather than normal aging. Yet, we know that several cognitive abilities are associated with age. One potential reason for the apparent age‐independence of some tools is that focusing on older drivers leads to ‘range restriction’, a statistical issue that reduces the magnitude of correlations when values for one variable are restricted to a smaller range than naturally occurs. Hence, the purpose of this study was to investigate whether age is correlated with scores on visual‐cognitive tests when we examine the full age range.

Self-rated confidence and on-road driving performance among older adults Autoévaluation de la confiance et de la performance au volant chez les personnes âgées

Background. Driver confidence can be measured through concepts such as driving frequency, situational avoidance, and self-perceptions. However, it is not clear how well confidence aligns with actual driving performance. Purpose. We examined the relationship between subjective measures of confidence in driving ability and on-road performance. Method. We report findings from two studies. The first compared scores from the Older and Wiser Driver Questionnaire to an on-road driving evaluation. The second looked at the Day and Night Driving Comfort Scales and Driving Habits and Intentions Questionnaire in relation to an on-road driving evaluation. Findings. No measures of confidence in driving ability were related to on-road driving performance. Implications. Confidence in driving ability bears little relationship to on-road performance. Future research should examine approaches to foster a better match between self-assessments and actual abilities among drivers.

The Ability to Drive in Mild Cognitive Impairment

Driving is a complex activity that, for many older adults, is a primary means of mobility. Driving draws upon multiple cognitive, sensory, and physical systems to operate the vehicle and navigate the roadway environment safely. It follows that when one of these systems is impaired, driving safety may be hindered. Individuals with mild cognitive impairment (MCI) are impaired in at least one cognitive domain, which may, depending on the nature of their deficit, make them at increased risk for collision. Research indicates that memory, executive functions, and attention are all associated with driving performance. While a number of assessment instruments are available to aid professionals’ decisions related to fitness to drive, health professionals must strike a balance between safety and mobility when making this determination. This chapter discusses the components of the driving task, the impact of an MCI diagnosis on driving fitness, methods to assess drivers with MCI, and strategies to promote continued mobility among adults who have ceased driving.