Driving in Parkinson?s disease?a health hazard?

Homann, Carl Nikolaus; Suppan, Klaudia; Homann, B; Crevenna, Richard; Ivanic, G. M.; Růžička, Evžen

doi:10.1007/s00415-003-0239-5

Cited by 32 publications

(22 citation statements)

References 30 publications

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“…5,[11][12][13]16 Epidemiologic data, however, are not well-established concerning crash rates in PD. [18][19][20] A retrospective survey study found that patients with Hoehn & Yahr (H&Y) stages 2 and 3 had a significantly higher crash risk compared to healthy controls. However, there was no evidence of increased crash risk among patients in H&Y stage 1.…”

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confidence: 99%

Parkinson disease and driving

2012

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The growing literature on driving in Parkinson disease (PD) has shown that driving is impaired in PD compared to healthy comparison drivers. PD is a complex neurodegenerative disorder leading to motor, cognitive, and visual impairments, all of which can affect fitness to drive. In this review, we examined studies of driving performance (on-road tests and simulators) in PD for outcome measures and their predictors. We searched through various databases and found 25 (of 99) primary studies, all published in English. Using the American Academy of Neurology criteria, a study class of evidence was assigned (I-IV, I indicating the highest level of evidence) and recommendations were made (Level A: predictive or not; B: probably predictive or not; C: possibly predictive or not; U: no recommendations). From available Class II and III studies, we identified various cognitive, visual, and motor measures that met different levels of evidence (usually Level B or C) with respect to predicting on-road and simulated driving performance. Class I studies reporting Level A recommendations for definitive predictors of driving performance in drivers with PD are needed by policy makers and clinicians to develop evidence-based guidelines. Neurology

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confidence: 99%

Parkinson disease and driving

2012

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“…Although many studies showed decreased driving performances in PD patients, there is no clear evidence on real risk of crashes in this population [20,21]. Some authors have shown an increased crash rate in driving simulator studies [13,22] or in retrospective studies, especially those in whom the disease is severe [23,24].…”

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confidence: 99%

Relationships between Cognitive Functions and Driving Behavior in Parkinson’s Disease

Ranchet¹,

Broussolle²,

Poisson³

et al. 2012

Eur Neurol

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Alterations in cognitive functions in Parkinson’s disease (PD) have been reported even in mild stages of the disease. These functions may play a role in complex daily activities, such as driving. This article provides an overview on the relationships between cognitive functions and driving behavior in PD in driving simulator and on-road studies. The role of attention, executive functions, visual memory, visuospatial construction and information processing speed is discussed. In driving simulator studies, driving performances were correlated with several neuropsychological measures, especially those of Trail Making Test (TMT), Brixton and Symbol Digit Modalities Test. In on-road studies, TMT, Useful Field Of View and Block Design tests appear as good predictors of driving performances. Most of these tests are also relevant to driving in Alzheimer’s disease and traumatic brain injury.

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“…Compared with neurologically healthy drivers, those with PD show greater impairment on route-finding tasks and landmark and traffic sign identification tasks (mild to moderate PD only; Uc et al, 2006bUc et al, , 2007. Yet, PD patients are not more prone to cause crashes than the rest of the population (Homann et al, 2003).…”

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Usefulness of Screening Tools for Predicting Driving Performance in People With Parkinson’s Disease

Classen

Witter

Lanford

et al. 2011

The American Journal of Occupational Therapy

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OBJECTIVE. We used screening tests administered by a certified driving rehabilitation specialist and by Parkinson's disease (PD) specialty neurologists to develop a model to predict on-road outcomes for patients with PD.METHOD. We administered a battery of screening tests to 41 patients with PD and 41 age-matched control participants before on-road testing. We used statistical models to predict actual on-road performance.RESULTS. The PD group had a higher failure rate, indicating more on-road errors. For the PD participants, the Useful Field of View (UFOV) Subtest 2 and Rapid Pace Walk were responsible for most of the variance in the on-road test. The model accurately categorized pass-fail outcomes for 81% of PD patients.CONCLUSION. Clinical screening batteries may be predictive of driving performance in PD. The UFOV Subtest 2, administered in approximately 15 min, may be the single most useful clinical test for such predictions.

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Driving in Parkinson?s disease?a health hazard?

Abstract: Further prospective community-based well designed studies on accident risk in PD patients are needed to provide evidence based driving recommendations.

Cited by 32 publications

References 30 publications

Parkinson disease and driving

Parkinson disease and driving

Relationships between Cognitive Functions and Driving Behavior in Parkinson’s Disease

Usefulness of Screening Tools for Predicting Driving Performance in People With Parkinson’s Disease

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