Thirty-nine Parkinson's patients and 25 control subjects (without neurological disease) completed testing in a driving simulator. "We were interested not only in the generalized likelihood of driving impairment in patients with Parkinson's," says study author Theresa Zesiewicz, MD. "We also hoped to determine which variables are significant predictors of driving risk."
Of the 39 Parkinson's patients, seven reported having stopped driving due largely to concentration difficulties, 10 reported a decrease in amount of driving, and 22 reported no change in driving habits, though most of these reported increased difficulty with driving since Parkinson's diagnosis. All participants completed a Mini-Mental State Exam (MMSE) and a self-report questionnaire regarding driving history and number of miles driven per month. Parkinson's patients were evaluated using Hoehn and Yahr (H &Y) staging (a Parkinson's disease progression rating scale) and the more complex Unified Parkinson's Disease Rating Scale.
Participants were each given 10 to 15 minutes to practice on the simulator prior to testing. All Parkinson's patients had more total collisions on the driving simulator than the control subjects, with collision rates corresponding directly to severity of disease progression (as determined by evaluation methods described above).
Among patients who were still driving, those who sustained collisions on the simulator were older and had worse MMSE scores, UPDRS and H & Y stage ratings. "We found it particularly interesting that there was no relationship between Parkinson's patients' self-reporting of moving violations and their total collisions on the driving simulator," notes Zesiewicz.
"Clearly, Parkinson's patients with advanced disease are at greater risk for motor vehicle collisions, due to both motor and cognitive dysfunction," according to Zesiewicz. "Still, in order to develop rigorous guidelines regarding driving safety for Parkinson's patients we would recommend larger, long-term prospective studies correlating simulator assessments with driving accidents."
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For a copy of the study contact: Cheryl Alementi, 651-695-2737, calementi@aan.com
Journal
Neurology