People with Parkinson's disease experienced greater declines in driving skills and safety on road tests over two years compared to drivers without Parkinson's, according to a new study published online on October 11 in Neurology.
Declining Driving Skills
Many of the primary symptoms of Parkinson's disease (PD), including impaired and unpredictable body movements, cognitive decline, and vision problems, can affect the ability to perform specialized tasks, such as driving a car.
Previous studies have shown that people with PD perform worse on road tests over time. To find out how much that has to do with normal aging or with Parkinson's disease, researchers compared the driving skills of healthy, aging individuals with those of people with PD.
Comparing Drivers
Researchers at the University of Iowa and the University of Nebraska recruited 67 people with PD from the Movement Disorders Clinics at the University of Iowa's department of neurology and the Veterans Affairs Medical Center in Iowa City. They also enrolled 110 healthy controls. All participants were active drivers who did not have any other conditions, such as psychiatric illnesses or visual problems that may have influenced results on the driving tests.
At the beginning of the study, participants completed a variety of tests designed to measure vision, cognition, and motor skills. Then they took an 18-mile road test in a midsized automatic car, which was outfitted with miniature cameras that captured the driver's face, pedal use, the lane position of the front wheels, and a forward view of the road. The participants learned how to use the vehicle before the test, and a trained experimenter rode in the passenger seat. The route included residential city streets, suburban commercial strips, rural two-lane highways, and a four-lane freeway with a speed limit of 65 miles per hour.
Two years after the start of the study, participants completed the same test a second time; about 43 percent of the drivers with PD, and 63 percent of the control drivers returned for repeat testing.
After all tests were completed, independent raters viewed the videos captured by the car's cameras to assess safety and count the number of errors.
Comparing Results
At the beginning of the study, the drivers with PD performed worse on the vision, cognitive, and motor tests compared to controls. They also committed more road safety errors on the first driving test (38 vs. 30.5).
On the second test two years later, people with PD had greater declines in driving skills compared to the healthy controls—they averaged 13.5 more errors compared to 3 more errors.
Additionally, drivers with PD who performed worse on the vision and cognitive tests had even greater declines over two years compared to drivers with PD who performed better on those tests.
More Regular Driving Evaluations
People with Parkinson's disease who continue to drive should undergo "periodic cognitive evaluations by a neuropsychologist and driving safety evaluations by a state licensing agency," such as the department of transportation, to determine whether it's still okay to drive, the study authors suggest. And doctors should regularly discuss driving status and associated driving concerns with their patients.
http://journals.lww.com/neurologynow/blog/breakingnews/pages/post.aspx?PostID=537
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