Driving safety in Parkinson’s disease

Zesiewicz, Theresa A.; Cimino, Cynthia R; Malek, Alexander; Gardner, Nolan; Leaverton, Paul E.; Dunne, Peter B.; Hauser, Robert A.

doi:10.1212/01.wnl.0000035636.83680.c6

Cited by 83 publications

(99 citation statements)

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“…Parkinson's disease has previously been found as a 14 major factor of driving cessation 49 and as a non-significant factor in crashes. 50 52 The high rate of driving cessation after a stroke was consistent with other studies. 11,12,49,53 Stroke survivors seemed to limit their driving exposure and/or rely on others for transportation, suggesting selfregulated behavior.…”

Section: Factors Associated With Driving Cessation Onlysupporting

confidence: 89%

Driving Cessation and Self-Reported Car Crashes in Older Drivers: The Impact of Cognitive Impairment and Dementia in a Population-Based Study

Lafont

Laumon

Helmer

et al. 2008

J Geriatr Psychiatry Neurol

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The complexity of driving activity has incited numerous developed countries to initiate evaluative procedures in the elderly, varying according to first evaluation age, frequency and screening tools. The objective of this paper is to improve the knowledge of the driving cessation process in regard to factors associated with crash involvement. Driving cessation and self-reported crashes during the past five years were analyzed with multivariate models, in a cross-sectional study including a population-based sample of 1051 drivers aged 65 years and more. Visual trouble, Parkinson disease, dementia and stroke history were associated with driving cessation. Future dementia was associated with self-reported crashes only. Attentional and executive deficits were associated with both outcomes. The detection of attentional and executive problems should be included in driving evaluation procedures in order to improve awareness of these deficits by older drivers.

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Section: Factors Associated With Driving Cessation Onlysupporting

confidence: 89%

Driving Cessation and Self-Reported Car Crashes in Older Drivers: The Impact of Cognitive Impairment and Dementia in a Population-Based Study

Lafont

Laumon

Helmer

et al. 2008

J Geriatr Psychiatry Neurol

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“…The review yielded 9 Class III studies. 6,9,14,[35][36][37][38][39][40] Conclusion. From the 9 Class III studies, we concluded that cognitive abilities may deteriorate even in mild to moderate stages of PD.…”

Section: Rating Article By Classmentioning

confidence: 96%

“…14 Disease severity (H&Y) was associated with worse simulated driving performance. 35 The use of external cues may help improve skills related to driving. 39 Recommendations.…”

Section: Rating Article By Classmentioning

confidence: 99%

“…Additionally, the MMSE has been shown to be a poor predictor of on-road performance in drivers with PD. 5,15,25,45 Differences between various simulator studies in technical characteristics (e.g., desktop simulator with 60-degree field of view 35 vs medium-high fidelity simulator with 180-degree field of view 9,37,38 ) and the primary outcomes, as well as a lack of validity due to the various types of simulators used in prior studies, are also a concern. However, simulators can be used to determine predictors of driving performance that cannot be tested on the road test due to ethical, safety, and practical reasons (e.g., night, high volume traffic, poor weather conditions, or hazardous experiments where rapid reactions are needed).…”

Section: Rating Article By Classmentioning

confidence: 99%

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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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“…Dubinsky and colleagues (Dubinsky et al, 1991) found that although self-reported accidents were more common among PD patients with moderately severe disease (Hoehn & Yahr III) compared to mild disease (Hoehn & Yahr I) or elderly controls, disease severity scales did not reliably predict inability to drive. However, Zesiewicz and colleagues (Zesiewicz et al, 2002) found that crash frequency in individuals with PD was in fact related both to Hoehn & Yahr (H&Y) stage (Hoehn & Yahr, 1967) and to Unified Parkinson Disease Rating Scale (UPDRS) motor score (Fahn et al, 1987). Consistent with these latter findings, Madeley et al (1990) found a correlation between PD severity on Webster's rating scale (a 10 item scale of Parkinsonian motor symptoms) and simulated driving reaction time and steering accuracy, and Radford et al (2004) found that the Webster's rating scale, but not cognitive measures, differentiated between safe and unsafe driving on a road test.…”

Section: Introductionmentioning

confidence: 99%