[Vehicle drivers with Parkinson disease: behavior schedules of a patient sample from the Community of Madrid].
The aim of this study was to evaluate features of the disease, habits patterns at the wheel, and reasons to give up driving motor vehicles in subjects with Parkinson's disease (PD). Prospective study using a semistructured questionnaire comparing current or former drivers with PD patients and a control group matched for age, sex and social background. In a PD and movement disorders clinic in an university hospital. Sixty-two out of 166 PD subjects interviewed owned a driving licence. Only 19.2% of PD subjects were currently active drivers. Compared to parkinsonian ex-drivers, they were 6 years younger on average, most were in disease stage II, and were less often under antidepressant medication. Nevertheless, disabling motor fluctuations and dyskinesias were present in 19% of the patients. A 47% of the active drivers reported no difficulty at the wheel; the remaining declared to experience a wide range of difficulties, particularly to manage pedals or to assess distances properly. PD itself lead to driving withdrawal in 80% of ex-drivers in contrast to 6% of controls who stop driving due to other illness. Only 40% of PD subjects were driving 5 years after diagnosis. Medical advice was influential in deciding to stop driving in a single patient. Disease onset in early adulthood often allowed to keep driving for 10 years or longer. Most subjects with PD give up driving during the first 5 years following disease onset, most due to the disease itself. Most active drivers adapt themselves to their physical circumstances, either by reducing the number of hours at the wheel or reducing speed. They are usually in early stages of the disease, despite which many experience subjective motor and visuospatial difficulties during driving. A minority keep on driving despite disabling fluctuations. This subset presumably represent a group at risk to suffer an increased rate of traffic accidents and in whom medical advice would be desirable.
Giménez-Roldán
S
S
Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid.
Dobato
J L
JL
Mateo
D
D
D000063:Accidents, Traffic; D000368:Aged; D001334:Automobile Driving; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
Conductores de vehículos con enfermedad de Parkinson: pautas de comportamiento en una muestra de pacientes de la Comunidad de Madrid.