Parkinson's disease and driving ability.
OBJECTIVE
To explore the driving problems associated with Parkinson's disease (PD) and to ascertain whether any clinical features or tests predict driver safety.


METHODS
The driving ability of 154 individuals with PD referred to a driving assessment centre was determined by a combination of clinical tests, reaction times on a test rig and an in-car driving test.


RESULTS
The majority of cases (104, 66%) were able to continue driving although 46 individuals required an automatic transmission and 10 others needed car modifications. Ability to drive was predicted by the severity of physical disease, age, presence of other associated medical conditions, particularly dementia, duration of disease, brake reaction, time on a test rig and score on a driving test (all p<0.001). The level of drug treatment and the length of driving history were not correlated. Discriminant analysis revealed that the most important features in distinguishing safety to drive were severe physical disease (Hoehn and Yahr stage 3), reaction time, moderate disease associated with another medical condition and high score on car testing.


CONCLUSIONS
Most individuals with PD are safe to drive, although many benefit from car modifications or from using an automatic transmission. A combination of clinical tests and in-car driving assessment will establish safety to drive, and a number of clinical correlates can be shown to predict the likely outcome and may assist in the decision process. This is the largest series of consecutive patients seen at a driving assessment centre reported to date, and the first to devise a scoring system for on-road driving assessment.
Singh
Rajiv
R
Department of Neurorehabilitation, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2HL, UK. rajiv.singh@lpct.scot.nhs.uk
Pentland
Brian
B
Hunter
John
J
Provan
Frances
F
D000367:Age Factors; D000368:Aged; D001334:Automobile Driving; D001336:Automobiles; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D011930:Reaction Time; D012720:Severity of Illness Index; D013647:Task Performance and Analysis