title: Driving performance and behaviors: a comparison of gender differences in Parkinson's disease.
abstract: OBJECTIVE
  The primary objective of this study was to determine gender differences by comparing self-reported driving behaviors, clinical tests, and on-road driving performance in a cohort of men and women drivers with Parkinson's disease (PD).
  
  
  METHODS
  In this prospective observational study, we analyzed data of a convenience sample of 63 men (mean age = 70.9 ± 6.6 years) and 21 women (mean age 67.1 ± 7.3 years) with diagnosed PD. All participants underwent a comprehensive driving evaluation by a certified driving rehabilitation specialist.
  
  
  RESULTS
  On average, both men and women were active drivers (driving ∼4.6 times/week). A substantial proportion of both groups avoided driving at night (40% of men versus 46% of women), during rush hour, and in heavy traffic (36% of men versus 57% of women), although the differences were not significant. Both groups reported some avoidance behaviors: making left-hand turns (9.7% men versus 9.5% women), driving in the rain (12.9% men versus 19.0% women), or on the interstate/highway (14.3% men versus 7.7% women). With respect to driving performance, both groups were equally likely to fail the on-road test (42.6% men versus 42.9% women). Although men committed slightly more total driving errors compared to women, the differences were not statistically significant. Specific driving errors also did not differ by gender. Controlling for gender and disease severity, age was an independent predictor of total driving errors in men but not in women. Additionally, a cut-point of ≥2.5 on the modified Hoehn and Yahr was predictive of pass-fail outcomes in men when controlling for age.
  
  
  CONCLUSIONS
  Our study shows preliminary evidence that few gender differences exist with respect to driving errors and overall driving performance. Future studies should better balance gender distribution by age in PD driving studies to determine whether there are indeed differences in driving performance between men and women.
authors.affiliation: Department of Occupational Therapy and Institute for Activity, Mobility and Participation, University of Florida, Gainesville, Florida 32601-0164, USA. acrizzle@sympatico.ca
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Crizzle
authors.forename: Sherrilene
authors.initials: S
authors.lastname: Classen
authors.forename: Desiree
authors.initials: D
authors.lastname: Lanford
authors.forename: Irene A
authors.initials: IA
authors.lastname: Malaty
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
authors.forename: Aparna
authors.initials: A
authors.lastname: Wagle Shukla
authors.forename: Nikolaus R
authors.initials: NR
authors.lastname: McFarland
mesh_terms: D000368:Aged; D001334:Automobile Driving / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D011446:Prospective Studies; D011597:Psychomotor Performance; D012737:Sex Factors