title: Driving errors in Parkinson's disease: moving closer to predicting on-road outcomes.
abstract: Age-related medical conditions such as Parkinson's disease (PD) compromise driver fitness. Results from studies are unclear on the specific driving errors that underlie passing or failing an on-road assessment. In this study, we determined the between-group differences and quantified the on-road driving errors that predicted pass or fail on-road outcomes in 101 drivers with PD (mean age = 69.38 ± 7.43) and 138 healthy control (HC) drivers (mean age = 71.76 ± 5.08). Participants with PD had minor differences in demographics and driving habits and history but made more and different driving errors than HC participants. Drivers with PD failed the on-road test to a greater extent than HC drivers (41% vs. 9%), χ²(1) = 35.54, HC N = 138, PD N = 99, p < .001. The driving errors predicting on-road pass or fail outcomes (95% confidence interval, Nagelkerke R² =.771) were made in visual scanning, signaling, vehicle positioning, speeding (mainly underspeeding, t(61) = 7.004, p < .001, and total errors. Although it is difficult to predict on-road outcomes, this study provides a foundation for doing so.
authors.affiliation: Sherrilene Classen, PhD, MPH, OTR/L, is Professor and Director, School of Occupational Therapy, Elborn College, Room 2555B, 1201 Western Road, Western University, London, Ontario N6G 1H1 Canada. At the time of the study, she was Director, Institute for Mobility, Activity and Participation, and Associate Professor, Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville; sclassen@uwo.ca.
authors.forename: Sherrilene
authors.initials: S
authors.lastname: Classen
authors.affiliation: Babette Brumback, PhD, is Professor and Program Director, Department of Biostatistics, University of Florida, Gainesville.
authors.forename: Babette
authors.initials: B
authors.lastname: Brumback
authors.affiliation: Miriam Monahan, MS OT, CDRS, is Occupational Therapist and Certified Driving Rehabilitation Specialist, Department of Occupational Therapy and Institute for Mobility, Activity and Participation, University of Florida, Gainesville.
authors.forename: Miriam
authors.initials: M
authors.lastname: Monahan
authors.affiliation: Irene I. Malaty, MD, is Assistant Professor, Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville.
authors.forename: Irene I
authors.initials: II
authors.lastname: Malaty
authors.affiliation: Ramon L. Rodriguez, MD, is Director, Movement Disorders Clinic, Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville.
authors.forename: Ramon L
authors.initials: RL
authors.lastname: Rodriguez
authors.affiliation: Michael S. Okun, MD, is Co-Director, Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
authors.affiliation: Nikolaus R. McFarland, MD, PhD, is Assistant Professor, Department of Neurology, University of Florida, Gainesville.
authors.forename: Nikolaus R
authors.initials: NR
authors.lastname: McFarland
mesh_terms: D000368:Aged; D001333:Automobile Driver Examination; D001334:Automobile Driving; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012449:Safety; D013647:Task Performance and Analysis