title: The Aeromedical Implications of Parkinson's Disease.
abstract: BACKGROUND
  Parkinson's disease is a progressive neurodegenerative disorder which is encountered in the pilot population and has clinical features that can impact on the flying role. This retrospective study reviewed the United Kingdom Civil Aviation Authority (UK CAA) experience of Parkinson's disease. The aeromedical implications of the condition are discussed and the UK CAA policy for the certificatory assessment of pilots with Parkinson's disease is described.
  
  
  METHODS
  A search of the UK CAA medical records database from 1990 to 2015 identified 34 pilots with a diagnosis of Parkinson's disease. Data was extracted for the class of medical certificate, time from first symptoms to diagnosis, age at diagnosis, the time from diagnosis to loss of certification and the reasons for loss of certification.
  
  
  RESULTS
  Of 15 professional (Class 1) and 19 private (Class 2) pilots, the mean time from onset of symptoms to diagnosis was 36 and 19 mo, respectively. The mean ages at diagnosis were 55 and 59 yr, respectively. The mean interval from diagnosis to loss of certification was 21 (0-93) and 37 (0-84) mo, respectively. The reasons for loss of certification are considered.
  
  
  CONCLUSIONS
  In the UK, pilots diagnosed with Parkinson's disease may be granted medical certification depending on their functional ability and the side effect profile of medication. The aeromedical implications of Parkinson's disease and the UK CAA policy for the certification of pilots with Parkinson's disease are discussed.
authors.affiliation: United Kingdom Civil Aviation Authority, Gatwick Airport, West Sussex RH6 0YR, UK.
authors.forename: Tania
authors.initials: T
authors.lastname: Jagathesan
authors.forename: Michael D
authors.initials: MD
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects; D001359:Aviation / Q000592:standards*; D002568:Certification; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D011640:Public Policy; D012189:Retrospective Studies; D013997:Time Factors; D006113:United Kingdom; D014938:Work Capacity Evaluation
chemical_list: D000978:Antiparkinson Agents