title: Comorbidity in Drivers with Parkinson's Disease.
abstract: OBJECTIVE
  To determine the effect of comorbidity on fitness-to-drive recommendations that physicians and on-road driving assessors make and to investigate the agreement in fitness-to-drive recommendations between physicians and on-road driving assessors.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Data on comorbidities associated with Parkinson's disease (PD) and fitness-to-drive recommendations were investigated.
  
  
  METHODS
  Individuals with PD who underwent an official on-road test in Belgium (N = 72).
  
  
  METHODS
  Correlations between comorbidity and fitness-to-drive recommendations were calculated. Stepwise logistic regression models were used to investigate whether comorbidity was an independent predictor of fitness-to-drive recommendations (pass/fail) that the physicians or the on-road assessors made. The percentage of agreement and the prevalence and bias-adjusted kappa (PABAK) were used to investigate agreement between the physicians and the on-road assessors.
  
  
  RESULTS
  Moderate correlations were found between comorbidity and fitness-to-drive recommendations that the physicians (ρ = 0.34, P = .004) and the on-road assessors (ρ = 0.30, P = .01) made. Comorbidity was the most important determinant (coefficient of determination = 0.16, P = .005) of the physicians fitness-to-drive recommendations. No significant effect of comorbidity on the on-road recommendations was found. The physicians and the on-road assessors agreed in 46 (64%) of the cases (PABAK = 0.46, P < .001).
  
  
  CONCLUSIONS
  Comorbidity plays a role in physicians' recommendations of fitness to drive that may explain, in part, inconsistencies between physicians and on-road assessors' fitness-to-drive recommendations. This study indicates the need for an interdisciplinary dialogue between physicians and on-road assessors to reach a comprehensive fitness-to-drive decision.
authors.affiliation: Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, Georgia.
authors.forename: Maud
authors.initials: M
authors.lastname: Ranchet
authors.affiliation: Center for Evaluation of Fitness to Drive and Car Adaptations, Belgian Road Safety Institute, Brussels, Belgium.
authors.forename: Mark
authors.initials: M
authors.lastname: Tant
authors.affiliation: Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, Georgia.|Dean's Office, College of Allied Health Sciences, Augusta University, Augusta, Georgia.
authors.forename: Abiodun Emmanuel
authors.initials: AE
authors.lastname: Akinwuntan
authors.affiliation: Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, Georgia.
authors.forename: Erin
authors.initials: E
authors.lastname: Neal
authors.affiliation: Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, Georgia.
authors.forename: Hannes
authors.initials: H
authors.lastname: Devos
mesh_terms: D000368:Aged; D001333:Automobile Driver Examination; D001334:Automobile Driving; D001530:Belgium; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology*
keywords: Parkinson's disease; comorbidity; fitness-to-drive recommendation; on-road assessor; physician