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Parkinson’s disease and driving ability
  1. Rajiv Singh1,
  2. Brian Pentland1,
  3. John Hunter2,
  4. Frances Provan3
  1. 1Department of Neurorehabilitation, Astley Ainslie Hospital, Edinburgh, UK
  2. 2Scottish Driving Assessment Service, Astley Ainslie Hospital, Edinburgh, UK
  3. 3Computing Services, Edinburgh University Main Library, Edinburgh, UK
  1. Correspondence to:
 Dr R Singh
 Department of Rehabilitation Medicine, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2HL, UK; rajiv.singh{at}lpct.scot.nhs.uk

Abstract

Objectives: 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.

  • H&Y, Hoehn and Yahr
  • PD, Parkinson’s disease

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Footnotes

  • Published Online First 18 December 2006

  • Competing interests: None declared.

  • RS is the author. BP corrected the manuscript and JH thought of the original idea for the project and also redrafted the manuscript. JH is the guarantor. FP helped with statistical analysis and advised on writing.

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