Background Fitness to drive (FTDr) and mobility in general are important aspects of quality of life. However, the cognitive, motor, and visual functions required for adequate procedural driving skills in a motor vehicle show a progressive decline in HD. Furthermore, patients with HD are at a greater risk of overestimating their own driving skills and FTDr due to impaired self-awareness (Paulsen, 2011), which could lead to potential dangerous traffic situations.

Objective Correctly identify FTDr in HD patients by means of classic neuropsychological tests, driving simulator tests, and tests that focus on the social cognitive functions required for adequate self-awareness such as self-inhibition and perspective taking. These results will be correlated with an on-road driving test, the gold standard for FTDr.

Study design A cohort study in 50 HD patients.

Study population Symptomatic HD patients who hold a drivers’ license between 18 and 74 years of age.

Methods Participation involves 1) a neurological assessment, 2) a neuropsychological assessment, 3) a driving simulator test, and 4) an on-road driving test.

Preliminary results All participants till date assessed themselves as fit to drive, however a third was deemed unfit by the on-road driving test. We were able to correctly identify these participants by the neuropsychological assessment. Some patients who were deemed fit to drive showed only mild deficits on classic neuropsychological tests. A more clear-cut difference between fit and unfit to drive was found on social cognitive tests.

Conclusion Although cognitive deficits that may interfere with FTDr, such as information processing speed, are present in HD they are not the most important determinants. A more clear-cut distinction between fit and unfit to drive could be achieved on the basis of performance on social cognitive tests.