NEW YORK (Reuters Health) - A short screening test, developed by a Belgian team, which measures four clinical variables can accurately predict the fitness of patients with Parkinson’s disease to drive, according to findings published in the current issue of the journal Neurology.
“Physicians often rely on a medical history and an interview with the patient and the next of kin regarding driving problems,” lead author Dr. Hannes Devos noted in comment to Reuters Health. However, “physicians often overestimate the driving skills of their patients.”
Devos of Catholic University in Leuven and colleagues developed a brief, efficient screening system to help physicians assess the fitness of Parkinson’s disease patients to drive a car.
Eighty individuals, including 40 with Parkinson’s disease and 40 healthy subjects matched to the patients for age and other variables, were assessed using a driving simulator, a driving history survey, and the Clinical Dementia Rating scale.
In addition, the Parkinson’s patients underwent a screening test and an evaluation designed by the Belgian Road Safety Institute. This included visual, intellectual and on-road testing.
The combination of assessments that included disease duration, sensitivity to contrasts, Clinical Dementia Rating, and the motor part of the Unified Parkinson’s Disease Rating Scale provided the best screening test to predict fitness to drive.
Overall, 36 (90 percent) patients with Parkinson’s disease were correctly classified as pass or fail using this screening method.
“When the result on the formula is positive, the patient can continue to drive without further restrictions,” Devos explained. When the patient fails, he may be allowed to drive with restrictions or be considered unfit to drive, he said. “Further assessment at an official driving assessment center then seems to be the right course of action.”
Parkinson’s disease “is often regarded as a disease that mainly affects motor functions, while visual and cognitive functions are often disregarded,” Devos noted. “Nonetheless, problems with attention, visuospatial organization, planning and judgment, and contrast sensitivity are also seen in Parkinson’s disease.”
“It is my opinion that the driving performance of Parkinson’s disease patients is often overestimated and that they should be evaluated on a more regular basis,” Devos concluded.
SOURCE: Neurology October 2, 2007.