Profiling unsafe drivers with Parkinson’s disease: Does clinical subtype predict on-road driving performance?

摘要

Aim: To investigate the relationship between clinical subtypes of Parkinson’s disease (PD)and on-road driving performance.Methods: A total of 100 patients with PD were categorized into three subtypes: PosturalImbalance and Gait Disorder (PIGD), n = 59; tremor-dominant (TD), n = 29; or indeterminate(IND), n = 12. All participants completed an off-road evaluation consisting of a clinicalquestionnaire, a driving history, visual and neuropsychological tests and an on-road drivingevaluation.Results: The three groups were matched for age, gender, and disease stage, but not forUPDRS scores. Failure rates on the road test differed between the three groups (p = 0.001).Participants with PIGD were more likely to fail the on-road test compared to those with TD(46% vs 7%, p = 0.0002). After adjustment for UPDRS differences, the odds of failing the on13road test for participants with PIGD was 9.49 (95% confidence interval, 1.66 – 54.21; p =0.01) times as high as those for patients with TD. The PIGD group performed worse onexecutive control (p = 0.006), cognitive interference (p = 0.046), and 4-choice movement time(p = 0.01). After correction for UPDRS scores, only executive control remained significant (p= 0.02).