The Clinical Findings Useful for Driving Safety Advice for Parkinson's Disease Patients.

Publisher: Japanese Society of Internal Medicine Country of Publication: Japan NLM ID: 9204241 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1349-7235 (Electronic) Linking ISSN: 09182918 NLM ISO Abbreviation: Intern Med Subsets: MEDLINE

Original Publication: Tokyo, Japan : Japanese Society of Internal Medicine, [1992-

Automobile Driving*; Accidents, Traffic/*statistics & numerical data ; Antiparkinson Agents/*therapeutic use ; Cognition/*drug effects ; Levodopa/*therapeutic use ; Parkinson Disease/*complications ; Parkinson Disease/*drug therapy; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Surveys and Questionnaires

Objective We conducted a study to obtain information that could be used to provide Parkinson's disease (PD) patients with appropriate advice on safe driving. Methods Consecutive PD patients who visited our office were studied. Among these patients, those who had experienced driving after being diagnosed with PD were interviewed by neurologists and a trained nurse to investigate their previous car accidents, motor function, cognitive function, sleepiness, levodopa equivalent dose (LED), and emotional dysregulation. The rates of major car accidents before and after the onset of PD were compared. Results Fifteen patients had experienced a major car accident resulting in human injury or serious property damage since the onset of PD. When the rates of major car accidents before and after the onset of PD were compared, the ratio was 4.3 [95% confidence interval (CI) 1.9-9.7]. The incidence of accidents after the onset of PD was correlated with age, disease duration, LED, the cognitive function Mini-Mental Scale Examination (MMSE), Japanese translation of the Montreal Cognitive Assessment (MoCA-J), but not the motor symptom score [Unified Pankinson's disease rating scale (UPDRS) part III at the time of the study]. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) score was also higher in patients with major car accidents. Conclusion The severity of symptoms (Hoehn-Yahr classification), cognitive function, and disease duration were expected to be risk factors for car accidents. However, the motor symptom score (UPDRS part III) was not associated with the incidence of major car accidents. In addition to a low cognitive function and the severity of symptoms, the QUIP score might be an independent factor that can be referenced when advising PD patients to refrain from driving.

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Keywords: Parkinson's disease; advice to refrain from driving; car accident; driving; safety

0 (Antiparkinson Agents)
46627O600J (Levodopa)

Date Created: 20180302 Date Completed: 20181015 Latest Revision: 20181114

20221213

PMC6096020

10.2169/internalmedicine.9653-17

29491315