Predictors of fitness to drive in people with Parkinson disease

被引:73
作者
Devos, H.
Vandenberghe, W.
Nieuwboer, A.
Tant, M.
Baten, G.
De Weerdt, W.
机构
[1] Katholieke Univ Leuven, Fac Kinesiol & Rehabil Sci, Dept Rehabil Sci, BE-3001 Louvain, Belgium
[2] Univ Hosp Gasthuisberg, Dept Neurol, B-3000 Louvain, Belgium
[3] Belgian Rd Safety Inst, CARA Unit, Brussels, Belgium
关键词
D O I
10.1212/01.wnl.0000277640.58685.fc
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To develop an efficient clinical screening battery to accurately predict the fitness to drive in people with Parkinson disease ( PD). Methods: This prospective study included 80 participants: 40 patients with PD and 40 healthy age- and sex- matched control subjects. All participants were assessed using a driving simulator, a driving history survey, and the Clinical Dementia Rating. The patients with PD also underwent a clinical test battery and an evaluation of fitness to drive performed by an official center, which included visual, cognitive, and on- road tests. A two- class decision from this driving assessment center was the main outcome measure. Results: A screening battery assessing four clinical variables ( disease duration, contrast sensitivity, Clinical Dementia Rating, and motor part of the Unified Parkinson's Disease Rating Scale) provided the best model ( R-2 = 0.52) to predict the fitness to drive and correctly classified 36 ( 90%) of the patients with PD as pass or fail ( sensitivity = 91%, specificity = 90%). The Test Ride for Investigating Practical fitness to drive ( TRIP) driving simulator score discriminated significantly between drivers with PD and their healthy peers ( p = 0.0008). When the TRIP driving simulator score was added to the clinical model, the total explained variance increased ( R2 = 0.60) and correctly classified 39 ( 97.5%) of drivers with PD into the pass/ fail category ( sensitivity = 91%, specificity = 100%). Conclusions: A short clinical screening battery that measures disease duration, contrast sensitivity, cognitive and motor functions can predict fitness to drive in people with Parkinson disease with a high degree of accuracy.
引用
收藏
页码:1434 / 1441
页数:8
相关论文
共 38 条
[21]   PARKINSONS-DISEASE AND DRIVING ABILITY [J].
MADELEY, P ;
HULLEY, JL ;
WILDGUST, H ;
MINDHAM, RHS .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1990, 53 (07) :580-582
[22]   EFFECT OF SYMPTOM DURATION ON COGNITIVE AND MOTOR-PERFORMANCE IN PARKINSONISM [J].
MATTHEWS, CG ;
HAALAND, KY .
NEUROLOGY, 1979, 29 (07) :951-956
[23]   THE CLINICAL DEMENTIA RATING (CDR) - CURRENT VERSION AND SCORING RULES [J].
MORRIS, JC .
NEUROLOGY, 1993, 43 (11) :2412-2414
[24]   Driving with Parkinson' s disease: More than meets the eye [J].
Newman, Nancy J. .
ANNALS OF NEUROLOGY, 2006, 60 (04) :387-388
[25]  
Pelli DG, 1993, CLIN VIS SCI, V34, P3526
[26]   The effects of cognitive abilities on driving in people with Parkinson's disease [J].
Radford, K ;
Lincoln, N ;
Lennox, G .
DISABILITY AND REHABILITATION, 2004, 26 (02) :65-70
[27]  
Rey A., 1959, TEST COPIE FIGURE CO
[28]   MEAUREMENT OF VISUAL ACUITY - A CRITICAL REVIEW [J].
SLOAN, LL .
AMA ARCHIVES OF OPHTHALMOLOGY, 1951, 45 (06) :704-725
[29]   DEPRESSION IN PARKINSONS-DISEASE [J].
STARKSTEIN, SE ;
PREZIOSI, TJ ;
BOLDUC, PL ;
ROBINSON, RG .
JOURNAL OF NERVOUS AND MENTAL DISEASE, 1990, 178 (01) :27-31
[30]   Neuropsychological function and driving ability in people with Parkinson's disease [J].
Stolwyk, R. J. ;
Charlton, J. L. ;
Triggs, T. J. ;
Iansek, R. ;
Bradshaw, J. L. .
JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY, 2006, 28 (06) :898-913