Abstract
The proportion of elderly people in the general population is rising, resulting in greater numbers of drivers with neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s disease. These neurodegenerative disorders impair cognition, visual perception, and motor function, leading to reduced driver fitness and greater crash risk. Yet neither medical diagnosis nor age alone is reliable enough to predict driver safety or crashes or to revoke the driving privileges of these individuals. Driving research utilizes tools such as questionnaires about driving habits and history, driving simulators, standardized road tests utilizing instrumented vehicles, and state driving records. Research challenges include outlining the evolution of driving safety, understanding the mechanisms of driving impairment, and developing a reliable and efficient standardized test battery for prediction of driver safety in neurodegenerative disorders. This information will enable healthcare providers to advise their patients with neurodegenerative disorders with more certainty, affect policy, and help develop rehabilitative measures for driving.
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References and Recommended Reading
Anderson SW, Rizzo M, Skaar N, et al.: Amnesia and driving. J Clin Exp Neuropsychol 2007, 29:1–12.
Ott BR, Anthony D, Papandonatos GD, et al.: Clinician assessment of the driving competence of patients with dementia. J Am Geriatr Soc 2005, 53:829–833.
Ott BR, Heindel WC, Papandonatos GD, et al.: A longitudinal study of drivers with Alzheimer disease. Neurology 2008, 70:1171–1178.
Lang AE, Lozano AM: Parkinson’s disease. First of two parts. N Engl J Med 1998, 339:1044–1053.
Uc EY, Rizzo M, Anderson SW, et al.: Visual dysfunction in Parkinson disease without dementia. Neurology 2005, 65:1907–1913.
Comella CL: Sleep disorders in Parkinson’s disease: an overview. Mov Disord 2007, 22:S367–S373.
Hobson DE, Lang AE, Martin WR, et al.: Excessive day-time sleepiness and sudden-onset sleep in Parkinson disease: a survey by the Canadian Movement Disorders Group. JAMA 2002, 287:455–463.
Homann CN, Suppan K, Homann B, et al.: Driving in Parkinson’s disease—a health hazard? J Neurol 2003, 250:1439–1446.
Dubinsky RM, Gray C, Husted D, et al.: Driving in Parkinson’s disease. Neurology 1991, 41:517–520.
Meindorfner C, Korner Y, Moller JC, et al.: Driving in Parkinson’s disease: mobility, accidents, and sudden onset of sleep at the wheel. Mov Disord 2005, 20:832–842.
Blennow K, de Leon MJ, Zetterberg H: Alzheimer’s disease. Lancet 2006, 368:387–403.
Hopkins RW, Kilik L, Day DJ, et al.: Driving and dementia in Ontario: a quantitative assessment of the problem. Can J Psychiatry 2004, 49:434–438.
Drachman DA, Swearer JM: Driving and Alzheimer’s disease: the risk of crashes. Neurology 1993, 43:2448–2456.
Friedland RP, Koss E, Kumar A, et al.: Motor vehicle crashes in dementia of the Alzheimer type. Ann Neurol 1988, 24:782–786.
Gilley DW, Wilson RS, Bennett DA, et al.: Cessation of driving and unsafe motor vehicle operation by dementia patients. Arch Intern Med 1991, 151:941–946.
Dubinsky RM, Stein AC, Lyons K: Practice parameter: risk of driving and Alzheimer’s disease (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology. Neurology 2000, 54:2205–2211.
Viitanen M, Johansson K, Bogdanovic N, et al.: Alzheimer changes are common in aged drivers killed in single car crashes and at intersections. Forensic Sci Int 1998, 96:115–127.
Singh R, Pentland B, Hunter J, Provan F: Parkinson’s disease and driving ability. J Neurol Neurosurg Psychiatry 2007, 78:363–366.
Heikkila VM, Turkka J, Korpelainen J, et al.: Decreased driving ability in people with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1998, 64:325–330.
Wood JM, Worringham C, Kerr G, et al.: Quantitative assessment of driving performance in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2005, 76:176–180.
Worringham CJ, Wood JM, Kerr GK, Silburn PA: Predictors of driving assessment outcome in Parkinson’s disease. Mov Disord 2006, 21:230–235.
Amick MM, Grace J, Ott BR: Visual and cognitive predictors of driving safety in Parkinson’s disease patients. Arch Clin Neuropsychol 2007, 22:957–967.
Uc EY, Rizzo M, Anderson SW, et al.: Impaired navigation in drivers with Parkinson’s disease. Brain 2007, 130:2433–2440.
Uc EY, Rizzo M, Anderson SW, et al.: Impaired visual search in drivers with Parkinson’s disease. Ann Neurol 2006, 60:407–413.
Uc EY, Rizzo M, Anderson SW, et al.: Driving with distraction in Parkinson disease. Neurology 2006, 67:1774–1780.
Duchek JM, Hunt L, Ball K, et al.: Attention and driving performance in Alzheimer’s disease. J Gerontol B Psychol Sci Soc Sci 1998, 53:130–141.
Uc EY, Rizzo M, Anderson SW, et al.: Driver route-following and safety errors in early Alzheimer disease. Neurology 2004, 63:832–837.
Uc EY, Rizzo M, Anderson SW, et al.: Driver landmark and traffic sign identification in early Alzheimer’s disease. J Neurol Neurosurg Psychiatry 2005, 76:764–768.
Reger MA, Welsh RK, Watson GS, et al.: The relationship between neuropsychological functioning and driving ability in dementia: a meta-analysis. Neuropsychology 2004, 18:85–93.
Madeley P, Hulley JL, Wildgust H, Mindham RH: Parkinson’s disease and driving ability. J Neurol Neurosurg Psychiatry 1990, 53:580–582.
Lings S, Dupont E: Driving with Parkinson’s disease. A controlled laboratory investigation. Acta Neurol Scand 1992, 86:33–39.
Moller JC, Stiasny K, Hargutt V, et al.: Evaluation of sleep and driving performance in six patients with Parkinson’s disease reporting sudden onset of sleep under dopaminergic medication: a pilot study. Mov Disord 2002, 17:474–481.
Zesiewicz TA, Cimino CR, Malek AR, et al.: Driving safety in Parkinson’s disease. Neurology 2002, 59:1787–1788.
Stolwyk RJ, Triggs TJ, Charlton JL, et al.: Impact of internal versus external cueing on driving performance in people with Parkinson’s disease. Mov Disord 2005, 20:846–857.
Stolwyk RJ, Triggs TJ, Charlton JL, et al.: Effect of a concurrent task on driving performance in people with Parkinson’s disease. Mov Disord 2006, 21:2096–2100.
Stolwyk RJ, Charlton JL, Triggs TJ, et al.: Neuropsychological function and driving ability in people with Parkinson’s disease. J Clin Exp Neuropsychol 2006, 28:898–913.
Devos H, Vandenberghe W, Nieuwboer A, et al.: Predictors of fitness to drive in people with Parkinson disease. Neurology 2007, 69:1434–1441.
Uc EY, Rizzo M, Sparks JD, et al.: Increased crash risk in drivers with Parkinson’s disease under low visual contrast lighting conditions. Neurology 2007, 68:A208.
Rizzo M, Reinach S, McGehee D, Dawson J: Simulated car crashes and crash predictors in drivers with Alzheimer disease. Arch Neurol 1997, 54:545–551.
Rizzo M, McGehee DV, Dawson JD, Anderson SN: Simulated car crashes at intersections in drivers with Alzheimer disease. Alzheimer Dis Assoc Disord 2001, 15:10–20.
Cox DJ, Quillian WC, Thorndike FP, et al.: Evaluating driving performance of outpatients with Alzheimer disease. J Am Board Fam Pract 1998, 11:264–271.
Anderson SW, Rizzo M, Shi Q, et al.: Cognitive abilities related to driving performance in a simulator and crashing on the road. Proceedings of the Third International Driving Symposium on Human Factors in Driver Assessment, Training and Vehicle Design. Iowa City: University of Iowa; 2005:286–292.
Uc EY, Rizzo M, Anderson SW, et al.: Unsafe rear-end collision avoidance in Alzheimer’s disease. J Neurol Sci 2006, 251:35–43.
Rizzo M, Shi Q, Dawson JD, et al.: Stops for cops: impaired response implementation for older drivers with cognitive decline. Transportation Res Record 2005, 1992, 1–8.
Breen DA, Breen DP, Moore JW, et al.: Driving and dementia. BMJ 2007, 334:1365–1369.
Molnar FJ, Patel A, Marshall SC, et al.: Clinical utility of office-based cognitive predictors of fitness to drive in persons with dementia: a systematic review. J Am Geriatr Soc 2006, 54:1809–1824.
MOlnar FJ, Patel A, Marshall SC, et al.: Systematic review of the optimal frequency of follow-up in persons with mild dementia who continue to drive. Alzheimer Dis Assoc Disord 2006, 20:295–297.
Bacon D, Fisher RS, Morris JC, et al.: American Academy of Neurology position statement on physician reporting of medical conditions that may affect driving competence. Neurology 2007, 68:1174–1177.
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Uc, E.Y., Rizzo, M. Driving and neurodegenerative diseases. Curr Neurol Neurosci Rep 8, 377–383 (2008). https://doi.org/10.1007/s11910-008-0059-1
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DOI: https://doi.org/10.1007/s11910-008-0059-1