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Neuropsychological deficits associated with driving performance in Parkinson's and Alzheimer's disease

Published online by Cambridge University Press:  21 October 2005

JANET GRACE ,
MELISSA M. AMICK ,
ANELYSSA D'ABREU ,
ELENA K. FESTA ,
WILLIAM C. HEINDEL  and
BRIAN R. OTT
JANET GRACE
Affiliation:
Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
MELISSA M. AMICK
Affiliation:
Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
ANELYSSA D'ABREU
Affiliation:
Department of Clinical Neurosciences, Brown University, Providence, Rhode Island
ELENA K. FESTA
Affiliation:
Department of Psychology, Brown University, Providence, Rhode Island
WILLIAM C. HEINDEL
Affiliation:
Department of Psychology, Brown University, Providence, Rhode Island
BRIAN R. OTT
Affiliation:
Department of Clinical Neurosciences, Brown University, Providence, Rhode Island
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Abstract

Neuropsychological and motor deficits in Parkinson's disease that may contribute to driving impairment were examined in a cohort study comparing patients with Parkinson's disease (PD) to patients with Alzheimer's disease (AD) and to healthy elderly controls. Nondemented individuals with Parkinson's disease [Hoehn & Yahr (H&Y) stage I–III], patients with Alzheimer's disease [Clinical Demetia Rating scale (CDR) range 0–1], and elderly controls, who were actively driving, completed a neuropsychological battery and a standardized road test administered by a professional driving instructor. On-road driving ability was rated on number of driving errors and a global rating of safe, marginal, or unsafe. Overall, Alzheimer's patients were more impaired drivers than Parkinson's patients. Parkinson's patients distinguished themselves from other drivers by a head-turning deficiency. Drivers with neuropsychological impairment were more likely to be unsafe drivers in both disease groups compared to controls. Compared to controls, unsafe drivers with Alzheimer's disease were impaired across all neuropsychological measures except finger tapping. Driving performance in Parkinson's patients was related to disease severity (H&Y), neuropsychological measures [Rey Osterreith Complex Figure (ROCF), Trails B, Hopkins Verbal List Learning Test (HVLT)-delay], and specific motor symptoms (axial rigidity, postural instability), but not to the Unified Parkinson Disease Rating Scale (UPDRS) motor score. Multifactorial measures (ROCF, Trails B) were useful in distinguishing safe from unsafe drivers in both patient groups. (JINS, 2005, 11, 766–775.)

Keywords

DementiaMotor vehiclesCognitionMemoryNeurodegenerative diseasesBasal ganglia
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 6 , October 2005 , pp. 766 - 775
Copyright
© 2005 The International Neuropsychological Society

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