Thompson, Trevor ORCID: 0000-0001-9880-782X , Poulter, Damian ORCID: 0000-0003-2521-5959 , Miles, Clare, Solmi, Marco, Veronese, Nicola, Carvalho, André F., Stubbs, Brendon and Uc, Ergun Y. (2018) Driving impairment and crash risk in Parkinson disease. Neurology. ISSN 0028-3878 (Print), 1526-632X (Online) (doi:https://doi.org/10.1212/WNL.0000000000006132)

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Abstract

OBJECTIVES:
To provide the best possible evidence base for guiding driving decisions in Parkinson disease (PD), we performed a meta-analysis comparing patients with PD to healthy controls (HCs) on naturalistic, on-the-road, and simulator driving outcomes.

METHODS:
Seven major databases were systematically searched (to January 2018) for studies comparing patients with PD to HCs on overall driving performance, with data analyzed using random-effects meta-analysis. RESULTS: Fifty studies comprising 5,410 participants (PD = 1,955, HC = 3,455) met eligibility criteria. Analysis found the odds of on-the-road test failure were 6.16 (95% confidence interval [CI] 3.79-10.03) times higher and the odds of simulator crashes 2.63 (95% CI 1.64-4.22) times higher for people with PD, with poorer overall driving ratings also observed (standardized mean differences from 0.50 to 0.67). However, self-reported real-life crash involvement did not differ between people with PD and HCs (odds ratio = 0.84, 95% CI 0.57-1.23, p = 0.38). Findings remained unchanged after accounting for any differences in age, sex, and driving exposure, and no moderating influence of disease severity was found.

CONCLUSIONS:
Our findings provide persuasive evidence for substantive driving impairment in PD, but offer little support for mandated PD-specific relicensure based on self-reported crash data alone, and highlight the need for objective measures of crash involvement.

Item Type:	Article
Uncontrolled Keywords:	Parkinson’s disease; neurodegeneration; driving; fitness to drive; meta-analysis; crashes
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Applied Psychology Research Group Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	13 Oct 2020 20:57
URI:	http://gala.gre.ac.uk/id/eprint/21175

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