Post written by Bradley Hiner, MD
When thinking of driving restrictions for patients with Parkinson’s, I am reminded of the old bumper sticker put out by gun-rights advocates. You remember the one, "You can have my gun when you pry it from my cold dead fingers!” Just substitute “car keys” for gun, and you get the idea.
Let’s face it: We are a car-oriented society. We are not the Dutch, where there are more bicycles than cars; nor the French/Japanese/fill in the blank — where mass transit is so readily available and good. Americans love their cars. And one of the toughest tasks faced by the neurologist is the heart-to-heart talk on giving it up.
Studies have shown that even with normal aging, we all lose some of our motor capabilities. Reaction time, strength, coordination, maneuvering ability are all known to be affected by aging. Compound that with the decrements imposed by Parkinson’s, and as I tell patients, “at some point you have to think about giving it up.”
A study published last August in the Journal of Neurology, Neurosurgery and Psychiatry, found that the duration of having PD directly correlated with driving safety as shown by this graph:
Bear in mind that on this scale, a score of 9-10 is good-excellent, 6-8 average, 4-5 poor, and 1-3 is, well, “you better park it right now.” Most concerning was the discrepancy between the examiner’s assessment (not good) and how the driver thought he/she had done (“I’ve driven for 50 years, and I’m a very good driver!”)
We are very fortunate to have certified driver’s assessment available through our Parkinson’s and Movement Disorders Program. Bill Reinhardt, Occupational Therapist tells me:
“We look at the functional components of driving, including: alternating attention, problem solving, visual spatial skills, upper and lower extremity motor skills including ROM (range of motion), strength and proprioception (position sense), and reaction time. Most important, we observe and assess any red flags that may impair driving safety. Currently, I believe that all persons with any neurological condition, especially those of a progressive nature, should be assessed at least yearly to assess their safety.”
I encourage anyone with PD to consider having this evaluation, if nothing else than for peace of mind. We want to avoid at all costs having one of those terrible accidents occur that we read about from time to time wherein a senior citizen really shouldn’t have been behind the wheel.