Skip to main content Accessibility help
×
Home

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

  • JANET GRACE (a1), MELISSA M. AMICK (a1), ANELYSSA D'ABREU (a2), ELENA K. FESTA (a3), WILLIAM C. HEINDEL (a3) and BRIAN R. OTT (a2)...

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.)

Copyright

Corresponding author

Reprint requests to: Dr. Janet Grace, Department of Medical Rehabilitation, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI, 02860. E-mail: Janet_Grace@mhri.org

References

Hide All

REFERENCES

Benedict, R. (1998). Hopkins Verbal Learning Test–Revised. Lutz, FL: Psychological Assessment Resources.
Brown, L.B. & Ott, B.R. (2004). Driving and dementia: A review of the literature. Journal of Geriatric Psychiatry & Neurology, 17, 232240.
Brown, L.B., Ott, B.R., Papandonatos, G.D., Sui, Y., Ready, R.E., & Morris, J.C. (2005a). Prediction of on-road driving performance in patients with early Alzheimer's disease. Journal of the American Geriatrics Society, 53, 9498.
Brown, L.B., Stern, R.A., Cahn-Weiner, D.A., Rogers, B., Messer, M.A., Lannon, M.C., Maxell, C., Souza, T., White, T., & Ott, B.R. (2005b). Driving Scenes test of the Neuropsychological Assessment Battery (NAB) and on-road driving performance in aging and very mild dementia. Archives of Clinical Neuropsychology, 20, 209216.
Drachman, D.A. & Swearer, J.M. (1993). Driving and Alzheimer's disease: The risk of crashes. Neurology, 43, 24482456.
Dubinsky, R.M., Gray, C., Husted, D., Busenbark, K., Vetere-Overfield, B., Wiltfong, D., Parrish, D., & Koller, W.C. (1991). Driving in Parkinson's disease. Neurology, 41, 517520.
Duchek, J.M., Carr, D.B., Hun, L., Roe, C.M., Xiong, C., Shah, K., & Morris, J.C. (2003). Longitudinal driving performance in early-stage dementia of the Alzheimer's type. Journal of the American Geriatrics Society, 51, 13421347.
Duff, K., Shoenberg, M.R., Scott, J.G., & Adams, R.L. (2005). The relationship between executive functioning and verbal and visual learning and memory. Archives of Clinical Neuropsychology, 20, 111122.
Fahn, S., Elton, R.L., & Members of the UPDRS Development Committee. (1987). Unified Parkinson's Disease Rating Scale. In S. Fahn, C.D. Marsden, M. Goldstein, D.B. Calne, (Eds.), Recent Developments in Parkinson's Disease, Vol. 2, (pp. 153–163, 293–304). Florham Park, NJ: Macmillan Healthcare Information.
Fitten, L.J., Perryman, K.M., Wilkinson, C.J., Little, R.J., Burns, M.M., Pachana, N., Mervis, J.R., Malmgren, R., Siembieda, D.W., & Ganzell, S. (1995). Alzheimer and vascular dementias and driving. Journal of the American Medical Association, 273, 13601365.
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-Mental State”—A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 12, 189198.
Heikkila, V.M., Turkka, J., Korpelainen, J., Kallanranta, T., & Summala, H. (1998). Decreased driving ability in people with Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 64, 325330.
Hoehn, M.M. & Yahr, M.D. (1967). Parkinsonism: Onset, progression, and mortality. Neurology, 17, 427442.
Hughes, C.P, Berg, L., Danziger, W.L., Coben, L.A., & Martin, R.L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566572.
Hunt, L.A., Murphy, C.F., Carr, D., Duchek, J.M., Buckles, V., & Morris, J.C. (1997). Reliability of the Washington University Road Test. Archives of Neurology, 54, 707712.
Madeley, P., Hulley, J.L., Wildgust, H., & Mindham, R.H.S. (1990). Parkinson's disease and driving ability. Journal of Neurology, Neurosurgery & Psychiatry, 53, 580582.
Marcotte, T.D., Heaton, R.K., Wolfson, T., Taylor, M.J., Alhassoon, O., Arfaa, K., Grant, I., & the HNRC Group (1999). The impact of HIV-related neuropsychological dysfunction on driving behavior. Journal of the International Neuropsychological Society, 5, 579592.
Maze Master (Version 1.01) (1992). Computerized Mazes. Boulder, CO: The Flatirons Group.
McKhann, G., Drachman, D., Folstein, M., Price, D., & Stadlan, E. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939944.
Radford, K.A., Lincoln, N.B., & Lennox, G. (2004). The effects of cognitive abilities on driving in people with Parkinson's disease. Disability Rehabilitation, 26(2), 6570.
Reger, M.A., Welsh, R.K., Watson, G.S., Cholerton, B., Baker, L.D., & Craft, S. (2004). The relationship between neuropsychological functioning and driving ability in dementia: A meta-analysis. Neuropsychology, 18, 8593.
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson, AZ: Neuropsychological Press.
Reitan, R.M. & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation, (2nd ed.). South Tucson, AZ: Neuropsychology Press.
Stern, R.A., Javorsky, D.J., Singer, E.A., Harris, N.G., Somerville, J.A., Duke, L.M., Thompson, J.A., & Kaplan, E. (1999). Boston Qualitative Scoring System of the Rey-Osterreith Complex Figure. Odessa, FL: Psychological Assessment Resources.
Stern, R.A. & White, T. (2004). Neuropsychological Assessment Battery (NAB). Lutz, FL: Psychological Assessment Resources.
Tremont, G., Halpert, S., Javorsky, D.J., & Stern, R.A. (2000). Differential impact of executive dysfunction on verbal list learning and story recall. The Clinical Neuropsychologist, 14, 295302.
Whelihan, W.W., DiCarlo, M.A., & Paul, R.H. (2005). The relationship of neuropsychological functioning to driving competence in older persons with early cognitive decline. Archives of Clinical Neuropsychology, 20, 217228.
Whithaar, F.K., Brouwer, W.H., & Van Zomeran, A.H. (2000). Fitness to drive in older drivers with cognitive impairment. Journal of the International Neuropsychological Society, 6, 480490.
Wood, J.M., Warringham, C., Kerr, G., Mallon, K., & Silburn, P. (2005). Quantitative assessment of driving performance in Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 76, 176180.
Zesiewicz, T.A., Cimino, C.R., Malek, A.R., Gardner, N., Leaverton, P.L., Dunne, P.B., & Hauser, R.A. (2002). Driving safety in Parkinson's disease. Neurology, 59, 17871788.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed