It doesn't take a rocket scientist to figure that one out.



Greg



-------Original Message-------



From: Parkinson's Information Exchange Network

Date: Tuesday, December 10, 2002 16:46:32

To: [log in to unmask]

Subject: Study: Parkinson's can impair driving



This St. Petersburg Times (http://www.sptimes.com) story has been sent to
you from [log in to unmask]







-----------------------------------------------------------------------------
-------------



http://www.sptimes.com/2002/12/10/State/Study__Parkinson_s_ca.shtml



Study: Parkinson's can impair driving

By WES ALLISON, Times Staff Writer



© St. Petersburg Times, published December 10, 2002





TAMPA -- A new study by researchers in Tampa found that Parkinson's patients
are much more likely to be involved in car accidents, eespecially as the
disease progresses.



In an article published today in the journal Neurology, the study recommends
establishing guidelines for when patients should surrender their licenses, a
notion gaining popularity among some advocates and researchers, but one most
states have not addressed.



"We shouldn't be afraid to say that we need to monitor a patient's driving
ability when they advance in disease," said Dr. Theresa A. Zesiewicz,
associate professor of neurology at the University of South Florida and the
study's lead author.



"We're not talking about restricting patients on a global scale," she said.
What we're talking about is there needs to be dialogue, that physicians need
to be aware that there is a potential problem. ... And as (patients) advance
in disease, their driving ability ... needs to be carefully monitored."



About 4-million Americans have Parkinson's disease, including about 55,000
in Florida. Although the study focused on Parkinson's, experts say it raises
issues germane to a variety of diseases affecting mind and body.



All states have special licensing requirements for people who suffer
seizures, as from epilepsy, but most don't address progressive neurological
diseases such as Alzheimer's or Parkinson's.



Whether people keep driving is usually left to them. Their family or doctor
may influence them, but Dr. Abraham Lieberman, medical director of the
National Parkinson's Foundation, said it's often hard to tell if someone
should be driving.



Lieberman recommends people with Parkinson's -- or any neurologic disease --
go to a driver's license office, explain their condition and ask for a road
test. They should retake the test periodically, he added.



"This study is an important study because it raises the issues, particularly
in a state like Florida where you have a large number of elderly people and
a lot of people with Parkinson's disease," said Lieberman, a neurology
professor at the University of Miami.



"When you first get the disease, you're doing okay. But three or four years
into the disease you're doing terribly, and there's no provision for someone
to say 'Okay, you've had Parkinson's, come and see me."'



The USF researchers enrolled 39 volunteers with Parkinson's and 25 without
any neurologic disease. Both groups had a median age of about 65. After
practicing for about 15 minutes, they were tested on a driving simulator.



The test counted only the accidents that the computer considered fatal.
Although Zesiewicz said she expected the Parkinson's patients to crash more,
she was shocked by the magnitude:



Among those with the earliest stage of Parkinson's -- Stage 1 on a 5-stage
scale -- 20 percent were involved in an accident, versus just a fraction of
study participants withoutt the disease.



56 percent of Stage 2 patients crashed.



And 90 percent of Stage 3 Parkinson's patients crashed.



All of the Stage 4 patients crashed, and Stage 5 patients generally are
considered unable to drive.



Only a few of the non-Parkinson's patients crashed.



Zesiewicz, assistant director of the Parkinson's Disease and Movement
Disorders Clinic at USF, said the problems stemmed from both mental and
physical declines. Parkinson's causes cognitive lapses in about one-third of
patients, and frequently causes tremors, stiffness or slowness of movement.



Janet Reno, former U.S. attorney general and Florida's best-known Parkinson
s patient, drove her red truck more than 30,000 miles during her
unsuccessful campaign for governor this year.



Both of her arms shake noticeably, but Reno says she has always asked
friends and family to tell her if she becomes wobbly behind the wheel.



"All of us, whether it's because of Parkinson's or something else, have got
to take steps to ensure that they're competent to drive," said Reno, who has
Stage 2 Parkinson's. "I think all of driving relies on one's good judgment."



Neurology is one of the nation's most respected medical journals, and today
s publication will likely aid Zesiewicz's efforts to win more funding for
further study.



But some aspects of the findings are bound to be disputed. Some researchers
question the accuracy of driving simulators, and suggest people drive better
on the road, when they know it counts.



Increasing restrictions on older drivers also has traditionally been met
with resistance in Florida, where little public transportation is available.



But Dr. Janan Smither, associate professor of psychology at the University
of Central Florida and head of the research subcommittee of the Florida
At-risk Driver Council, said focusing on specific diseases and driving,
rather than age, may ease the resistance.



In Florida, anyone can anonymously report an unfit driver to the Department
of Highway Safety and Motor Vehicles, and the state can require drivers to
submit a medical report or undergo an examination.



Otherwise, Floridians may renew their license three times -- up to 18 years
-- via phone, mail or the Internet, without passing so much as an eye exam.
Some states, such as Illinios, rrequire drivers over 70 or 75 to pass a road
test when they renew licenses, but most have few restrictions.



What's lacking, experts say, is a quick and reliable test that seniors can
take at a community center or doctor's office to see if they need additional
testing.







Disease stages







Progressive stages of Parkinson's disease, based on the Hoen and Yahr scale.
Drugs often help patients stay at Stage 2 or Stage 3. Few reach Stage 5.



Stage 1: Tremors or rigidity affecting one side of the body.



Stage 2: Tremors or rigidity affecting both sides of the body.



Stage 3: Stage 2, plus postural instability, or awkwardness of gait.



Stage 4: Stage 3, plus need for routine assistance.



Stage 5: Must use wheelchair.



----------------------------------------------------------------------

To sign-off Parkinsn send a message to: mailto:[log in to unmask]

In the body of the message put: signoff parkinsn

----------------------------------------------------------------------
To sign-off Parkinsn send a message to: mailto:[log in to unmask]
In the body of the message put: signoff parkinsn