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By Anne Harding
NEW YORK (Reuters Health) - People with Parkinson's disease have difficulty 
spotting traffic signs and roadside landmarks while driving, and are more 
likely to make safety errors on the road, a new study shows.
These difficulties are related to the cognitive and visual effects of 
Parkinson's rather than better-known motor symptoms such as tremor, 
investigators say.
People with Parkinson's often continue to drive, and some continue to drive 
well and safely, but there is currently no reliable way to test which ones 
will fare better behind the wheel, Dr. Ergun Uc of the University of Iowa in 
Iowa City noted in an interview with Reuters Health. He is leading a 
five-year, National Institutes of Health-funded study of Parkinson's patients 
with the goal of developing a system to predict their driving abilities. 

In the current investigation, which is part of the larger study, Uc and his 
colleagues had 79 drivers with Parkinson's disease and 151 healthy older 
people complete a battery of tests to measure their visual, cognitive and 
motor abilities.
Study participants then completed a 16.7-mile course in a Ford station wagon 
equipped with a variety of sensors and cameras. They were asked to look for 
and report the presence of traffic signs and restaurants about a minute 
before these landmarks appeared. They were also monitored for unsafe driving 
behaviors such as moving into another lane or onto the road shoulder or 
slowing or stopping inappropriately.
On average, the Parkinson's patients fared significantly worse on the road 
tests than the control group, the authors report in the Annals of Neurology.
For example, they made .64 safety errors per mile, which jumped to nearly two 
such errors per mile when they were asked to identify landmarks as they 
drove.
The control group averaged 0.15 errors per mile while driving, and 0.45 errors 
per mile while looking for landmarks.   
Parkinson's patients were able to identify 47.8 percent of the landmarks and 
traffic signs, compared to 58.7 percent for the control subjects. Seventeen 
percent of the Parkinson's patients made no safety errors at all, however.
Uc also noted "the cognitive and visual tests are more predictive of driving 
errors and driving performance than the motor function."
The findings clearly show that people with Parkinson's drive less safely than 
their age-matched peers without the disease, and that vision tests are not 
enough to gauge their driving ability, Dr. Nancy J. Newman of the Emory 
University School of Medicine in Atlanta notes in an editorial accompanying 
the study.
"The question remains whether early identification and application of 
rehabilitation targeted to those aspects of driving most troublesome for this 
group of patients would improve their driving performance and prolong their 
independence, without risking their safety and the safety of others," she 
writes. 
REUTERS PICTURES

SOURCE: Annals of Neurology, October 2006.

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