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Monday March 30, 1998 Parkinson's Disease Affects Driving NEW YORK (Reuters) -- People with even mild Parkinson's disease can have greatly diminished driving skills, a decline which may not be apparent to their physicians or to the individuals themselves, say Finnish researchers. A team led by Dr. Veli-Matti Heikkila, of the Merikoski Research and Rehabilitation Centre, in Oulu, Finland, found that it is difficult to evaluate patients' driving ability without psychological testing in combination with a driving test. Parkinson's disease progressively weakens patients' motor skills and can also impair thought processes. Patients often have trouble focusing their attention and may have slower reaction times. The researchers compared the driving, cognitive (brain function) and psychomotor skills of 20 men with mild to moderate Parkinson's disease with those of healthy men of the same age. All of the men were tested by a neurologist, a psychologist, a vocational rehabilitation counselor, and a driving instructor. The study subjects were also asked to rate their own driving ability. The men with Parkinson's disease did worse than the healthy men on all of the laboratory and driving tests, especially in regard to visual short-term memory, decision-making time, and information processing. They had difficulty making left turns and driving in city traffic, and they committed more "risky faults and offenses" on the 45-minute driving test. The neurologist's assessments of patients' driving ability were "much more optimistic" than those of the psychologist and the driving instructor and tended to overestimate patients' skills. "Our joint opinion is that we should place more trust on the driving instructor's and the psychologist's results, as their estimates are directly based on traffic specific information," the researchers write. The patients who were ranked by the driving instructor as unable to drive safely described their own skills as "satisfactory or even good," the investigators note. To evaluate driving safety for a person with Parkinson's, tests should examine the individual's "(1) vigilance and concentration, (2) visual perception, (3) choice reaction times, (4) information processing in a complex situation," they conclude. The study results are published in the current issue of the Journal of Neurology and Neurosurgical Psychiatry. SOURCE: Journal of Neurology and Neurosurgical Psychiatry (1998;64:325-330)