Motor vehicle accidents in Parkinson's disease: A questionnaire study

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Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms (rest tremor, bradykinesia, rigidity, and loss of post‐ural reflexes) and non‐motor symptoms (autonomic dysfunction, cognitive/neurobehavioral abnormalities, sleep disorders, and sensory abnormalities),1 affecting health‐related quality of life.2 Patients with PD can experience difficulties in driving a vehicle because both motor and non‐motor symptoms negatively impact driving performance.3 Sleepiness during driving is a risk for motor vehicle accidents (MVA) worldwide.18 Sleep difficulties are frequent in PD, and patients with PD often develop excessive daytime sleepiness (EDS).21 Because PD is a progressive neurodegenerative disorder,1 it is clinically important to be aware that the driving performance of patients with PD becomes increasingly unsafe as the disease progresses. Unfortunately, it is not possible to determine whether patients with PD can drive safely based solely on self‐assessment reports.4 Furthermore, neurological evaluations do not provide reliable assessments of the driving ability of patients with PD.4 Therefore, clinicians should decide whether patients with PD can safely drive based on other available clinical information.
Motor, cognitive, and visual deficits, in addition to daytime sleepiness, may affect the ability of patients with PD to safely drive a motor vehicle.4 However, few studies have investigated the frequency of motor vehicle accidents (MVAs) in patients with PD.10 Moreover, there is little evidence documenting and comparing risk factors associated with sleep‐related and non‐sleep‐related MVAs in PD. To address this critical knowledge gap, we had Japanese PD patients fill out detailed questionnaires to identify potential risk factors and other variables associated with both types of MVAs.
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