Neurology Department, Hospital General Yague, Burgos, Spain.
Disabil Rehabil. 2010;32(5):374-8. doi: 10.3109/09638280903168507.
To determine the most significant clinical predictors that influence driving ability in Parkinson disease (PD).
National-multi-centre, cross-sectional study covering PD outpatients. Clinical assessment was based on the following questionnaires: cognition (SCOPA-Cog); motor impairment and disabilities (SCOPA motor); depression/anxiety; sleep (SCOPA-Sleep); psychosis and severity/global impairment (HY and CISI-PD). Driving status data was obtained using a standardized questionnaire. Comparisons between drivers and ex-drivers were calculated using chi(2) and Student t-tests as appropriate. Multi-variate logistic regression analysis was performed to identify independent driving ability clinical predictors.
Compared with the drivers, the ex-drivers were older (p = 0.00005), had longer disease duration (p = 0.03), had more overall cognitive dysfunction (p = 0.004) and had greater motor impairment, as measured by the CISI (p = 0.02), HY stage (p = 0.034) and by the SCOPA-motor scale (p = 0.002) and difficulty in activities of daily life (p = 0.002). In the regression model analysis, aging and ADL impairment were the principal clinical predictors that differentiated drivers from ex-drivers.
Although overall driving impairment in PD is associated with advancing disease severity, driving ability seems to be more strongly influenced by age and ADL impairment. Multi-disciplinary teams are required to assess driving ability in patients with PD and develop rehabilitation measures for safer driving.
确定影响帕金森病（PD）患者驾驶能力的最重要的临床预测因素。
这是一项全国多中心、横断面研究，涵盖了 PD 门诊患者。临床评估基于以下问卷：认知功能（SCOPA-Cog）；运动障碍和残疾（SCOPA 运动）；抑郁/焦虑；睡眠（SCOPA-Sleep）；精神病和严重程度/整体损害（HY 和 CISI-PD）。驾驶状态数据通过标准化问卷获得。使用卡方检验（chi(2)）和学生 t 检验（Student t-tests）比较驾驶员和非驾驶员。采用多变量逻辑回归分析确定独立的驾驶能力临床预测因素。
与驾驶员相比，非驾驶员年龄更大（p = 0.00005），疾病持续时间更长（p = 0.03），整体认知功能障碍更严重（p = 0.004），运动障碍更严重，如 CISI（p = 0.02）、HY 分期（p = 0.034）和 SCOPA 运动量表（p = 0.002）以及日常生活活动困难（p = 0.002）。在回归模型分析中，年龄和日常生活活动能力损害是区分驾驶员和非驾驶员的主要临床预测因素。
尽管 PD 患者的整体驾驶障碍与疾病严重程度的进展有关，但驾驶能力似乎更多地受到年龄和日常生活活动能力损害的影响。需要多学科团队来评估 PD 患者的驾驶能力，并制定更安全的驾驶康复措施。
