School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada,
J Neurol. 2013 Oct;260(10):2562-8. doi: 10.1007/s00415-013-7017-9. Epub 2013 Jul 3.
This study examined whether symptoms (motor, cognitive, vision, sleepiness, depression) of Parkinson's disease (PD) were associated with restricted driving practices. To quantify driving practices, electronic devices were installed in the vehicles of 27 drivers with PD (78 % men; M = 71.6, SD = 6.6; Unified Parkinson's Disease Rating Scale (UPDRS) motor score M = 30.1, SD = 8.6; disease duration M = 3.9, SD = 2.8 years) and 20 controls (80 % men; M = 70.6, SD = 7.9) for 2 weeks. Participants completed measures of sleepiness, depression, quality of life, and assessments of motor, cognitive and visual functions. The PD group had significantly slower brake response times (p < 0.05), poorer cognitive and quality of life scores (p < 0.01) and greater depression (p < 0.05) compared to controls. Slower reaction time was significantly related to reduced driving; specifically, fewer trips (r = -0.46; p < 0.05), distance (r = -0.54, p < 0.01) and duration at night (r = -0.58, p < 0.01). Better cognitive scores were associated with driving less often in difficult situations such as bad weather and rush hour (p < 0.05), as well as reduced speed on city streets, but only for the control group. While most drivers with PD rated their overall health as good or excellent, the five PD drivers who rated their health more poorly had significantly worse clinical symptoms (UPDRS motor scores, contrast sensitivity, depression, brake response time) and more restricted driving patterns. These findings show that drivers with PD who perceive their health poorly have greater symptomatology and were more likely to restrict their driving, possibly due to noticeable declines in multiple driving-related abilities.
这项研究考察了帕金森病(PD)的症状(运动、认知、视力、嗜睡、抑郁)是否与受限的驾驶行为有关。为了量化驾驶行为,在 27 名 PD 驾驶员(78%为男性;M=71.6,SD=6.6;统一帕金森病评定量表(UPDRS)运动评分 M=30.1,SD=8.6;疾病持续时间 M=3.9,SD=2.8 年)和 20 名对照者(80%为男性;M=70.6,SD=7.9)的车辆中安装了电子设备,为期 2 周。参与者完成了嗜睡、抑郁、生活质量以及运动、认知和视觉功能评估的测量。PD 组的制动反应时间明显较慢(p<0.05),认知和生活质量评分较差(p<0.01),抑郁程度较高(p<0.05)。与对照组相比,反应时间较慢与驾驶减少显著相关;具体而言,减少出行次数(r=-0.46;p<0.05)、行驶距离(r=-0.54,p<0.01)和夜间行驶时间(r=-0.58,p<0.01)。认知能力较好与在恶劣天气和高峰时段等困难情况下较少开车(p<0.05)以及在城市街道上降低速度有关,但仅限于对照组。尽管大多数 PD 驾驶员将其整体健康状况评为良好或优秀,但五名将其健康状况评为较差的 PD 驾驶员的临床症状(UPDRS 运动评分、对比敏感度、抑郁、制动反应时间)明显更差,且驾驶模式受限更多。这些发现表明,自我健康评估较差的 PD 驾驶员的症状更严重,更有可能限制驾驶,这可能是由于与驾驶相关的多种能力明显下降所致。