Giménez-Roldán S, Mateo D, Dobato J L
Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Rev Neurol. 1997 Sep;25(145):1337-42.
The legal requirement to renew a driving licence is feared by most symptomatic or already formally diagnosed individuals with Parkinson's disease (PD) as the medical assessment they are required to submit may eventually conclude in withdrawal of their driving licence.
The purpose of our study was to gain information about PD patients applying for a driving licence renovation and their willingness to uncover his or her illness to medical personnel in charge, and how often current medical assessment procedures proved unable to detect abnormalities among parkinsonian applicants who retain data on their health status. Using a confidential, 'face-to-face' questionnaire, we obtained information from 62 licensed parkinsonian drivers (32 current drivers) and 120 age and sex matched drivers controls gathered from an identical socioeconomic background.
Thirty eight individuals with symptomatic PD (in 30 of who the disorder has been already diagnosed) applied with a view to licence renovation. Drivers with PD did not retain information regarding their health status more often than sex- and age-matched control drivers with various other chronic ailments as 63.1% and 77% respectively, abstained from declaring (z = 0.945; p = 0.344). A parkinsonian subject illegally managed to renew his driving licence without submission to any medical assessment. The attending physicians perceived abnormalities related to motor difficulties in 30.4% of those parkinsonian who withdrew information. A similar proportion of controls (29.1%) were also informed about health problems during their medical assessment, in the vast majority related to sight problems.
Overall, the exam concluded in cancellation of the driving licence in 10.8% of the parkinsonian and 1.6% of the controls, a significant difference (z = 2.075; p = 0.03). We conclude that at the time of renewal of a driving licence parkinsonian patients do not retain problems related to fitness to drive more often than the general population afflicted by other medical conditions do. However, current tests for driving performance appears to be not sensitive enough to detect selective difficulties in motor execution tasks that may impair driving ability in persons with PD.
大多数有症状或已被正式诊断为帕金森病(PD)的患者担心更新驾照的法律要求,因为他们需要提交的医学评估最终可能导致驾照被吊销。
我们研究的目的是获取有关申请驾照更新的PD患者的信息,以及他们向负责的医务人员透露病情的意愿,以及当前的医学评估程序在保留健康状况数据的帕金森病申请人中无法检测到异常的频率。我们使用一份保密的“面对面”问卷,从62名有驾照的帕金森病司机(32名现任司机)以及120名年龄和性别匹配、来自相同社会经济背景的司机对照组中获取信息。
38名有症状的PD患者(其中30名已被诊断出患有该疾病)申请更新驾照。与患有其他各种慢性疾病、年龄和性别匹配的对照司机相比,PD司机没有更频繁地保留其健康状况信息,分别有63.1%和77%的人未声明(z = 0.945;p = 0.344)。一名帕金森病患者在未提交任何医学评估的情况下非法成功更新了他的驾照。主治医生在30.4%的隐瞒信息的帕金森病患者中察觉到与运动困难相关的异常。在对照组中,类似比例(29.1%)的人在医学评估期间也被告知健康问题,绝大多数与视力问题有关。
总体而言,检查导致10.8%的帕金森病患者和1.6%的对照组被吊销驾照,存在显著差异(z = 2.075;p = 0.03)。我们得出结论,在更新驾照时,帕金森病患者与患有其他疾病的普通人群相比,没有更频繁地保留与驾驶适宜性相关的问题。然而,目前的驾驶性能测试似乎不够敏感,无法检测到可能损害PD患者驾驶能力的运动执行任务中的选择性困难。