Driving under low-contrast visibility conditions in Parkinson disease.

Full Abstract

OBJECTIVE: To assess driving performance in Parkinson disease (PD) under low-contrast visibility conditions. METHODS: Licensed, active drivers with mild to moderate PD (n = 67, aged 66.2 +/- 9.0 years, median Hoehn-Yahr stage = 2) and controls (n = 51, aged 64.0 +/- 7.2 years) drove in a driving simulator under high- (clear sky) and low-contrast visibility (fog) conditions, leading up to an intersection where an incurring vehicle posed a crash risk in fog. RESULTS: Drivers with PD had higher SD of lateral position (SDLP) and lane violation counts (LVC) than controls during fog (p < 0.001). Transition from high- to low-contrast visibility condition increased SDLP and LVC more in PD than in controls (p < 0.01). A larger proportion of drivers with PD crashed at the intersection in fog (76.1% vs 37.3%, p < 0.0001). The time to first reaction in response to incursion was longer in drivers with PD compared with controls (median 2.5 vs 2.0 seconds, p < 0.0001). Within the PD group, the strongest predictors of poor driving outcomes under low-contrast visibility conditions were worse scores on measures of visual processing speed and attention, motion perception, contrast sensitivity, visuospatial construction, motor speed, and activities of daily living score. CONCLUSIONS: During driving simulation under low-contrast visibility conditions, drivers with Parkinson disease (PD) had poorer vehicle control and were at higher risk for crashes, which were primarily predicted by decreased visual perception and cognition; motor dysfunction also contributed. Our results suggest that drivers with PD may be at risk for unsafe driving in low-contrast visibility conditions such as during fog or twilight.

Author information

Author/s: Uc, E Y (EY); Rizzo, M (M); Anderson, S W (SW); Dastrup, E (E); Sparks, J D (JD); Dawson, J D (JD);

Affiliation: Department of Neurology, University of Iowa, Carver College of Medicine, 200 Hawkins Dr., 2RCP, Iowa City, IA 52242, USA. ergun-uc(-atsign-)uiowa.edu

Grants: R01 AG 15071 (Agency:NIA NIH HHS) ; R01 AG 17717 (Agency:NIA NIH HHS) ; R01 NS044930 (Agency:NINDS NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: Neurology (Neurology), published in United States. (Language: eng)

Reference: 2009-Oct; vol 73 (issue 14) : pp 1103-10

Dates: Created 2009/10/06; Completed 2009/10/30;

PMID: 19805726, status: MEDLINE (last retrieval date: 10/30/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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