Parkinson disease and driving
DOI: 10.1212/wnl.0b013e3182749e95
archive: archived pipeline: cataloged verified
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Summary
This evidence-based review addresses the lack of standardized clinical guidelines for determining driving fitness in patients with Parkinson disease (PD). Because PD involves complex motor, cognitive, and visual impairments that may not correlate with standard disease severity scales, clinicians often rely on subjective judgments, which can lead to overestimation of patient safety. The authors aimed to synthesize existing literature to identify specific predictors of driving performance and establish evidence-based recommendations for clinical practice. The researchers conducted a systematic search of medical and scientific databases for primary studies published between 1995 and 2011 examining driving performance in PD. They identified 25 eligible studies, comprising 16 on-road tests and 9 simulator studies. Using American Academy of Neurology criteria, the authors assigned levels of evidence (Class I–IV) and recommendations (Level A–U) to various clinical measures. The review focused on predictors such as motor scores, cognitive tests, and visual assessments, noting that most included studies involved patients with mild to moderate disease severity. The analysis revealed that drivers with PD generally performed worse than healthy controls on on-road tests. For on-road driving, Level B recommendations (probably predictive) were assigned to the Useful Field of View (UFOV) test, contrast sensitivity, Trails B, Rey-Osterrieth Complex Figure Test, functional reach, and UPDRS motor scores during the "off" medication period. Conversely, UPDRS motor scores during the "on" period, Hoehn & Yahr stages, disease duration, and the Mini-Mental State Examination (MMSE) were deemed probably not predictive. Simulator studies yielded Level C recommendations (possibly predictive) for MMSE and contrast sensitivity, while other measures lacked sufficient data for definitive conclusions. The study concludes that no single clinical battery currently provides definitive (Level A) evidence for predicting driving fitness in PD. Motor severity scales alone are insufficient predictors because they fail to capture critical visual and cognitive deficits. The authors recommend that clinicians utilize a multidisciplinary evaluation involving neurologists, neuropsychologists, and certified driving rehabilitation specialists. They emphasize the urgent need for large-scale Class I studies to establish standardized screening tools and specific cutoff points for risk assessment, which are necessary for developing robust, evidence-based policy guidelines.
Provenance
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | OpenAlex-citations | — | — | 1 | 2026-06-25 |
| archive | success | semantic_scholar | — | — | 6 | 2026-06-26 |
| extract | success | cached | — | — | 2 | 2026-06-26 |
| clean | success | clean | — | — | 1 | 2026-06-25 |
| chunk | success | chunk | — | — | 1 | 2026-06-25 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-25 |
| promote | success | — | — | — | 1 | 2026-06-25 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 1 | 2026-06-26 |
| tag | success | vector_similarity | — | — | 6 | 2026-06-25 |
| verify | success | — | — | — | 1 | 2026-06-26 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.
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