Digital driving data can track driving exposure and quality of life in Parkinson’s disease

Abstract

Objective

Parkinson’s disease (PD) impairs motor and non-motor functions. Driver strategies to compensate for impairments, like avoiding driving in risky environments, may reduce on-road risk at the cost of decreasing driver mobility, independence, and quality of life (QoL). It is unclear how PD symptoms link to driving risk exposure, strategies, and QoL. We assessed associations between PD symptoms and driving exposure (1) overall, (2) in risky driving environments, and (3) in relationship to QoL.

Methods

Twenty-eight drivers with idiopathic PD were assessed using the Movement Disorders Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and RAND 36-Item Short Form Health Survey (SF-36). Real-world driving was monitored for 1 month. Overall driving exposure (miles driven) and risky driving exposure (miles driven in higher risk driving environments) were assessed across PD symptom severity. High traffic, night, and interstate roads were considered risky environments.

Results

18,642 miles (30,001 km) driven were collected. Drivers with PD with worse motor symptoms (MDS-UPDRS Part III) drove more overall (b = 0.17, P < .001) but less in risky environments (night: b = −0.35, P < .001; interstate roads: b = −0.23, P < .001; high traffic: b = −0.14, P < .001). Worse non-motor daily activities symptoms (MDS-UPDRS Part I) did not affect overall driving exposure (b = −0.05, P = .43) but did affect risky driving exposure. Worse non-motor daily activities increased risk exposure to interstate (b = 0.36, P < .001) and high traffic (b = 0.09, P = .03) roads while reducing nighttime risk exposure (b = −0.15, P = .01). Daily activity impacts from motor symptoms (MDS-UPDRS Part II) did not affect distance driven. Reduced driving exposure (number of drives per day) was associated with worse physical health–related QoL (b = 2.87, P = .04).

Conclusions

Results provide pilot data revealing specific PD symptom impacts on driving risk exposure and QoL. Drivers with worse non-motor impairments may have greater risk exposure. In contrast, drivers with worse motor impairments may have reduced driver risk exposure. Reduced driving exposure may worsen physical health–related QoL. Results show promise for using driving to inform clinical care.

Keywords:

• Parkinson’s disease
• real-world driving
• MDS-UPDRS
• digital biomarker
• driving restriction
• road safety

Acknowledgements

We thank our research and clinical team for coordinating this project. We thank Robin Taylor for editorial assistance.

Disclosure statement

The authors have no conflicts of interest to report.

Data availability

Data are not available to protect the privacy of the research participants.

Additional information

Funding

The study was funded by the Mind & Brain Health Lab and Department of Neurological Sciences at the University of Nebraska Medical Center Foundation (Skate-A-Thon for Parkinson’s).