Parkinson’s Disease: When Is Driving No Longer Safe?
Parkinson’s – The Disease
The Parkinson’s Disease Foundation reports that as many as one million Americans live with Parkinson’s disease. Rooted deep within the brain, the disease is a movement disorder that is both chronic and progressive, meaning that the symptoms are likely to continue and will probably worsen over time. Although there is no known cure for the disease, medicine and treatment options can make the disorder more manageable.
This mysterious disease, whose cause is still unknown, was discovered in 1817 by British physician James Parkinson. Only about 4% of Americans diagnosed with Parkinson’s disease are diagnosed before the age of 50, the remaining 96% are diagnosed in their later years.
As with so many other neurological disorders, the physical symptoms associated with Parkinson’s disease vary from person to person, but typically include tremors, slowness of movements, limb and muscle stiffness, problems with standing and coordination, impaired balance, and an overall decline in motor skills. Cognitive symptoms of the disease may include an erosion of thinking and/or language, as well as visuospatial and problem-solving skills.
To complicate matters, anxiety and depression have proven to be common occurrences for those afflicted with Parkinson’s, as the world observed first-hand with the tragic and untimely passing of actor Robin Williams. Seventy-five percent of patients with the disease are likely to experience cognitive impairment and up to 40% will develop some form of dementia.
Parkinson’s medications have a well-documented history of producing side effects such as sleepiness, dizziness, blurred vision and confusion.
Levodopa is a common drug used for the treatment of Parkinson’s disease symptoms. It is most effective for those patients experiencing rigidity and difficulties moving all or part of their body (akinesia). Common side effects of levodopa include sleepiness, dizziness, confusion, agitation, which over time may advance to hallucinations, delusions and even psychosis. Long term use of levodopa is also associated with motor fluctuations and dyskinesias (abnormal, involuntary movements that cause rapid jerking or slow and extended muscle spasms).
Anticholinergics, also used to treat the symptoms of Parkinson’s, are a class of drugs that block the action of the neurotransmitter acetylcholine in the brain, and help slow involuntary movements of the muscles. Unfortunately, they are also known to cause confusion, sedation and memory impairment.
A Short Story
Intrigued by the mysteriousness of the disease, and wanting to learn more about the impact it has on its victim’s driving abilities, I have had the good fortune to attend several Parkinson’s support group meetings. One particular, well-attended meeting was led by a local physician who was discussing the merits of deep-brain stimulation surgery and how it can, in some cases, be used to drastically reduce the symptoms associated with the disease.
Near the end of the doctor’s presentation, an older gentleman in the back of the room stood up and asked “The other night I was driving home and I saw a car coming towards me. As it got closer, the two oncoming headlights morphed into three headlights. It scared me but somehow I made it past the oncoming car safely. If that happens again, what should I do…just aim for the middle headlight?” The gentleman, a retired farmer, was very serious with his question and displayed not a hint of humor. Rather, his face exhibited concern and fear.
Being uneducated on the issue of the side effects of Parkinson’s medications, I was startled by the seriousness of the farmer’s question. I was equally surprised to see that the audience saw the merit in the question and that they were very interested to hear the physician’s advice on how to handle similar situations. It was as if everyone in the room had experienced this or a very similar situation in the past.
The Driving Issue
One can easily imagine the adverse effects these symptoms, and the medications designed to ease them, can have on an individual’s ability to safely operate a motor vehicle. It is very important that the person afflicted with Parkinson’s disease remain responsible about his or her actions, and must never forget the potential dangers the disease presents to driving. Not giving ample attention to the effects of the disease and its medications will create an even more dangerous driving environment for those afflicted. As the disease continues to progress, it will eventually affect reaction time, vision, judgement and one’s ability to handle the multiple tasks required for safe driving. When the physical and cognitive symptoms of Parkinson’s disease begin to erode the individual’s ability to safely operate a motor vehicle, steps should be taken to retire from what was probably a long and successful driving career. Remember that the disease is progressive and that even though the individual may be safe to drive today, their safe driving status is likely to decline over time.
Fortunately, much is being done to help find both the cause and a cure for this debilitating disease. Earlier this year the National Institute of Neurological Disorders and Stroke held a conference in Bethesda, Maryland, titled “Parkinson’s Disease 2014: Advancing Research, Improving Lives,” in which they brought together leading neuroscience researchers, physicians, patients and caregivers to set aggressive priorities for Parkinson’s disease research.
The United Kingdom’s University of Nottingham is currently doing work that will lead to more effective brain scans for Parkinson’s patients. In March, Rutgers University received a 3.4 million dollar grant from the National Institutes of Health to convene a study to further explore the brain for keys to solving Parkinson’s disease.
Author: Matt Gurwell is a speaker, author, and expert on the issue of older drivers and drivers with certain disabilities. He is also the founder of Keeping Us Safe, a national organization with a mission to provide assistance to older drivers and their families as they face the challenging issue of diminished driving skills. Visit the Keeping Us Safe website at www.keepingussafe.org for more information on their services.