Self-regulation of driving behavior in people with Parkinson disease

Objective: To determine the extent and nature of driving selfregulation in drivers with Parkinson disease (PD) and factors associated with self-regulatory practices. Background: Although people with PD have consistently been shown to have driving impairments, few studies have examined self-regulatory driving practices and their relationship to driving performance. Methods: We used a self-report driving questionnaire to examine driving self-regulation in 37 drivers with PD and 37 healthy agematched controls. We also analyzed factors associated with selfregulatory practices, primarily demographic, disease-related, psychological, and simulated driving performance variables. Results: The drivers with PD reported significantly higher rates of self- perceived decline in their driving ability (P = 0.008) and driving significantly shorter distances per week (P = 0.004) than controls. Unfamiliar situations (P = 0.009), in-car distractions (P <0.001), low visibility conditions (P = 0.004), and long journeys (P = 0.003) were particularly challenging for the drivers with PD, and their pattern of driving avoidance mirrored these difficulties. The use of self-regulatory strategies among drivers with PD was associated with female sex (rho = 0.42, P = 0.009) and perceived decline in driving ability (rho = 0.55, P <0.001), but not with age or objective measures of disease severity, cognition, or simulated driving performance. Conclusions: Drivers with PD reported driving less overall and restricting their driving to avoid particularly difficult circumstances. Further research is warranted on effective use of self-regulation strategies to improve driving performance in people with PD.