As a result of certain diseases, motor, sensory and/ or cognitive impairment can occur, which can have a negative effect on driving a vehicle. Despite intensive research efforts, the complex relationships between cognitive impairments and driving skills are not yet fully understood. The primary objective of this report was to contribute to a better understanding of disease-related impairments of driving skills through the presentation and analysis of current and central scientific findings. Therefore, the influence of six neurological and neurodegenerative diseases on driving behaviour was described and analyzed. The diseases were selected on the basis of their comparatively high prevalence and the neurological and neuropsychological symptoms that typically occur among them, which are of particular significance for answering the central questions of this report. The relevance of the diseases regarding activities to improve road safety was derived from the combination of selected parameters. These findings provide important indications which diseases should be addressed more intensively in the future, for example within the framework of communicative measures or in research. In order to present a complete picture of the current state of research, studies with methodological limitations (e.g. small sample) were also taken into account in the evaluation of the diseases. This procedure should also make it possible to identify and analyse (systematic) weaknesses in this field of research. Based on the available data, dementia, traumatic brain injuries (TBI) and hepatic encephalopathy are highly relevant for road safety. The relevance of Parkinson‘s disease for road safety is somewhat lower, but still high. Based on the available data, the relevance of strokes for road safety is most likely to be moderate, while that of mild cognitive impairment (MCI) is most likely to be low. These conclusions refer to a theoretical risk at a group level derived from literature. This risk is not suitable for drawing conclusions related to fitness to drive. Derivations on the individual risk of an ill driver are inadmissible. The reviewed literature gave insights into correlations between cognitive performance and driving competence. Besides several forms of attention and visual spatial performance, executive functions seem to be of particular relevance for coping with the driving task. There are indications that individual training to improve cognitive performance and practical driving training can contribute to a sustainable improvement in road safety. Overall, it is important to sensitize people which suffer from one of the diseases, those who are treating them and those who are involved in road safety activities to the relevance of certain diseases in this context. With regard to future activities and due to the limitations of the current research, it is recommended to develop a theoretically and/or empirically guideline for the implementation of driving competence studies with patients. Future research priorities could be cognitive requirements of specific driving tasks, in-depth analyses of the correlations between diseases and driving skills as well as the development of valid measurement and test procedures. In the medium to long term, the presented measures should make it possible to reduce disease-related risks in road traffic and to identify new ways of maintaining the mobility of sick drivers. (Author/publisher)
Abstract