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[Influence of neurological diseases on mobility and ability to drive]
Günther Thayssen1, Klaus Püschel2
1Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland. gth@uke.de.
Abstract:
Neurology deals with organic diseases of the muscles, the peripheral nerves of the trunk and extremities, and the central nervous system (spinal cord, brain, stem, cerebellum, and cerebrum). Diseases that lead to dysfunction of these structures can cause both physical and cognitive problems. Therefore, neurological diseases can particularly impair personal mobility through both physical limitations and cognitive deficits. Many of the diseases show a significant increase in frequency with age.Physical impairments in mobility primarily manifest as gait disorders. These are found to a relevant extent in two-thirds of people older than 80 years of age and are a common cause of falls, often with considerable sequelae. Driving a car can have negative effects, for example, on reaction speed, braking power, and looking over the shoulder. Parkinson's disease as well as paralysis and sensory disorders in the context of polyneuropathies can be responsible for this.Driving a car is an obvious compensatory mechanism with respect to impaired walking ability. However, the cause of many diseases that affect the fitness to walk lies in the central nervous system, often in the area of the cerebrum. Consequently, cognitive deficits manifest themselves in addition to physical ones, which further restrict mobility through the loss of the fitness to drive. Neurological diseases typical of old age that limit mobility in this way include Parkinson's disease and circulatory disorders of the brain. In addition, epileptic seizures occur more frequently in old age as a symptom of other diseases.
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