Fig. 2

The diagram illustrating the role of physician in the determination of fitness to drive in patients with Parkinson’s disease (PD). In PD drivers who are deemed to be fit to drive, they can continue driving with an unconditional license. In cases where PD drivers were identified from ‘clinical red flags’ to be unsafe, they should undergo an off-road test which is composed of three major components to determine an individually driving ability, including motor, cognitive, and visual assessments. Some of these assessments (e.g., HY, MMSE) are part of standard clinical examination which can be performed by treating physicians during routine consultations. However, others (e.g., UFoV test, Pelli-Robson contrast sensitivity) may not be available locally and require additional referral. For PD drivers who passes an off-road test, they can continue driving as usual, but with a recommendation of annual evaluation. For PD driver who fails an off-road test, a physician might request for further evaluation for fitness to drive by using an on-road test, driving simulator, or naturalistic driving depending on patient’s conditions, availability, local guidelines, and regulations. HY: Hoehn & Yahr; MMSE: Mini-Mental Status Examination; UFoV: Useful Field of View