Journal article
Objective Real-World Mobility Patterns in Parkinson’s Disease: Driving and Walking After Levodopa Dosing
Parkinsonism & related disorders, Vol.140, 108055
11/2025
DOI: 10.1016/j.parkreldis.2025.108055
PMID: 41014965
Abstract
Introduction
Levodopa is the primary treatment for motor symptoms in Parkinson's disease (PD), yet its real-world effects on activities of daily living (ADLs) across the day remain unclear. This study used continuous real-world monitoring to examine how levodopa dosing influences walking (basic ADL) and driving (instrumental ADL) in individuals with PD.
Methods
In a four-week observational study, 24 participants with early-stage PD underwent continuous monitoring of walking and driving using in-vehicle sensors, wrist-worn actigraphy, and medication logs. Activity was analyzed in 30-min intervals up to 4 h post-dose. Mixed-effects models assessed associations between time since last dose and activity, stratified by morning (wake to 1 p.m.) and afternoon (1 p.m. to bedtime), adjusting for age, sex, employment, motor severity, and levodopa equivalent daily dose (LEDD).
Results
Morning activity increased significantly post-medication, peaking at 120–150 min. Afternoon activity declined: driving likelihood decreased by 120 min, and walking declined by 180 min, reaching the lowest levels at 210–240 min. Higher motor symptom severity (MDS-UPDRS Part III) was associated with reduced walking but not driving.
Conclusion
Real-world mobility data reveal distinct time-of-day patterns in levodopa's effects. Morning doses yielded greater benefit, while afternoon effects diminished. Aligning medication timing with functional demands and integrating continuous monitoring may improve PD management.
Details
- Title: Subtitle
- Objective Real-World Mobility Patterns in Parkinson’s Disease: Driving and Walking After Levodopa Dosing
- Creators
- Jun Ha Chang - University of Nebraska Medical CenterErgun Y. Uc - University of IowaChristopher L. Shaffer - University of Nebraska Medical CenterMatthew Rizzo - University of Nebraska Medical Center
- Resource Type
- Journal article
- Publication Details
- Parkinsonism & related disorders, Vol.140, 108055
- DOI
- 10.1016/j.parkreldis.2025.108055
- PMID
- 41014965
- NLM abbreviation
- Parkinsonism Relat Disord
- ISSN
- 1353-8020
- eISSN
- 1873-5126
- Publisher
- ELSEVIER SCI LTD
- Language
- English
- Electronic publication date
- 09/21/2025
- Date published
- 11/2025
- Academic Unit
- Neurology
- Record Identifier
- 9984964810702771
Metrics
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