Are interventions effective at improving skills in older drivers?

Author(s): Martin Lavallière, Alexander Crizzle

Slidedeck Presentation Only (no paper submitted):

4A - Lavalliere


Background: With the aging population, the number of older drivers are rapidly increasing. This poses significant challenges for public health initiatives as older drivers have a higher risk for crashes (when taking exposure into account). While many studies focus on developing screening tools to identify medically at-risk drivers, little research has been done in developing training programs or interventions to promote, maintain or enhance driving related abilities. As driving cessation has been linked to negative outcomes (i.e. social isolation, depression), interventions/programs that can prolong the skills needs to drive safely is important given the older driver demographic.

Aim: The study purposes were to conduct a systematic review to synopsize the literature on programs or interventions in older drivers, to identify gaps and provide recommendations for future research.

Methods: Relevant databases such as MEDLINE/PUDMED, CINAHL, PsychInfo, Ageline and Scopus were searched for primary articles published in between January, 1995 and August, 2014. Articles were identified using MeSH search terms (in English only): older drivers, self-evaluation, driving courses, interventions, driver improvement, skills training, speed of processing training and cognitive training. All retrieved abstracts were reviewed, and full-texts printed if deemed relevant. Articles were also searched via footnote chasing (secondary sourcing). The ‘‘gray literature’’ (technical and internal reports, non-peer-reviewed journals) was also evaluated when mentioned in peer-reviewed journals. Two independent reviewers extracted data from each article, with any differences resolved by collaborative review.

Results: Articles were classified according to: 1) Classroom settings; 2) Computer based training for cognitive or visual processing; 3) Physical training; 4) In-simulator training; and 5) On-road training. A comparative examination will allow the identification of what might benefit or not the appropriation of good driving skills (i.e. car handling and maneuvers) and behaviours (i.e. respect of traffic regulations and other road users) at short and long term. Results show that different types of approaches have been successful at improving specific driving skills and / or behaviours. However, there are clear discrepancies in how driving performance/behaviours are evaluated between studies and therefore make direct comparisons between these studies difficult.

This review highlighted potential interventions that can be used to maintain or improve driving performance in older drivers. Future studies need to further test these interventions and determine if any are effective at improving driving performance.