Driving training may decrease car crashes and enhance driving skills in older adults 

Ishii H, Okubo Y, Doi T, et al. Effect of driving training on car crashes and driving skills in older people: A systematic review and meta-analysis Geriatr Gerontol Int. 2023; 11: 771-778.

Review question

Is driving training effective in decreasing car crashes and improving driving skills in older adults? What is the best kind of driving training program for skill improvement?

Background

In 2050, an estimated 1.5 billion people across the globe will be 65 years old or over. Driving a car is an important method of transportation, helping older adults preserve their mobility. But compared to younger drivers, older drivers are responsible for more car accidents that result in death. Previous research has shown that driving-related strategies may hold promises for reducing car accidents in older adults, however a more comprehensive look at the evidence is needed.         

How the review was done

This is a systematic review and meta-analysis of 11 randomized controlled trials. These studies were published between 2008 and 2020 and included a total of 1480 participants.

Key features of the studies:

• Participants were older adults between the ages of 65 and 93 who lived in the community and were current drivers. The vast majority were cognitively healthy.
• Participants either received on-road training plus education or off-road training consisting of one or more of the following elements: cognitive training, video training, and use of a driving simulator with or without Advanced Driver Assistance Systems that inform drivers about traffic at intersections and whether it is safe to cross.
• Driving training programs ranged from 1-10 weeks in length, the number of training sessions ranged from 1 to 20, and the total time spent on training (aka dose) ranged from 40 minutes to about 18 hours.
• Researchers measured self or state-reported car crashes and on-road and off-road driving skills.
• Participants receiving driving training were compared to control groups not engaging in any strategy, just receiving education, waiting to participate in driving training at a later time, or also engaging in driving training but with slight differences.       

What the researchers found

The review found that driving training may decrease car crashes and enhance driving skills in older adults aged 65 years old and over. However, the result related to car crashes was based on just two studies and therefore should be interpreted carefully. For driving skill improvement, it appears that on-road training may be superior to off-road training. Additionally, training programs lasting 3 weeks or more with a total training time/dose of 3 hours or more spread over 3 or more training sessions may be effective.     

Conclusion

In older adults aged 65 and over, driving training may have the potential to reduce car crashes and improve driving skills. Effective program characteristics linked to better driving skills include on-road training and medium to long or high program lengths, session numbers, and total session dose/time.