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A Randomized Trial of an Education Program to Enhance Older Driver Performance

Departments of ¹ Internal Medicine and ⁵ Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut.
² Geriatrics and Extended Care Section, ³ Cooperative Studies Program Clinical Epidemiology Research Center, and ⁴ Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, Connecticut.

Address correspondence to Richard A. Marottoli, MD, MPH, Yale University School of Medicine, Section of Geriatrics, 20 York Street, TMP 15, New Haven, CT 06504. E-mail: Richard.Marottoli{at}ynhh.org

Background. This study was designed to determine whether an education program consisting of classroom and on-road training could enhance driving performance.

Methods. This randomized controlled trial with blinded endpoint assessment enrolled 126 community-living drivers 70 years old or older who were recruited from clinic and community sources. Treatment assignment was concealed until eligibility was established. Participants randomized to intervention underwent two 4-hour classroom and two 1-hour on-road sessions focused on common problem areas of older drivers. Controls received modules directed at vehicle, home, and environmental safety. A knowledge test and driving performance were assessed at baseline and 8 weeks. On-road driving performance was assessed by an experienced evaluator in a dual-brake–equipped vehicle in urban, residential, and highway traffic. Driving performance was rated on a 36-item scale with potential scores from 0 to 72 (higher score better). The knowledge test included 20 road knowledge and eight road sign questions, scored from 0 to 28 correct.

Results. The least squares mean change in road test score relative to baseline was 2.87 points higher in the intervention than in the control group (p =.001). The least squares mean change in knowledge test scores relative to baseline was 3.45 points higher in the intervention than in the control group (p <.001).

Conclusions. An education program consisting of classroom and on-road training targeted to common errors of older drivers enhanced performance on knowledge and on-road tests. Such interventions offer older drivers the potential to continue driving safely longer and to maintain their out-of-home mobility.