A systematic review and meta-analysis of older driver interventions

Fausto, Bernadette A.; Maldonado, Pedro F Adorno; Ross, Lesley A.; Lavallière, Martin; Edwards, Jerri D.

doi:10.1016/j.aap.2020.105852

Cited by 27 publications

(22 citation statements)

References 77 publications

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“…Interventions tailored to individual drivers can improve driving performance (Fausto et al, 2021; Sangrar et al, 2019), suggesting that an approach focused on meeting the needs of older drivers in different classes may be important. High-avoidance drivers may have a more pressing need than others for information about transportation options (such as ride-hailing or ride-sharing) to meet mobility needs when they are not able or choose not to drive.…”

Section: Discussionmentioning

confidence: 99%

Examining Patterns of Driving Avoidance Behaviors Among Older People Using Latent Class Analysis

2022

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Objectives: Some older drivers choose to avoid certain situations where they do not feel confident driving. Little is known about the process by which older drivers may use avoidance in transitioning to non-driving. Methods: We analyzed 2015 ConsumerStyles data for 1198 drivers aged 60+. Driving patterns were examined by sociodemographic and driving characteristics. Avoidance classes were characterized by latent class analysis. Results: Among drivers 60+, 79% reported driving 3+ days/week and 84% reported good to excellent health. We identified four driving avoidance classes (low, mild, moderate, and high). High- (versus low-) avoidance drivers were more likely female, 75+, not White/non-Hispanic, and to have income <$25,000/year. Discussion: Avoidance of selected driving behaviors may be one component of a multi-step process supporting the transition to non-driving. Drivers displaying avoidance behaviors may be receptive to resources to prepare for this transition and minimize negative health and quality of life outcomes that accompany driving cessation.

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Section: Discussionmentioning

confidence: 99%

Examining Patterns of Driving Avoidance Behaviors Among Older People Using Latent Class Analysis

2022

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“…[9][10][11] Family members want to discuss driving with their loved ones and are often uncertain of how and when to do so, especially since these discussions are not routine in primary care. 9,12,13 The challenge of how to support older adults making decisions about driving [14][15][16] gains urgency with the aging population and a growing number of older adults living with physical and cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

“Is it time to stop driving?”: A randomized clinical trial of an online decision aid for older drivers

Betz

Hill

Fowler

et al. 2022

J American Geriatrics Society

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Background Many older adults face the difficult decision of when to stop driving. We sought to test whether an online driving decision aid (DDA) would improve decision quality. Methods This prospective two‐arm randomized trial enrolled English‐speaking licensed drivers (age ≥70 years) without significant cognitive impairment but with ≥1 diagnosis associated with increased likelihood of driving cessation; all participants received primary care in clinics associated with study sites in three states. The intervention was the online Healthwise® DDA for older adults addressing “Is it time to stop driving?”; control was web‐based information for older drivers only. The primary outcome was decision conflict as estimated by the Decisional Conflict Scale (DCS; lower scores indicate higher quality). Secondary outcomes were knowledge and decision self‐efficacy about driving decisions. We examined postrandomization differences in primary and secondary outcomes by study arm using generalized linear mixed‐effects models with adjustment for site and prerandomization scores. Results Among 301 participants (mean age: 77.1 years), 51.2% identified as female and the majority as non‐Hispanic (99.0%) and white (95.3%); 98.0% lived in an urban area. Participant characteristics were similar by study arm but differed across sites. Intervention participants had a lower mean DCS score (12.3 DDA vs 15.2 control; adjusted mean ratio [AMR] 0.76, 95%CI 0.61–0.95; p = 0.017). Intervention participants had higher mean knowledge scores (88.9 DDA vs. 79.9 control; OR 1.13, 95%CI 1.01–1.27, p = 0.038); there was no difference between groups in self‐efficacy scores. The DDA had high acceptability; 86.9% of those who viewed it said they would recommend it to others in similar situations. Conclusions The online Healthwise® DDA decreased decision conflict and increased knowledge in this sample of English‐speaking, older adults without significant cognitive impairment, although most chose to continue driving. Use of such resources in clinical or community settings may support older adults as they transition from driving to other forms of mobility. Trial registration http://clinicaltrials.gov identifier “Advancing Understanding of Transportation Options (AUTO)” NCT04141891.

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“…The effects of age-related decline on global driving skills have been widely demonstrated (Renge et al, 2020). Changes in visual-perceptual abilities and executive functions may modify driving performance, especially in challenging traffic situations such as dense traffic, complex junctions or in situations involving high temporal constraints (Fausto et al, 2021). Reduction of the visual field leads to a decreased ability to register relevant information while driving, and results in an increased risk of accident (Ball & Owsley, 1991).…”

Section: Introductionmentioning

confidence: 99%

“…Older drivers with cognitive deficits display a significant deterioration in driving behavior (Brouwer et al, 2002). Their ability to concentrate, to make quick decisions and avoid other vehicles or pedestrians is more impaired than in younger drivers (Fausto et al, 2021). The link between age-related executive deficits, assessed by neuropsychological tests (e.g.…”

Section: Introductionmentioning

confidence: 99%