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A Randomized Trial of a Physical Conditioning Program to Enhance the Driving Performance of Older Persons

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Abstract

Background

As the number of older drivers increases, concern has been raised about the potential safety implications. Flexibility, coordination, and speed of movement have been associated with older drivers’ on road performance.

Objective

To determine whether a multicomponent physical conditioning program targeted to axial and extremity flexibility, coordination, and speed of movement could improve driving performance among older drivers.

Design

Randomized controlled trial with blinded assignment and end point assessment. Participants randomized to intervention underwent graduated exercises; controls received home, environment safety modules.

Participants

Drivers, 178, age ≥ 70 years with physical, but without substantial visual (acuity 20/40 or better) or cognitive (Mini Mental State Examination score ≥24) impairments were recruited from clinics and community sources.

Measurements

On-road driving performance assessed by experienced evaluators in dual-brake equipped vehicle in urban, residential, and highway traffic. Performance rated three ways: (1) 36-item scale evaluating driving maneuvers and traffic situations; (2) evaluator’s overall rating; and (3) critical errors committed. Driving performance reassessed at 3 months by evaluator blinded to treatment group.

Results

Least squares mean change in road test scores at 3 months compared to baseline was 2.43 points higher in intervention than control participants (P = .03). Intervention drivers committed 37% fewer critical errors (P = .08); there were no significant differences in evaluator’s overall ratings (P = .29). No injuries were reported, and complaints of pain were rare.

Conclusions

This safe, well-tolerated intervention maintained driving performance, while controls declined during the study period. Having interventions that can maintain or enhance driving performance may allow clinician–patient discussions about driving to adopt a more positive tone, rather than focusing on driving limitation or cessation.

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Acknowledgements

The authors thank Robbin Bonanno for her assistance in preparing this manuscript.

Grant Support

Claude D. Pepper Older Americans Independence Center at Yale Intervention Development Study (P60-AG10469- NIA); Dr. Marottoli was supported by a VA Health Services Research and Development Career Development Award, a Beeson Physician Faculty Scholars in Aging Research Award, and a Donaghue Foundation Investigator Award.

Potential Financial Conflicts of Interests

None disclosed.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA

    Richard A. Marottoli MD, MPH, Heather Allore PhD, Katy L. B. Araujo MPH, Lynne P. Iannone MS, Denise Acampora MPH, Peter Charpentier MPH & Peter Peduzzi PhD

  2. Geriatrics and Extended Care Section, VA Connecticut Healthcare System, West Haven, CT, USA

    Richard A. Marottoli MD, MPH

  3. Cooperative Studies Program Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, CT, USA

    Richard A. Marottoli MD, MPH

  4. Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA

    Peter Peduzzi PhD

  5. Department of Rehabilitation Services, Yale-New Haven Hospital, New Haven, CT, USA

    Margaret Gottschalk PT, MS

  6. Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA

    Stanislav Kasl PhD & Peter Peduzzi PhD

Authors
  1. Richard A. Marottoli MD, MPH
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  2. Heather Allore PhD
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  3. Katy L. B. Araujo MPH
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Corresponding author

Correspondence to Richard A. Marottoli MD, MPH.

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Marottoli, R.A., Allore, H., Araujo, K.L.B. et al. A Randomized Trial of a Physical Conditioning Program to Enhance the Driving Performance of Older Persons. J GEN INTERN MED 22, 590–597 (2007). https://doi.org/10.1007/s11606-007-0134-3

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  • DOI: https://doi.org/10.1007/s11606-007-0134-3

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