A systematic review and meta-analysis of older driver interventions

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

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


The purpose of this systematic review and meta-analysis was to summarize and quantify the effects of different driving interventions among older adults on outcomes of crashes, on-road driving performance, self-reported outcomes of errors and crashes, and driving simulator performance. Randomized controlled trials examining the effects of a driving intervention among older adults ≥ 50 years of age were included. Thirty-one studies were identified using a systematic literature review, and 26 were included in meta-analyses. The following types of driving interventions were identified: physical retraining/exercise (e.g., flexibility and coordination training); visual-perceptual training (e.g., improving figure-ground discrimination); cognitive training (e.g., Useful Field of View cognitive training); education (e.g., classroom driver refresher course); context-specific training (i.e., on-road training in car, driving simulator training); combined intervention approaches (e.g., education and context-specific training combined). Effect sizes were calculated for each driving intervention type relative to control groups using random-effects. Physical retraining/exercise, visual-perceptual training, and combined intervention approaches demonstrated medium to large effects on on-road driving performance, ds = 0.564–1.061, ps < .050. Cognitive training approaches reduced at-fault crashes by almost 30 %, OR = 0.729, 95 % CI [0.553, 0.962], p = .026. Education and context-specific approaches were not efficacious to improve driving safety outcomes, ps> .050. In summary, skill-specific interventions (physical retraining/exercise, visual-perceptual training, cognitive training) and combined intervention approaches improved on-road driving performance and reduced at-fault crashes. Optimizing interventions that target age-related functional declines and combined intervention approaches is recommended.

Original languageEnglish (US)
Article number105852
JournalAccident Analysis and Prevention
StatePublished - Jan 2021

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Safety, Risk, Reliability and Quality
  • Law
  • Human Factors and Ergonomics


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