Long-Term Effects of Driving Skill Training on Safe Driving in Older Adults with Mild Cognitive Impairment.

Background/objective: A driving skill program had positive effects on safe driving performance in older adults, even those with cognitive impairment. However, the long-term effects of the program remain unclear. The purpose of this study was to examine whether such effects were maintained at 1 year after the intervention in older adults with cognitive impairment who had low driving skills.
Design: A secondary analysis of single-blind randomized controlled trial.
Setting: Community setting in Japan.
Participants: Community-living adults, aged 65 years or older (n = 159), with mild cognitive impairment (MCI).
Intervention: The intervention group completed 10 classroom sessions of 1 hour and 10 on-road sessions of 50 minutes, focusing on common problem areas of older drivers. The control group received one education class about safety driving.
Measurements: On-road driving performance was assessed by certified driving school instructors in a driving school at preintervention and postintervention, and 1-year follow-up.
Results: A total of 159 community-living older drivers participated in this study and were randomized to either an intervention group (n = 71) or a control group (n = 88). One year after the intervention, 104 of 159 community-living older drivers completed the follow-up assessment (intervention group, n = 58). Regarding the safe driving skill score, there was a significant group × time interaction (P < .01), indicating benefits of the intervention over time. Although the intervention group showed a significant decline in the safe driving skill score from postintervention (score = 38.9 ± 46.1) to 1-year follow-up (score = -0.3 ± 55.2), there was a significant difference between the groups at 1-year follow-up (control group score = -148.5 ± 46.4) (P < .05), and between preintervention (score = -132.0 ± 54.6) and 1-year follow-up in the intervention group (P < .05).
Conclusion: The driving skill program maintained safe driving performance that had been improved by the intervention in older adults with MCI.
(© 2020 The American Geriatrics Society.)