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Driver education programs may not aid elderly

Educational programs designed to help elderly drivers improve their skills may not make them safer drivers or help prevent future accidents, a new study shows.
/ Source: WebMD

Educational programs designed to help elderly drivers improve their skills may not make them safer drivers or help prevent future accidents a new study shows.

Researchers say that drivers over age 60 have among the highest rates of car crashes per mile driven of all age groups, and they are the fastest growing group of drivers on the road.

Those dangers have prompted many elderly drivers to enroll in driver education programs designed to promote safe driving practices. Despite the growing popularity of these programs, researchers say few studies have evaluated their effectiveness in terms of increasing driver safety and reducing automobile accidents.

But a new study shows that a Cadillac version of a one-on-one safety educational program failed to reduce car crashes among high-risk elderly drivers who suffer from vision problems.

"So many people enroll in these programs in their older years, and the public needs to be clear about what these programs do and what these programs don't do," says researcher Cynthia Owsley, Ph.D., MSPH, professor of ophthalmology at the University of Alabama at Birmingham.

Owsley presented the results of the study today at an American Medical Association briefing on patient communication and adherence in New York City. The results appear in the April issue of the American Journal of Preventive Medicine.

Education alone doesn't make drivers safer
Researchers say two previous studies have also found that education programs did not reduce collision rates among a broad group of elderly drivers, but this study involved high-risk drivers that had been involved in a crash within the previous year and also suffered from vision problems.

The study consisted of 403 men and women over age 60 who were licensed drivers in the state of Alabama, drove at least five days or 100 miles per week or both, and had one of two forms of vision impairment, including problems with detailed vision and/or visual processing speed that creates a delay in processing visual information and making decisions about it.

The participants were randomly assigned to receive an eye examination alone or an eye exam plus an individually tailored educational intervention that promoted safe-driving strategies.

The intervention included two one-on-one sessions that discussed the individual's own driving needs, lifestyle, and visual problems. The discussion also focused on maneuvers and settings that the individual found difficult and increased their risk of collision, such as driving at night, during rush hour, and during inclement weather.

The program also educated the participant about strategies to avoid driving in those situations, including:

Doing errands requiring driving during daylight hours Driving less popular routes Driving at nonrush hour times Postponing trips during bad weather Seeking routes where three right turns might be substituted for one left turn

At the end of the session, the participants were asked to set personal goals in a written contract that listed ways they could modify their driving behavior.

After two years of follow up, researchers found that there was no significant difference in the number of car crashes per mile driven between the group that participated in the education program and the others.

"Like other studies, there is no evidence for a safety benefit from this program," says Owsley. "However in terms of behavior, it seems that we were successful in helping them change behaviors."

Owsley says elderly drivers that participated in the education program reported that they were monitoring their own driving skills more carefully, avoiding challenging situations, and cutting back on their driving time.

Owsley says that the kinds of behavioral changes that the participants instituted may not reflect in a reduced car crash rate because crashes are uncommon events.

Although this educational program was unsuccessful in reducing collision rates during the two-year follow-up period, researchers say they may still produce long-term benefits by making elderly drivers more aware of their driving behaviors. In a news release, Owsley explains that the study shows that on average older drivers do embrace these new behaviors.

SOURCES: Owsley, C. American Journal of Preventive Medicine, April 2004; vol 26: pp 222-229. Cynthia Owsley, Ph.D., MSPH, professor of ophthalmology, University of Alabama at Birmingham.