Older driver retraining: an updated systematic review of evidence of effectiveness.
OBJECTIVE
The number of older drivers who might benefit from driver retraining is growing. A previous review on the effectiveness of older driver retraining included intervention studies up to 2004. The objective was to perform an updated systematic review of the effectiveness of older driver retraining for improving driving-related skills and reducing crash rates.


METHODS
Articles published from 2004-2008 were grouped according to the intervention provided and outcome studied. Randomized clinical trials (RCTs) were appraised using the Physiotherapy Evidence Database (PEDro) Scale and scored for quality according to their internal validity. Each intervention's effectiveness was then rated and assigned a level of evidence by combining pre- and post- 2004 findings.


RESULTS
Three RCTs and one matched-pairs cohort design met the inclusion criteria. There is strong evidence (Level 1a) that education combined with on-road training improves driving performance and moderate evidence (Level 1b) that it improves knowledge. There is moderate evidence (Level 1b) that physical retraining improves driving performance. There is moderate evidence (Level 1b) that an educational intervention curriculum alone is not effective in reducing crashes.


CONCLUSIONS
The updated evidence on the effectiveness of retraining aimed at older drivers is sufficiently encouraging to merit assertive health promotion actions regarding intervention and program planning.


CONCLUSIONS
These positive findings warrant a comprehensive plan that has both behavioral and monetary incentives encouraging older driver participation in programs aimed at driver safety.
McGill University, Faculty of Medicine, School of Physical and Occupational Therapy, Montreal, Quebec, Canada. nicol.korner-bitensky@mcgill.ca
Nicol
N
Korner-Bitensky
Ailene
A
Kua
Claudia
C
von Zweck
Kathy
K
Van Benthem
D000063:Accidents, Traffic / Q000517:prevention & control*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000193:education*; D006801:Humans; D008875:Middle Aged