title: Evidence-based review of interventions for medically at-risk older drivers.
abstract: OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association's classification criteria (Levels I-V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention. RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual-perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I). CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers.
authors.affiliation: Sherrilene Classen, PhD, MPH, OTR/L, is Adjunct Professor, Institute for Mobility, Activity and Participation, College of Public Health and Health Professions, University of Florida, Gainesville, and Professor and Chair, School of Occupational Therapy, Western University, Elborn College, 1201 Western Road, London, Ontario, Canada N6G 1H1; sclassen@uwo.ca.
authors.forename: Sherrilene
authors.initials: S
authors.lastname: Classen
authors.affiliation: Miriam Monahan, MS, OTR/L, CDRS, is Visiting Scholar, Institute for Mobility, Activity and Participation, College of Public Health and Health Professions, Department of Occupational Therapy, University of Florida, Gainesville.
authors.forename: Miriam
authors.initials: M
authors.lastname: Monahan
authors.affiliation: Beth Auten, MLIS, MA, AHIP, is Librarian, Health Science Center Libraries, Gainesville, FL.
authors.forename: Beth
authors.initials: B
authors.lastname: Auten
authors.affiliation: Abraham Yarney, MS, is Graduate Research Assistant, Institute for Mobility, Activity and Participation, College of Public Health and Health Professions, University of Florida, Gainesville.
authors.forename: Abraham
authors.initials: A
authors.lastname: Yarney