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Randomized Controlled Trial
. 2017 Oct 1;57(5):838-846.
doi: 10.1093/geront/gnw143.

The Impact of Three Cognitive Training Programs on Driving Cessation Across 10 Years: A Randomized Controlled Trial

Lesley A Ross  1 , Sara A Freed  1 , Jerri D Edwards  2 , Christine B Phillips  1 , Karlene Ball  3
Affiliations
Randomized Controlled Trial

The Impact of Three Cognitive Training Programs on Driving Cessation Across 10 Years: A Randomized Controlled Trial

Lesley A Ross et al. Gerontologist. .

Abstract

Purpose of the study: Driving is important for older adults' health and well-being, yet little research has examined interventions to maintain driving mobility. As fluid cognitive abilities are strongly linked to driving, targeted cognitive training interventions may impact driving mobility longitudinally. This study assessed the effects of three different cognitive training programs (reasoning, speed of processing, and memory) on driving cessation in older adults across 10 years (n = 2,390).

Design and methods: Cox regression analyses evaluated the impact of each program relative to a no-contact control group with intent-to-treat (ITT) analyses. The effects of randomization to additional booster sessions were also examined. Subsample analyses repeated these models in participants who were at-risk for driving mobility declines.

Results: There were no training (n = 2,390) or booster training (n = 1,540) effects on driving cessation with ITT analyses. Individuals at-risk for future mobility declines were 49% (Hazard Ratio (HR) = 0.51, 95% confidence interval [CI]: 0.28, 0.94; n = 336) less likely to cease driving after speed of processing training and 55% (HR = 0.45, 95% CI: 0.24, 0.86; n = 324) less likely to quit driving subsequent to reasoning training. Additional booster sessions for speed of processing training resulted in a 70% reduction of driving cessation (HR = 0.30, 95% CI: 0.11, 0.82; n = 252) in the subsample analyses. There were no significant effects of memory training.

Implications: Some cognitive interventions transfer to maintained driving among those at-risk for mobility declines due to cognitive impairment. Future research should identify moderators and mediators of training and transfer effects.

Keywords: Cognitive intervention; Everyday functioning; Memory training; Reasoning training; Speed of processing training.

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Figures

Figure 1.
Figure 1.
Risk of driving cessation by study arm across 10 years in participants with poor baseline Useful Field of View performance. Note: Covariates included study site, gender, and baseline driving frequency. Sample sizes were: reasoning trained (n = 154), speed of processing trained (n = 166), memory trained (n = 166), and no-contact control (n = 170).
Figure 2.
Figure 2.
Risk of driving cessation by study arm across 10 years in participants with poor baseline Useful Field of View performance who received booster training. Note: Covariates included study site, gender, and baseline driving frequency. Booster training occurred at Years 1 and 3. Sample sizes for booster analyses were: reasoning trained (n = 87), speed of processing trained (n = 82), memory trained (n = 97), and no-contact control (n = 170).
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References

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