An increasing number of older people participates in active driving. With increasing age specific changes of sensory, motor and cognitive functions emerge which are relevant for driving. However, many seniors drive inconspicuously because they activate compensatory mechanisms. Against this background the question emerges whether older drivers are posing an increased risk, and, if so, whether this risk can be counteracted by interventions. On the basis of a comprehensive literature search we have compiled and discussed in this report intervention measures for decreasing the accident risk and for increasing the driving competence of older drivers. Such measures can be located on different levels, namely a) the layout of the traffic environment, b) the layout of car technology, c) education at a general level, and d) training procedures at an individual level. The latter is in the focus of the present study. In chapter 2 age-related functional changes that are relevant for driving as well as compensatory mechanisms are outlined and the usefulness of sensory and cognitive tests for the prediction of fitness to drive is discussed. Here we propose integrated screening tests, which should be followed by a driving test and, if necessary, intervention measures. In the central chapter 3 intervention measures which are based on controlled studies are outlined and critically discussed. The design of traffic environment appears to be relevant, particularly for situations which impose problems for elderly. Here the problematic design of traffic routeing for left-turns at complex intersections should be re-designed, in particular at critical intersections. The layout of car technology, in particular the use of driver assistance systems, could be useful in critical driving situations. Driver assistance systems are, however, expensive and their benefit often questionable. Intersection assistants which support the driver during left-turns are judged to be particularly useful; however, they are still in development. Too little attention is devoted to small systems such as turnable seat rests, which should be applied more intensively. There are only few studies concerning person-related interventions. Occasionally educational studies are reported which are aimed at influencing driver behaviour. However, they appear to have little impact on accident prevention. Controlled studies on individual driving trainings in real traffic and in a driving simulator are extremely rare. A relevant training study in real traffic is the "Dortmunder Fahrtrainingsstudie" (POSCHADEL et al., 2012a). Here it could be demonstrated that older drivers could improve their driving behavior after a special driving training in real traffic, compared to a control group. This improvement was mainly observed in drivers with poor a priori driving performance. Simulator trainings yield improvements of single driving-related action chains. Function centered trainings, which target driving-relevant functions directly are mentioned more frequently in the literature. However, they originate mainly from one working group, and comprise only the "UFOV®-Training". This training yields clear improvements of driving competence and increases the duration of mobility in older drivers. However, given the poor state of studies, there is urgent need for further studies on different and multifaceted functional trainings. In order to include the persons concerned a focus group of older drivers was consulted concerning their subjective driving problems and meaningful intervention measures. Complex driver assistant systems were seen rather negative, simple technical aids rather positive. As to traffic design the reduction of information overload was reminded. The seniors well noticed their decay of vision, particularly in darkness and rain. A majority voted for mandatory annual tests of vision; a regular check of driving performance was generally refused. All participants voted for practical trainings, but are concerned about their costs. In summary, particularly the practical individual trainings yield good effects on the driving competence of elderly. The benefit of driving training in real traffic is relatively clear and mainly improves drivers with poor a priori performance, as shown in the Dortmunder Fahrtrainingsstudie. The few studies to simulator-based and functional trainings suggest positive and partly enduring effects on driving performance and mobility in older drivers. Here, further research is urgently necessary, which should focus on low-cost training techniques. (Author/publisher)
Abstract