Cognitive training can reduce crash risk by half for older drivers

Research published today in the Journal of the American Geriatric Society demonstrates that cognitive training can cut the risk of at-fault car crashes among older drivers by half.

The research, part of a randomized, controlled, multi-site clinical trial called ACTIVE, showed that the training was effective in improving cognitive abilities, including reasoning and speed of processing. This improvement protected older drivers from future crashes compared to older drivers who did not receive the training, according to the study's author, Karlene Ball, Ph.D., chair of the Department of Psychology in the University of Alabama at Birmingham College of Arts and Sciences.

Speed-of-processing training focuses on speed and accuracy and trains users to increase their useful field of view (UFOV) - the area over which a person can extract information in a single glance, without moving the head or eyes, says Ball, who also is director of the UAB Roybal Center for Research on Applied Gerontology. A normal, wide UFOV allows a driver to process information quickly about objects moving toward the driver, which is critical for safe driving. 

Many studies have established that poor performance on UFOV tests increases with age. Studies also have established that those older drivers with poorer performance on this test are at higher risk of car crashes relative to other older drivers who perform well.

The current study analyzed a subset of the ACTIVE participants (908 healthy, older drivers with a mean age of 73) from four states: Alabama, Indiana, Maryland and Pennsylvania. Ball reports that older drivers could be trained to increase the speed with which they process information from a wider space; drivers randomly assigned to receive up to 10 hours of specialized computer-based speed-of-processing training cut their crash risk in half relative to the control group over the next six years of driving.

Because of population trends, the number of older drivers will continue to increase. Older drivers are more likely to be determined to be at fault when involved in crashes and are more susceptible to injuries and fatalities, according to the study. Declines in cognitive abilities most often are associated with older driver crashes. The results have great potential to sustain independence and quality of life for older drivers, Ball says.

"We have previously shown that UFOV assessments can be used to predict crash risk and that speed of processing training can reduce crash risk," Ball says, "but this is the first time the reduction of crash incidence has been demonstrated in a randomized controlled trial over time by tracking actual state crash records.  We now can say definitively that this technology has the potential to save lives."

"This gives professionals and clinicians a new way to talk with older family members about continuing to drive, Ball says. "There is a simple, objective way to establish crash risk, and this risk potentially can be reduced with a modest amount of training."

Ball added that this study builds on more than 20 years of NIH and privately sponsored research into UFOV technology. "I have spent most of my career studying cognitive fitness and its relationship to everyday skills such as driving," Ball says. "Maintaining safe driving ability is viewed as essential to independence for most older adults, and we know having to give up driving can be psychologically unnerving and can lead to poorer health and function.  Now, we have a way to potentially extend the period of safe driving, determining when we should stop and helping people age with greater dignity and vigor."

The research was funded by the National Institute of Aging and the National Institute on Nursing Research. Information about this training program may be obtained by contacting 205-975-2290.