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

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.

[1]  Amanda A. Holup,et al.  Does Self-Efficacy Affect Responsiveness to Cognitive Speed of Processing Training? , 2014, Journal of aging and health.

[2]  I. Robertson,et al.  The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: A systematic review and meta-analysis , 2014, Ageing Research Reviews.

[3]  George W Rebok,et al.  Ten‐Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults , 2014, Journal of the American Geriatrics Society.

[4]  Karlene K. Ball,et al.  Speed of Processing Training in the ACTIVE Study , 2013, Journal of aging and health.

[5]  Jeanine M. Parisi,et al.  Memory Training in the ACTIVE Study , 2013, Journal of aging and health.

[6]  S. Willis,et al.  Reasoning Training in the ACTIVE Study , 2013, Journal of aging and health.

[7]  Jerri D. Edwards,et al.  Cognitive training and selective attention in the aging brain: An electrophysiological study , 2013, Clinical Neurophysiology.

[8]  Chae Man Lee,et al.  Biopsychosocial Risk Factors for Driving Cessation , 2013, Journal of aging and health.

[9]  Jennifer J. Lister,et al.  An examination of mediators of the transfer of cognitive speed of processing training to everyday functional performance. , 2013, Psychology and aging.

[10]  Jamie L. Emerson,et al.  Predictors of driving outcomes in advancing age. , 2012, Psychology and aging.

[11]  Jerri D Edwards,et al.  Patterns of level and change in self-reported driving behaviors among older adults: who self-regulates? , 2012, The journals of gerontology. Series B, Psychological sciences and social sciences.

[12]  Andrew Pipingas,et al.  Improved Processing Speed: Online Computer-based Cognitive Training in Older Adults , 2012 .

[13]  Yue Gao,et al.  The Impact of Processing Speed Training on Working Memory in Old Adults , 2012 .

[14]  A. Santos,et al.  Summary of Travel Trends: 2009 National Household Travel Survey , 2011 .

[15]  Lesley A Ross,et al.  Cognitive Training Decreases Motor Vehicle Collision Involvement of Older Drivers , 2010, Journal of the American Geriatrics Society.

[16]  U. Lindenberger,et al.  A theoretical framework for the study of adult cognitive plasticity. , 2010, Psychological bulletin.

[17]  S. Willis.  Long-term effects of cognitive training , 2010, Alzheimer's & Dementia.

[18]  Gayla M. Cissell,et al.  Ten years down the road: predictors of driving cessation. , 2010, The Gerontologist.

[19]  M. V. Vander Weg,et al.  Speed of processing training protects self-rated health in older adults: enduring effects observed in the multi-site ACTIVE randomized controlled trial , 2009, International Psychogeriatrics.

[20]  Peter B. Delahunt,et al.  Cognitive speed of processing training delays driving cessation. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[21]  D. Roth,et al.  Driving cessation and health trajectories in older adults. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[22]  Gayla M. Cissell,et al.  The longitudinal impact of cognitive speed of processing training on driving mobility. , 2009, The Gerontologist.

[23]  David M. Smith,et al.  The ACTIVE cognitive training trial and predicted medical expenditures , 2009, BMC health services research.

[24]  M. V. Vander Weg,et al.  The effect of speed-of-processing training on depressive symptoms in ACTIVE. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[25]  Gayla M. Cissell,et al.  Do older drivers at-risk for crashes modify their driving over time? , 2009, The journals of gerontology. Series B, Psychological sciences and social sciences.

[26]  Lesley A Ross,et al.  Driving status and three-year mortality among community-dwelling older adults. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[27]  G. Rebok,et al.  Social integration and social support among older adults following driving cessation. , 2008, The journals of gerontology. Series B, Psychological sciences and social sciences.

[28]  C. Lustig,et al.  Who Benefits From Memory Training? , 2007, Psychological science.

[29]  Lesley A Ross,et al.  The Impact of Speed of Processing Training on Cognitive and Everyday Functions. , 2007, The journals of gerontology. Series B, Psychological sciences and social sciences.

[30]  K. Ball,et al.  Long-term effects of cognitive training on everyday functional outcomes in older adults. , 2006, JAMA.

[31]  David M. Smith,et al.  The ACTIVE cognitive training trial and health-related quality of life: protection that lasts for 5 years. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[32]  Karlene K Ball,et al.  Predictors of driving exposure and avoidance in a field study of older drivers from the state of Maryland. , 2006, Accident; analysis and prevention.

[33]  B. Munoz,et al.  Driving status and risk of entry into long-term care in older adults. , 2006, American journal of public health.

[34]  Kaarin J Anstey,et al.  Predicting Driving Cessation over 5 Years in Older Adults: Psychological Well‐Being and Cognitive Competence Are Stronger Predictors than Physical Health , 2006, Journal of the American Geriatrics Society.

[35]  D L Roenker,et al.  The impact of speed of processing training on cognitive and everyday performance , 2005, Aging & mental health.

[36]  Kara E MacLeod,et al.  Driving cessation and increased depressive symptoms. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[37]  Karlene K. Ball,et al.  Speed-of-Processing and Driving Simulator Training Result in Improved Driving Performance , 2003, Hum. Factors.

[38]  Karlene K. Ball,et al.  Transfer of a Speed of Processing Intervention to Near and Far Cognitive Functions , 2002, Gerontology.

[39]  J N Morris,et al.  ACTIVE: a cognitive intervention trial to promote independence in older adults. , 2001, Controlled clinical trials.

[40]  Beth T. Stalvey,et al.  Older drivers and cataract: driving habits and crash risk. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[41]  Christianna S. Williams,et al.  Driving Cessation and Increased Depressive Symptoms: Prospective Evidence from the New Haven EPESE , 1997, Journal of the American Geriatrics Society.

[42]  Lesley A Ross,et al.  The Transfer of Cognitive Speed of Processing Training to Older Adults' Driving Mobility Across 5 Years. , 2016, The journals of gerontology. Series B, Psychological sciences and social sciences.

[43]  Lesley A Ross,et al.  Longitudinal predictors of driving cessation among older adults from the ACTIVE clinical trial. , 2008, The journals of gerontology. Series B, Psychological sciences and social sciences.

[44]  CynthiaOwsley,et al.  Older Drivers and Cataract : Driving Habits and Crash Risk , 2022 .