Video feedback intervention for cognitively impaired older drivers: A randomized clinical trial

Abstract

Abstract Introduction This clinical trial aimed to determine whether in‐car video feedback about unsafe driving events (UDE) to cognitively impaired older drivers and family members leads to a reduction in such driving behaviors. Methods We randomized 51 cognitively impaired older drivers to receive either (1) a weekly progress report with recommendations and access to their videos, or (2) video monitoring alone without feedback over 3 months. Results UDE frequency/1000 miles was reduced by 12% in feedback (rate ratio [RR] = 0.88, 95% confidence interval [CI] = .58–1.34), while remaining constant with only monitoring (RR = 1.01, 95% CI = .68–1.51). UDE severity/1000 miles was reduced by 37% in feedback (RR = 0.63, 95% CI = .31–1.27), but increased by 40% in monitoring (RR = 1.40, 95% CI = .68–2.90). Cognitive impairment moderated intervention effects (P = .03) on UDE frequency. Discussion Results suggest the potential to improve driving safety among mild cognitively impaired older drivers using a behavior modification approach aimed at problem behaviors detected in their natural driving environment.

Keywords

• Alzheimer's disease
• clinical trial
• dementia
• driving
• mild cognitive impairment