Does Physical Exercise Improve the Driving Performance of Older

Adults?
Annie L. Guiliano, OTS and Danielle D. Palmer, OTS
Touro University Nevada, School of Occupational Therapy

Results

Introduction
Driving is an instrumental activity of daily living (IADL) that is
very important to older people. Driving enables older adults to
live independently, making access to shopping, leisure and
social activities, and medical management possible. Staying
behind the wheel is important for the health and wellness of
older adults because it keeps them involved with meaningful
activities. Finding alternative transportation can be
inconvenient, causing older adults to withdraw from engaging
in activities that define who they are as occupational beings
(Singh, 2004).

With the baby boomers aging, it is estimated that by 2020

more than 40 million individuals in the United States over the
age of 65 will be driving (NHTSA, 2013). As drivers age, there
is an increased risk that they will die in a motor vehicle
accident. Fatalities are the highest in accidents involving
drivers over the age of 85 (NHTSA, 2013). Aging can result in a
gradual decline of sensory, cognitive, and physical functioning
necessary for safe driving (Eby, Molnar, & Pellerito, 2005).

Identifying effective interventions to improve the driving

performance in older adults is important for road safety and
promoting the quality of life for older adults. The driving
performance of older adults is impacted by decreased
flexibility, coordination, and speed of movement. The benefits
of physical exercise on successful aging has been well studied.
A synthesis of literature indicates that the participation in
physical activity has a multitude of potentially positive effects
on the aging process (Singh, 2004).
There is limited research on the direct impact of physical
exercise on the driving performance of older adults (Singh,
2004). The objective of this critically appraised topic (CAT) is to
summarize the body of evidence resulting from studies related
to the effects of physical exercise on the driving performance of
older adults.

Methods

Inclusion Criteria
Level I and II studies
Written in English
Published in peer reviewed journals
Full text article publication
Answered all aspects of the focus question

Level of
Evidence

Implications for OT

Study Design/Methodology of Selected Articles

Number of Articles
Selected

Systematic reviews, meta-analysis, randomized controlled

trials

II

Two groups, nonrandomized studies (e.g., cohort, casecontrol)

III

One group, nonrandomized (e.g., before and after, pretest,

and posttest)

IV

Descriptive studies that include analysis of outcomes

(single subject design, case series)

Case reports and expert opinion, which include narrative

literature reviews and consensus statements

Other

Qualitative Studies

TOTAL:

Conclusions
Cognition, an important factor for safe driving, can be improved in older adult drivers by an
intervention of combined aerobic and anaerobic exercise (Chattha, 2011).
Physical exercise can improve the reaction time of older adult drivers (Marmeleira, Soares de Melo,
Tlemcani, & Godinho, 2011; Marmeleira, Godinho, & Fernandes, 2009).
Ankle training with elastic bands can decrease the foot movement time from the gas pedal to the
brake pedal in older adult women drivers (Weber & Porter, 2010).
A home exercise program targeting flexibility, coordination, and speed of movement can maintain the
driving performance of older adults, as well as decrease the risk for falls (Marottoli, Allore, Araujo,
Ianone, Acampora, Gottschalk, & Peduzzi, 2007).
A physical fitness program for older adult drivers incorporating range-of-motion exercises, such as
static-stretching, can improve shoulder flexibility, trunk rotation, and improve scores on observed
driving skills (Ostrow, Shaffron, & McPherson, 2009).
A driving fitness program designed for older adults, consisting of engineering enhancements, driver
education, and physical fitness, can improve strength, endurance, agility, flexibility, hand reaction
time, and driving confidence (Caragata, Tuokko, & Damini, 2009).

Exclusion Criteria
Level III, IV, or V studies
Systematic reviews
Studies not published in English
Non-peer reviewed research literature
Published prior to 1990
Key Search Terms
Adults
Elderly
Older adults
Old aged

0
10

The clinical and community-based practice of OT

As consultants, OTs can help design programs at community
centers, senior centers, and work out centers which include
physical exercise that specifically targets improving the
driving performance of older adults.

Program development
Exercise should be included in driving programs to improve
the performance skills in older adult drivers. OTs can
recommend a home exercise program focused on improving
the driving performance of older adults.

Societal Needs
Society will be faced with the consequences of the declining
driving performance of older adults. Exercise is an effective
intervention to address this problem.
Healthcare delivery and policy
Non-pharmaceutical interventions, such as exercise, are
needed in healthcare to improve the driving performance of
older drivers.

Education and training of OT students

OT students should have knowledge regarding the
performance skills needed when driving and how these skills
can be improved with physical exercise.

Refinement, revision, and advancement of factual

knowledge or theory
More research needs to be conducted to identify specific
exercises that can improve driving performance.

References (Partial
List)

Caragata, G., Tuokko, H., & Damini, A. (2009). Fit to drive: a pilot
study to improve the physical fitness of older
drivers.Activities, Adaptation & Aging,33(4), 240-255.
doi:10.1080/01924780903349080.
Chattha, H. K. (2011). The influence of physical activity on
driving performance and cognitive functioning in older adults:
A randomized controlled trial (Unpublished doctoral
dissertation). Lakehead University, Ontario, Canada.
DAmbrosio, L. (2013). Keeping fit and fit to drive: An
experimental intervention to explore the impact of physical
exercise on older adults driving. New England University
Transportation Center, 1-3.

Contact Information
Retrieved from: www.myimprov.com

Retrieved from:
www.napervilleseniorcenter.com

OT16.Annie.Guiliano@nv.touro.edu
OT16.Danielle.Palmer@nv.touro.edu