Researchers tracking 220 adults aged 65 and older for over five years found that greater white matter damage in the brain was linked to decreased driving, fewer trips, repetitive routes, and more driving errors, particularly in those who later developed dementia. The study, which used car sensors to monitor driving behavior, revealed that older adults with more white matter hyperintensities tended to drive less and showed sharper declines in their willingness or ability to change driving routes and habits.
Among the 17% of participants who developed cognitive impairment during the follow-up period, higher white matter hyperintensity burden was associated with unsafe driving practices like hard braking and more crashes. Those with white matter hyperintensities located in the back of the brain faced even higher crash risks than those with changes in other brain areas. Most individuals who developed cognitive impairment were later diagnosed with Alzheimer's disease.
In contrast, participants taking blood pressure medications, particularly angiotensin-converting enzyme (ACE) inhibitors, were less likely to exhibit risky driving behaviors compared to those not taking any blood pressure medication. This protective effect persisted even when brain scans revealed significant white matter damage. The findings suggest these medications may help support brain health as people age, aligning with the 2025 American Heart Association High Blood Pressure Guideline recommendation for early treatment to maintain brain health and cognition.
The study's implications extend beyond individual safety to broader economic and societal impacts in Texas, where transportation independence is crucial for maintaining workforce participation and community engagement among older adults. For businesses serving Texas's aging population, these findings highlight potential opportunities in developing monitoring technologies and preventive healthcare solutions. The research suggests that monitoring driving behavior with commercial in-vehicle data loggers could help identify older adults at higher risk for unsafe driving, loss of independence, and subtle cognitive problems before traditional memory symptoms appear.
Key limitations include the small study size and homogeneous participant group, as most were white, college-educated adults, meaning results may not generalize to more diverse populations. Medication use was self-reported, which could introduce errors. The next research step involves larger studies with more diverse participants to confirm and extend these findings. The study is a research abstract to be presented at the American Stroke Association's International Stroke Conference 2026, and findings are considered preliminary until published in a peer-reviewed journal.
