A preliminary study presented at the American Stroke Association’s International Stroke Conference 2026 suggests that monitoring driving habits in older adults could provide early clues about brain health and dementia risk. The research, involving 220 adults aged 65 and older, tracked driving patterns over five years using in-vehicle sensors and correlated them with brain imaging data.
The study found that individuals with greater white matter damage, indicated by white matter hyperintensities on MRI scans, tended to drive less, take fewer trips, follow more repetitive routes, and exhibit more unsafe driving behaviors such as hard braking and crashes. These associations were particularly strong among the 17% of participants who developed cognitive impairment or Alzheimer’s disease during follow-up.
“Driving habits in older adults can reveal early changes in brain health. How often people drive, where they go, and how much they vary their routes may signal underlying damage to the brain’s white matter, which is linked to cognitive decline and dementia,” said study author Chia-Ling Phuah, M.D., M.M.Sc., an associate professor of neurocritical care at Barrow Neurological Institute. “These findings suggest that even small shifts in daily driving patterns can offer important clues about brain changes—sometimes before traditional memory and thinking symptoms are noticeable.”
White matter damage in the posterior brain regions, responsible for visual processing and coordination, was most strongly tied to unsafe driving and crashes, pointing to a potential early marker for driving risk.
Interestingly, participants taking blood pressure medications, particularly ACE inhibitors, were less likely to exhibit risky driving behaviors, even when brain scans showed significant white matter damage. This effect was independent of whether blood pressure was at target levels, suggesting these medications may help preserve brain function. “One especially promising finding was that people taking blood pressure medications, particularly ACE inhibitors, tended to maintain safer driving habits even when their brain scans revealed more damage,” Phuah noted.
Nada El Husseini, M.D., M.H.Sc., FAHA, chair of the American Heart Association’s 2023 scientific statement on cognitive impairment after stroke, commented, “What’s surprising about these findings is that people taking ACE inhibitors were less likely to have impairment in their driving despite the extent of white matter disease. The impact of ACE inhibitors on cognitive function and driving safety in people with white matter disease requires further investigation.”
The study, part of the Driving Real-World In-Vehicle Evaluation System (DRIVES) project at Washington University in St. Louis, included predominantly white, college-educated participants, limiting generalizability. Researchers plan larger, more diverse studies to confirm findings.
According to the American Heart Association 2026 Heart and Stroke Statistics, about 6.9 million U.S. adults aged 65 and older were living with Alzheimer’s disease in 2024. The findings underscore the potential of using commercial in-vehicle data loggers to identify at-risk older adults, offering a window into brain health before traditional symptoms emerge.
For more information on brain health and stroke, visit stroke.org or the American Heart Association.
