Driving Habits in Older Adults May Signal Early Dementia Risk

A groundbreaking study presented at the American Stroke Association’s International Stroke Conference 2026 reveals a powerful connection between everyday driving habits and early brain health decline in older adults. Researchers from the Driving Real-World In-Vehicle Evaluation System (DRIVES) project at Washington University in St. Louis tracked 220 adults aged 65 and older for over five years using in-vehicle data loggers. They discovered that subtle changes—such as driving less frequently, taking fewer trips, sticking to repetitive routes, and making more errors—were strongly linked to greater white matter damage in the brain, particularly in areas responsible for visual processing and movement coordination. This damage, known as white matter hyperintensities and often caused by reduced blood flow, served as an early warning marker, with 17% of participants who developed these patterns later being diagnosed with cognitive impairment or Alzheimer’s disease. The study, led by Dr. Chia-Ling Phuah of the Barrow Neurological Institute, suggests that monitoring driving behavior could become a non-invasive tool to identify individuals at higher risk for dementia long before traditional memory symptoms appear.

In a promising counterpoint, the research found that older adults taking blood pressure medications, especially ACE inhibitors, were significantly less likely to exhibit risky driving behaviors even when brain scans showed white matter damage. This protective effect was observed regardless of whether their blood pressure was at target levels, hinting at potential brain health benefits beyond cardiovascular management. Experts like Dr. Nada El Husseini of Duke University, who chairs the American Heart Association’s scientific statement on Cognitive Impairment After Ischemic and Hemorrhagic Stroke, noted the surprise in these findings, emphasizing that they warrant further investigation into how such medications might support cognitive function and driving safety. The study underscores the critical link between vascular health and brain integrity, aligning with the 2025 American Heart Association High Blood Pressure Guideline, which recommends early treatment to maintain cognition.

The implications of this research extend far beyond academic circles, touching the lives of millions of older adults and their families. With about 6.9 million U.S. adults over 65 living with Alzheimer’s disease, as noted in the American Heart Association 2026 Heart and Stroke Statistics, the ability to detect decline through routine activities like driving could revolutionize early intervention strategies. Personal stories, such as that of caregiver Pam Duncan, highlight the real-world impact: her husband Larry experienced anxiety in unfamiliar driving situations before his Alzheimer’s diagnosis, illustrating how subtle shifts can signal deeper issues. While the study has limitations—including a small, predominantly white sample and self-reported medication data—its findings pave the way for larger, more diverse studies. Ultimately, this work champions a proactive approach to aging, where tools like commercial data loggers might help preserve independence and safety, offering a clearer window into brain health through the simple act of driving.