Get Healthy!

• Posted January 29, 2026

Driving Habits Provide Window Into Seniors' Brain Health

Larry Duncan valued driving as part of his independence.

But Duncan — a retired business owner from Pinehurst, North Carolina — started to become more nervous behind the wheel prior to his diagnosis with Alzheimer’s disease in 2023.

“Larry was fine driving in familiar areas, but in new places where he had to make quick decisions, he became anxious,” his wife and caregiver, Pam Duncan, said in a news release.

Such subtle changes in seniors’ driving habits can provide insight into their brain health, a new study says.

Seniors who start driving less or are unwilling to change their usual routes are more likely to have greater brain damage linked to dementia, researchers are scheduled to report next week at the American Stroke Association’s annual meeting in New Orleans.

They are also more likely to engage in unsafe driving practices and wind up in more car crashes, researchers said.

“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,” lead researcher Dr. Chia-Ling Phuah, co-director of the Neuro Analytics Center at Barrow Neurological Institute in Phoenix, said in a news release.

“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,” Phuah said.

For the new study, researchers studied the brain health and driving habits of 220 seniors 65 and older living independently in St. Louis, Missouri. All were without dementia at the beginning of the study.

Each participant underwent an MRI brain scan when they entered the study, and about half had a second MRI at least 12 months later.

Car sensors were used to track their driving behavior for more than five years, tallying up examples of speeding, collisions, hard braking or hard cornering. The sensors also tracked how often seniors drove and the routes they took.

Researchers compared their driving behavior to changes in the white matter of the brain, looking specifically at changes indicative of brain damage called white matter hyperintensities.

During follow-up, 17% of the participants developed cognitive impairment, and most were later diagnosed with Alzheimer’s disease, researchers said.

Greater white matter damage in the brain was tied to decreased driving, fewer trips, repetitive routes and more driving errors, especially among people who later developed dementia.

White matter damage in the back part of the brain – which helps people process visual information and coordinate movement – was most strongly tied to unsafe driving and crashes, researchers said.

“Participants with white matter hyperintensities located in the back of the brain — a region responsible for processing what people see and how they move — were at even higher risk of crashes than those with changes in other brain areas, making them more likely to experience unsafe driving episodes and car accidents over time," Phuah explained.

However, seniors who were taking blood pressure medicines – especially ACE inhibitors – were less likely to show risky driving behaviors, even when brain damage was present, the study found.

“This effect was observed regardless of whether their blood pressure levels were at target levels,” Phuah said. “This suggests that these medications may help support brain health as we age.”

American Stroke Association spokesperson Dr. Nada El Husseini called the results related to blood pressure medicine “surprising.”

“The impact of ACE inhibitors on cognitive function and driving safety in people with white matter disease requires further investigation. Also, these results suggest cognitive screening and brain imaging might be considered for people with driving difficulties,” El Husseini said in a news release. She’s a professor of neurology at Duke University Medical Center in Durham, North Carolina, and was not involved in the study. 

Pam Duncan, who now volunteers for the ASA, said her husband’s case demonstrates that such changes in driving habits shouldn’t be waved off as meaningless. 

“In early-stage cognitive impairment, symptoms can be subtle, and driving is one of them,” she said.

“Don’t ignore these changes,” Duncan continued. “As caregivers, our role is to support independence while having the courage to make tough decisions. You can live well with dementia, but it starts with awareness and action.”

The findings are scheduled to be presented Thursday. 

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The Alzheimer’s Association has more on early signs of dementia.

SOURCE: American Stroke Association, news release, Jan. 29, 2026