WHITE MATTER HYPERINTENSITIES AND DRIVING BEHAVIOR - MITIGATING EFFECTS OF HYPERTENSION TREATMENT - Innovation in Aging 2025 Vol. 9 No. S2 113

Q: How were WMH and driving behavior measured in this study?

WMH were quantified using deep learning, and driving behavior was assessed through longitudinal in-vehicle dataloggers capturing multiple driving metrics over time.

Q: Did hypertension treatment affect the relationship between WMH and driving decline?

Anti-hypertensive medication users showed less decline in driving frequency and complexity over time, suggesting potential mitigation of WMH-related driving changes.

Sep 28, 2026

Uploaded by Damian

White matter hyperintensities (WMH) can erode cognitive reserve and may hasten dementia. Using longitudinal naturalistic driving data, the study examined 212 cognitively intact older adults in the DRIVES Project cohort. Deep-learning WMH quantification and linear mixed-effects models assessed WMH effects on changes in 16 driving metrics over 74,275 weeks (2015–2024). Higher WMH burden was linked to reduced trip frequency, fewer near-home trips, fewer unique destinations, and lower driving entropy over time. Posterior WMH in parietal and occipital regions related to driving complexity decline, with stronger effects in those developing cognitive impairment, while anti-hypertensive medication users showed less decline.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Abstract

Study design and participants

Outcomes in driving performance

Regional WMH associations

Role of cognitive impairment and antihypertensive treatment

Innovation in Aging, 2025, Vol. 9, No. S2 113 Abstract citation ID: igaf122.376 WHITE MATTER HYPERINTENSITIES AND DRIVING BEHAVIOR: MITIGATING EFFECTS OF HYPERTENSION TREATMENT David Carr1, Madhur Parihar2, Jin-Moo Lee3, Ganesh Babulal4, Yasheng Chen5, and Chia-Ling Phuah2, 1. Washington University in St. Louis, St Louis, Missouri, United States, 2. Barrow Neurological Institute, Phoenix, Arizona, United States, 3. Washington University in St. Louis, St. Louis, 114 Innovation in Aging, 2025, Vol. 9, No. S2 Missouri, United States, 4. Washington University School of Medicine in St. Louis, SAINT LOUIS, Missouri, United States, 5. WashU Medicine, St. Louis, Missouri, United States White matter hyperintensities (WMH) compromise cognitive reserve, potentially accelerating dementia onset. We investigated WMH’s impact on complex cognitive performance through longitudinal analysis of naturalistic driving behavior in older adults (OA) . We examined 212 cognitively intact OA (aged >65 years, CDR=0) in the DRIVES Project cohort, analyzing 16 driving metrics using in-vehicle dataloggers, and quantifying WMH using deep learning. Linear mixed-effects models, adjusted for demographics, socioeconomic status, and composite vascular risk, assessed WMH influence on longitudinal changes in driving performance. Our study analyzed 74,275 weeks of driving data (2015-2024, average follow-up of 6.1 years). Higher WMH burden correlated with decreased trip frequency, fewer near-home trips, reduced unique destinations, and lower driving entropy over time (all p < 0.002). Posterior WMH lesions, particularly in parietal and occipital regions, were primarily linked to driving complexity decline (beta=-0.16, p = 0.009, beta =-0.15, p = 0.01, respectively). WMH impact intensified in participants developing cognitive impairment (n = 36), manifesting as increased hard braking and impact events. Anti-hypertensive medication users (n=147) showed less decline in driving frequency and complexity (p = 0.03) . WMH in OA significantly impacts driving behavior, leading to latent self-regulation and reduced driving complexity. Anti-hypertensive use may mitigate WMH effects on driving behavior change over time, despite posterior WMH suggesting a prominent role for AD in driving decline, warranting further study of blood pressure treatment. WMH shows potential as abiomarker for identifying individuals at higher risk of unsafe driving and early cessation, underscoring its value in screening and intervention for road safety among aging populations.

FAQs

How were WMH and driving behavior measured in this study?

WMH were quantified using deep learning, and driving behavior was assessed through longitudinal in-vehicle dataloggers capturing multiple driving metrics over time.

What driving outcomes were associated with higher WMH burden?

Higher WMH burden correlated with decreased trip frequency, fewer near-home trips, fewer unique destinations, and reduced driving entropy over time.

Did hypertension treatment affect the relationship between WMH and driving decline?

Anti-hypertensive medication users showed less decline in driving frequency and complexity over time, suggesting potential mitigation of WMH-related driving changes.

Sep 28, 2026

Uploaded by Damian