White Matter Hyperintensity Burden and Decline in Driving Performance Among Older Adults

How is total or regional white matter hyperintensity (WMH) burden associated with longitudinal changes in naturalistic driving performance among older adults?In this cohort study of 220 cognitively normal older adults followed up longitudinally, greater baseline and progressive WMH burden, particularly in posterior regions, was associated with reduced driving frequency, complexity, and safety, especially among participants who later developed cognitive impairment. In the unadjusted model, antihypertensive therapy was associated with reduced WMH-related adverse driving behaviors; however, there was no association after adjustment.This study suggests that posterior WMH burden may serve as a biomarker of increased driving risk in older adults.

Corresponding Author: Chia-Ling Phuah, MD, MMSc, Barrow Neurological Institute, 240 W Thomas Rd, Ste 400, Phoenix, AZ 85013 (cphuah@barrowneuro.org).

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