ASA: White matter hyperintensity burden tied to future decline in older adults' driving ability

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White matter hyperintensity (WMH) burden predicts functional decline in real-world driving among older adults, according to a study scheduled to be presented at the annual American Stroke Association International Stroke Conference, held from Feb. 4 to 6 in New Orleans.

Chia-Ling Phuah, M.D., from the Barrow Neurological Institute in Phoenix, and colleagues examined the relationship between WMH burden (quantified using deep learning-based magnetic resonance imaging segmentation) and longitudinal real-world driving behavior. Analysis included 220 community-dwelling adults ≥65 years without dementia at baseline.

The researchers found that greater WMH burden was associated with reduced driving frequency, trip diversity, and adaptability at baseline and with faster decline in these outcomes over time. Over a mean follow-up of 5.6 years, 17% of participants with greater WMH burden developed cognitive impairment. WMH burden predicted more crashes and hard braking, with posterior WMH growth conferring the highest crash risk (β = 0.59).