Thursday, January 29, 2026

 

Older adults’ driving habits offer window into brain health, cognitive decline



American Stroke Association International Stroke Conference 2026, Abstract A111



American Heart Association

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Research Highlights:

  • A study of over 200 adults followed for five years found that greater white matter damage in the brain was linked to decreased driving, fewer trips, repetitive routes and having more driving errors, especially in those who later developed dementia.
  • In contrast, adults ages 65 and older who were taking blood pressure medicines, particularly ACE inhibitors, were less likely to show risky driving behaviors, even when brain damage was present (evidence of white matter damage caused by reduced blood flow to brain tissue).
  • Subtle changes in everyday driving habits may be early warning signs of brain changes and higher dementia risk, even before traditional memory and thinking symptoms appear, the researchers noted.
  • White matter damage in the back part of the brain, which helps people process what they see and coordinate movement, was most strongly tied to unsafe driving and crashes, pointing to a potential early warning marker for higher driving risk in older adults.
  • Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association/American Stroke Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 4 a.m. CT/5 a.m. ET, Thursday, Jan. 29, 2026

DALLAS, Jan. 29, 2026 — Older adults’ driving habits revealed clues about their brain health and may provide early warning signs of cognitive decline or dementia, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2026. The meeting is in New Orleans, Feb. 4-6, 2026, and is a world premier global event dedicated to advancing stroke and brain health science.

“Driving habits in older adults can reveal early changes in brain health. 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,” said study author Chia-Ling Phuah, M.D., M.M.Sc., an associate professor of neurocritical care and co-director of the Neuro Analytics Center at Barrow Neurological Institute in Phoenix. “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.”

According to the American Heart Association 2026 Heart and Stroke Statistics, about 6.9 million (10.9%) – or 1 in 9 - adults 65 years or older in the United States were living with Alzheimer’s disease in 2024.

Researchers reviewed driving habits for 220 adult volunteers, ages 65 and older, living independently in St. Louis, Missouri. Detailed cognitive assessments indicated participants were free of dementia at the start of the study. Car sensors were used to track participants’ driving behavior (including speeding, collisions, hard braking or hard cornering) for more than five years. They conducted additional brain imaging studies within the first year of the study to measure changes in the brain’s white matter, specifically white matter hyperintensities — areas of white matter damage caused by reduced blood flow to brain tissue.

The analysis found:

  • Older adults who had more white matter hyperintensities tended to drive less and show sharper declines in their willingness or ability to change driving routes and habits.
  • Over more than five years of follow-up, 17% of participants developed cognitive impairment and most of these individuals were later diagnosed with Alzheimer’s disease.
  • Among the 17% of participants who developed cognitive impairment, higher white matter hyperintensity burden on brain imaging was linked to a greater likelihood of unsafe driving practices, such as hard braking, and to more crashes.
  • “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.
  • Participants taking medications to manage high blood pressure, especially angiotensin-converting enzyme (ACE) inhibitors, were less likely to exhibit risky driving when compared with those who were not taking any blood pressure medication.

Overall, the study’s findings suggest that monitoring driving behavior with commercial in-vehicle data loggers may help identify older adults at higher risk for unsafe driving, loss of independence and subtle cognitive problems, Phuah noted.

“One especially promising finding was that people taking blood pressure medications, particularly ACE inhibitors, tended to maintain safer driving habits even when their brain scans revealed more damage. 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.”

Nada El Husseini, M.D., M.H.Sc., FAHA, chair of the American Heart Association’s 2023 scientific statement, Cognitive Impairment After Ischemic and Hemorrhagic Stroke said, “What’s surprising about these findings is that people taking ACE inhibitors were less likely to have impairment in their driving despite the extent of white matter disease. 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 is an associate professor of neurology at Duke University Medical Center in Durham, North Carolina and was not involved in this study.

Normal blood pressure is less than 120/80, and treatment is recommended for people with blood pressure levels 140/90 mm Hg or higher (stage 2 hypertension). Recent research confirms that blood pressure affects brain health, including cognitive function and dementia, so early treatment is recommended for people diagnosed with high blood pressure to maintain brain health and cognition, according to the 2025 American Heart Association High Blood Pressure Guideline.

Key limitations include a small study size, most participants were white, college-educated adults, so results may not generalize to people from more diverse backgrounds, and medication use was self-reported, which could introduce errors.

The next step will be larger studies that include more diverse participants to confirm and extend these findings.

Study details, background and design:

  • The study included 220 adults (average age of 73 years; 54% men, 46% women, 88% white and 12% Black) living in St. Louis, Missouri, who did not have dementia when they enrolled in the study.
  • Data was collected over a nine-year period, from 2016 to 2024, as part of the Driving Real-World In-Vehicle Evaluation System (DRIVES) project based at Washington University in St. Louis.
  • Participants were monitored for continuous in-vehicle driving metrics, such as trip frequency, distance and destination, as well as safety events, including time spent speeding, collisions, hard braking or hard cornering.
  • All participants had brain magnetic resonance imaging (MRI) scans to measure white matter hyperintensities at enrollment, which was around the time they started their driving assessments. About half (102 participants) had a second MRI scan at least 12 months after their first scan. Participants also underwent annual clinical and cognitive assessments.
  • Researchers analyzed the relationship between total and regional white matter hyperintensities and driving patterns and safety.
  • Statistical models were used to adjust for demographics, social/economic factors and health factors.

Patient perspective: A caregiver’s view of driving and cognitive decline

For Larry Duncan, a retired business owner from Pinehurst, North Carolina, driving was part of his independence. But subtle changes began to appear before his Alzheimer’s diagnosis in 2023. “Larry was fine driving in familiar areas,” recalls his wife and caregiver, Pam Duncan. “But in new places where he had to make quick decisions, he became anxious.”

As his cognitive challenges progressed, Duncan’s doctor advised him to stop driving, a decision she describes as heartbreaking but necessary.

“In early-stage cognitive impairment, symptoms can be subtle, and driving is one of them,” said Pam Duncan, who now volunteers for the American Stroke Association, a division of the American Heart Association. “Don’t ignore these changes. 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.”

Women with stroke history twice as likely to have another during or soon after pregnancy


American Stroke Association International Stroke Conference 2026, Abstract DP006



American Heart Association

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Research Highlights:

  • Female stroke survivors were more than twice as likely as their stroke-free counterparts to have another stroke while pregnant and in the six weeks after childbirth, according to an analysis of a large national database of electronic health records.
  • In addition, the risk of ischemic stroke during pregnancy and the early postpartum period was 82% more likely among pregnant women who had a previous heart attack and 25% more likely in women with obesity.
  • Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association/American Stroke Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as full manuscripts in a peer-reviewed scientific journal.

Embargoed until 4 a.m. CT/5 a.m. ET, Thursday, Jan. 29, 2026

DALLAS, Jan. 29, 2026 — Having had a stroke caused by blocked blood vessels (ischemic stroke) more than doubled an expectant mother’s odds of having another stroke during pregnancy and within six weeks of childbirth, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2026. The meeting is in New Orleans, Feb. 4-6, 2026, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

“A common question for women is whether to risk pregnancy after a previous ischemic stroke. Our analysis found that women are at a greater risk of recurrent ischemic stroke during pregnancy and in the six weeks after giving birth, and the increased risk is not influenced by other risk factors,” said study lead author Adnan I. Qureshi, M.D., a professor of neurology at the University of Missouri in Columbia, Missouri, and founder of Zeenat Qureshi Stroke Institutes. “Now, women and their health care professionals can make a more informed decision about the risks related to pregnancy. Women who have experienced a stroke and become pregnant need additional attention to ensure they get the highest level of care to reduce their risk of another stroke.”

Using electronic health records from hospitals across the U.S., researchers analyzed the risk of new ischemic stroke in women ages 15 to 50 with and without a history of previous stroke who had recently delivered a baby (considered the early postpartum period). They compared the rates of strokes from 2015 to 2025 in women who had a recurrent stroke in pregnancy or soon after childbirth with the other women who had a first-time stroke during the same period.

The analysis found:

  • The stroke rate was higher in pregnant women who had a prior stroke compared to those who had been stroke-free: 415 new ischemic strokes among 1,192 pregnant women who had a previous stroke (34.82%) compared to 737 new strokes among 219,287 (0.34%) pregnant women without a history of ischemic stroke.
  • Among 1,192 pregnant women with a history of stroke, 415 new strokes occurred during pregnancy and soon after childbirth.
  • Out of 219,287 pregnant women without a prior stroke, 737 new strokes occurred during the same period.
  • After adjusting for demographic and health factors, such as race, other medical conditions and medications, women who had a history of prior stroke were more than twice as likely to have a second stroke during pregnancy and in the early postpartum period compared with those who had no previous stroke.
  • The risk of ischemic stroke during pregnancy and the early postpartum period was 82% more likely among pregnant women who had a previous heart attack and 25% more likely in women with obesity.

According to Jennifer Lewey, M.D., M.P.H., chair of the writing committee of the 2024 American Heart Association Scientific Statement: Opportunities in the Postpartum Period to Reduce Cardiovascular Disease Risk After Adverse Pregnancy Outcomes, “Stroke during pregnancy or the early postpartum period can have devastating long-term consequences for the mother and her family. The results of this study give us an opportunity to think about how to prevent maternal stroke among those at highest risk. Women with prior ischemic stroke should receive pre-conception counseling to discuss stroke risk during pregnancy and risk reduction. Furthermore, an interdisciplinary team of neurologists and obstetricians can develop a surveillance and treatment plan during pregnancy and the postpartum period.” Lewey is also director of the Penn Women’s Cardiovascular Health Program and an assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine in Philadelphia and was not involved in this study.

Study authors say that the risk of having another stroke during pregnancy and soon after childbirth means preventive efforts should be intensified for women with a history of ischemic stroke. Future research will need to explore how specifically to lower the risk of a second stroke in this group of women. Identifying the cause of the first stroke, reviewing medications during pregnancy, managing blood pressure, eating a healthy diet and regular physical activity are proven strategies to reduce the risk of additional strokes.

“Attention should be brought to the fact that this is a very high-risk pregnancy. Women who are pregnant and with a history of stroke should be managed at health care centers that have experience with high-risk pregnancies. There are no clinical guidelines for the management of these high-risk pregnancies. Hopefully, this study will promote the identification and categorization of these women in the high-risk pregnancy group so they can get a higher level of care from the beginning,” Qureshi said.

The study is an observational analysis that relies on data from a large database of electronic health records, which is a limitation of the findings.

Study details, background and design:

  • The analysis included 220,479 pregnant women (ages 15 to 50 years old) with and without a previous ischemic stroke.
  • Participants were 60.74% white women, 21.81% Black women, 1.34% Asian women, .17% Native American women and 15.94% other race.
  • Researchers used the Oracle Health Real-World Data, a large U.S. national database of electronic health records, to analyze the rate of ischemic stroke in pregnant women between 2015 and 2025. They compared the rate of second stroke during pregnancy and in the postpartum period with the rate of first-time stroke during the same period.

Patient Perspective: Pregnancy after stroke

Leslie Jordan was starting out her law career in Charlotte, North Carolina, when she experienced a life-altering ischemic stroke shortly after giving birth to her first child in 2018. What began as a joyful moment turned into a frightening experience. Recovery was slow and challenging, marked by small victories like holding her baby, taking her first steps and, years later, driving again.

When Jordan became pregnant again in 2025, she knew this pregnancy carried significant risk. She worked closely with her obstetrician and neurologist to assemble a team of specialists and created a proactive plan that included daily blood thinner injections, baby aspirin, exercise and a diet focused on lean proteins and whole foods.

“After my stroke, I knew this pregnancy would be high risk. I focused on building a care team that understood my risks and could support me every step of the way,” said Jordan, who now volunteers for the American Stroke Association, a division of the American Heart Association. “Focus on what you can control and give yourself grace. It’s possible to have a healthy pregnancy after something as scary as a stroke.”

Stimulating the brain with electromagnetic therapy after stroke may help reduce disability



American Stroke Association International Stroke Conference 2026, Abstract A071


American Heart Association

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Research Highlights:

  • Electromagnetic network-targeted field (ENTF) therapy, which targets specific connections in the brain, combined with physical therapy, significantly reduced disability in stroke survivors after 90 days.
  • An analysis of two small clinical trials suggests that ENTF therapy is safe and works well in reducing overall disability after stroke.
  • Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association/American Stroke Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 4 a.m. CT/5 a.m. ET, Thursday, Jan. 29, 2026

DALLAS, Jan. 29, 2026 — A type of therapy that stimulates specific brain pathways with electromagnetic pulses combined with physical therapy significantly reduced overall disability in stroke survivors compared to survivors who received sham (inactive) electromagnetic stimulation combined with physical therapy, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2026. The meeting is in New Orleans, Feb. 4-6, 2026, and is a world premier global event dedicated to advancing stroke and brain health science.

Although advances in stroke treatments have saved lives, many survivors still face disabilities that prevent them from returning to their normal daily activities. According to researchers, one promising treatment, called electromagnetic network-targeted field (ENTF) therapy, stimulates the interconnected networks related to motor movement, cognitive functions and other brain activities.

“These neural networks show electrical disorganization after a stroke. Stimulating these networks with electromagnetic pulse patterns derived from studies in people who have not had a stroke can model and facilitate the reestablishment of normal network organization,” said lead study author Jeffrey L. Saver, M.D., FAHA, who is a distinguished professor, SA vice chair for Clinical Research, and holder of the Carol and James Collins (endowed) chair in the department of Neurology at the David Geffen School of Medicine at UCLA. “This therapy has shown beneficial effects upon organized brain electrical activity and, most importantly, was associated with improved functional recovery for patients after stroke.”

Researchers examined the combined data from two double-blind, randomized, controlled studies (meaning both participants and researchers did not know who received actual vs. placebo or sham treatment) to characterize the potential effects of ENTF therapy on reducing disability after ischemic stroke. In total, 124 stroke survivors were included in the analysis: 65 were treated with ENTF therapy, and 59 received an inactive or sham treatment. Participants were enrolled in the study on average 14 days after their stroke occurred and were moderately to severely disabled; the average modified Rankin Scale (mRS) score was 3.9 at enrollment. All participants received 40 to 45 sessions of ENTF therapy or sham treatment over 8 to 12 weeks, and both groups received physical therapy during the stimulation sessions. In both trials, participants began ENTF therapy in the hospital and continued with at-home treatments using portable kits. Participants were assessed for overall disability and their motor and cognitive abilities after three months of treatment.

The analysis found:

  • The percentage of participants who achieved freedom from disability was 22% higher in the ENTF group compared to the group that received the sham treatment (33.8% versus 11.9%, respectively).
  • Measurable improvements were also seen in ENTF participants’ disability levels across the full range of disability outcomes, with both less moderately to severe disability (mRS of 3-5) and less moderate disability (mRS of 2).
  • No serious adverse effects were reported among participants who received ENTF therapy.

“It’s clear that we need more effective rehabilitation therapies to fully improve patient outcomes. This promising potential therapy is unique in that it would be able to be conducted at home by the stroke survivor using a portable kit,” Saver said.

American Stroke Association volunteer expert Joseph P. Broderick, M.D., FAHA, said, “This study examines two small trials of electromagnetic network-targeted field (ENTF) therapy for stroke patients. The results are preliminary, highlighting the need for larger trials with balanced participant groups to assess the therapy’s effectiveness. ENTF showed no safety issues, and there’s a strong demand for new recovery methods post-stroke.” Broderick is a professor at the University of Cincinnati’s Gardner Neuroscience Institute, part of the University of Cincinnati College of Medicine in Ohio and was not involved in this study.

The main limitation of the study is that it is an analysis of data from two small pilot studies. A single, larger trial is needed to confirm these results.

In the United States, stroke is the fourth leading cause of death and a leading cause of long-term disability, according to the American Heart Association’s Heart Disease and Stroke Statistics 2026 Update. Depending on the part of the brain affected, stroke may impair arm and/or leg movement and activities of daily life among survivors. Motor impairment (arm and/or leg weakness) is the most common complication after stroke.

Study details, background and design:

  • The study included 124 adults who had an ischemic stroke, and a baseline modified Rankin Score (mRS) of 3.9, indicating moderate to severe disability. Participants’ average age was 58 years and 31% were women.
  • Data were derived from two double-blind, randomized, sham-controlled trials (the BQ3 and EMAGINE trials, conducted between 2021 and 2025). Researchers combined the individual patient data into a single meta-analysis to characterize the potential effects of ENTF therapy on overall disability after stroke.
  • Participants in these two trials were randomized to receive either ENTF therapy or a sham treatment between four and 21 days after stroke. Sixty-five (65) participants received 40-45 sessions of ENTF therapy, and 59 received the sham intervention. Both groups also received physical therapy as part of their stroke rehab care.
  • The primary outcome of the analysis was for participants to be disability-free, as measured by an mRS score of 0-1, at 8-12 weeks.

Co-authors, disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies that are presented at the American Heart Association/American Stroke Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

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About the American Stroke Association

The American Stroke Association is a relentless force for a world with fewer strokes and longer, healthier lives. We team with millions of volunteers and donors to ensure equitable health and stroke care in all communities. We work to prevent, treat and beat stroke by funding innovative research, fighting for the public’s health, and providing lifesaving resources. The Dallas-based association was created in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit stroke.org. Follow us on Facebook and X.



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