White matter hyperintensities as a new predictor of driving cessation in the elderly

Abstract

Background/aims

Motor, perceptual, and cognitive functions affect driving competence. White matter hyperintensities (WMH) changes on brain MRI are associated structural brain changes along with cognitive and motor performance. The aim of this study was to investigate the association between WMH and driving ability in the elderly.

Methods

Participants (n = 540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort study. Each participant underwent clinical evaluations, neuropsychological tests, and interview for caregiver including driving capacity, which was categorized as ‘now driving’, and ‘driving cessation (driving before, not now)’. A total 540 participants were divided into three groups (389 mild, 116 moderate, and 35 severe) depending on the degree of WMH. The same evaluations of them were followed after each year. The statistical analyses were performed using χ² test, an analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE).

Results

In a SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive and motor dysfunction (β = –0.110, P < 0.001). In GEE models controlling for age, sex, education, cognitive, and motor dysfunction, the more severe changes of the degree of WMH was associated with the faster change from ‘now driving’ state to ‘driving cessation’ state over time in the elderly (β = –0.508, P < 0.001).

Conclusion

In both cross-sectional and longitudinal aspects, the degree of WMH might be one of the predictive factors for driving cessation in the elderly, reflecting both motor and cognitive functions or independently.

Disclosure of interest

The authors have not supplied their declaration of competing interest.