Memory problems and driving: why remembering a route is not enough
The thinking skills safe driving needs and how a driving evaluation checks them
You may know the way to the grocery store by heart. You have driven it hundreds of times, and you could name every turn. So when your doctor or your family says you are not ready to drive, it can feel unfair.
The route is only a small part of any trip. Most of driving happens between the turns, when a car drifts toward your lane or a child steps off the curb. Moments like that give you a second or two to see the problem and respond.
This article covers the other thinking skills driving uses, the warning signs to watch for and how a driving evaluation checks each one. It is written for survivors and for the family members who ride with them.
Why knowing the way can feel like proof
After a brain injury, memory often changes unevenly. Learning new information and recalling recent events tend to suffer most. Older memories, like the streets of your hometown, usually hold up better [1]. That is why you might recall a route from 10 years ago but forget where you parked this morning. You can read more in Why can I remember years ago but forget yesterday?
Driving researchers often describe three levels of driving [2]:
- Planning: choosing where to go, when to leave and which roads to take. Route memory lives here.
- Handling traffic: judging gaps, keeping a safe distance, adjusting speed, scanning and responding to signals.
- Controlling the car: steering, braking and keeping the car steady in its lane.
A 2026 review of 36 studies looked at the mistakes brain injury survivors made in simulators and on real roads. Survivors made more errors than uninjured drivers at the middle level [2]. Common slips included following too closely, drifting within the lane, poor speed changes, reacting late to signals and not scanning enough [2]. Basic car control errors showed up less often [2]. Route memory helps only at the planning level, and the most frequent problems turned up one level down, in moment to moment traffic.
What one left turn asks of your brain
Picture yourself waiting to turn left at a busy light. You know exactly where you are going. Now think about everything else you need to do in the next few seconds:
- Watch the oncoming cars and judge how fast they are coming.
- Keep in mind the bicycle you saw in your mirror a moment ago.
- Check the crosswalk you are about to turn across.
- Ignore the phone buzzing in the cup holder.
- Notice the light turn yellow and decide whether to go or wait.
- Move your foot to the gas or the brake at the right moment.
Each step leans on a different skill. You need speed of thinking, a short term mental notepad, scanning, focus, judgment and quick reactions. Memory for the route plays almost no part. If even one of those skills is slowed, the whole turn becomes riskier.
The thinking skills driving uses beyond memory
The table below matches each skill with what it looks like in the car and a sign that it may be a problem. Anyone can have an off moment, so watch for signs that come back over several drives. A repeating pattern is the reason to get checked.
Comparison compiled by Safety Behind the Wheel Foundation
Thinking skills behind the wheel
| Skill | What it means | On the road | Possible warning sign |
|---|---|---|---|
| Focused attention | Keeping your mind on one task | Staying alert for a whole trip, even a dull one | Missing a stop sign on a quiet road |
| Divided attention | Handling two or more things at once | Watching traffic while a passenger talks or the GPS speaks | Going silent, slowing down or missing signals when things get busy |
| Processing speed | How fast you take in and make sense of what you see | Noticing brake lights ahead in time | Braking hard and late; other drivers honking |
| Working memory | Holding a few facts in mind for a few seconds while you use them | Remembering the car in your blind spot while you look ahead | Starting a lane change into a car you had already seen |
| Visual scanning | Moving your eyes across mirrors, sides and the road ahead | Spotting a walker at the edge of a parking lot | Seeming surprised by cars, people or signs |
| Judgment and problem solving | Weighing choices and picking a safe one | Deciding if a gap is big enough; handling a detour | Misjudging space when stopping or turning |
| Reaction time | How quickly your hands and feet respond | Braking when the car ahead stops short | Near misses and new scrapes or dents |
| Self awareness | Knowing your own limits | Choosing not to drive when tired or upset | Saying driving is fine while passengers feel unsafe |
| New learning | Storing new information | Following a new route or remembering a road closure | Getting lost, even in familiar places |
Memory still matters. Brain injury groups list getting lost in a familiar area as a warning sign [4, 8]. Losing your way is a reason to stop and get checked. Finding your way, by itself, does not clear you to drive.
What research shows about memory tests and driving
Researchers have tried to learn which office tests best predict how someone will do on a real road test. Memory tests turn out to be among the weaker ones.
- A 2023 review looked at ways to test driving after brain injury. Memory tests, on their own, did a poor job of predicting road test results, and tests of attention and thinking speed lined up more often [3].
- Two tests come up again and again. The Useful Field of View (UFOV) is a computer test of how much you can take in at a glance, even while splitting your attention. Trail Making Part B is a timed task of connecting numbers and letters in turn. In people with a brain injury, both were linked to how they drove on the road [9].
- People tested within a day of a mild head injury were slower to spot hazards in traffic video clips. The comparison group had minor bone or joint injuries [10].
- A small simulator study tested young adults with a concussion, which is a mild brain injury from a blow or jolt. They drove within two days after their symptoms cleared. Even so, they drifted out of their lane more often than matched peers, most of all on curves [11].
One research team concluded that no test, or set of tests, can reliably predict safe driving after a brain injury. They called for a full assessment with both office and road parts [12]. A federal guide for state licensing agencies agrees. It says an office exam alone is rarely enough, and road or simulator testing is often needed [7].
The awareness gap: why you may feel ready before you are
Knowing your own abilities is a brain skill too. An injury can dull it the same way it slows reaction time. Many people with a brain injury cannot see their own driving problems. That is why family, friends and the care team should share in the decision [4].
In one study of moderate to severe brain injury, people who failed an on road test had rated their own driving too highly [5]. Poorer awareness went along with slower thinking speed and more trouble shifting attention [5]. People with more depression or anxiety tended to rate their driving lower, so mood can color your self judgment as well [5].
If you are a family member, one practical step is to ride along and watch calmly over several trips.
Checklist from Safety Behind the Wheel Foundation
Signs to watch for on a ride along
- Speed is often well above or below the flow of traffic
- Stop signs, lights or speed limit changes get missed
- The car drifts over lane lines or hugs the edge of the road
- Stops come too late, or turns are too wide or too tight
- The driver needs you to point out hazards or give directions
- The driver gets lost on a route they know well
- Traffic leaves the driver angry, rattled or confused
- There are near misses or new dents and scrapes
- Close calls are always another driver’s fault
These signs come from lists published by brain injury and driver rehabilitation groups [4, 8]. If you see several, talk with the care team before the next drive. You do not have to argue in the car. A few written notes with dates give the care team something concrete to work with.
How a comprehensive driving evaluation tests these skills
A comprehensive driving evaluation is the most complete check of driving readiness after a brain injury. A federal guide written for state licensing agencies recommends this kind of evaluation for many people after a brain injury [7]. It is usually done by an occupational therapist with driver rehabilitation training. Some hold the certified driver rehabilitation specialist (CDRS) credential [4, 8].
The evaluation usually has two parts.
The clinic visit. At one university program, this visit takes about two hours [6]. It covers:
- Vision, including sharpness, side vision and depth perception [6]
- Physical skills, including strength, range of motion, coordination, balance and reaction speed [6]
- Thinking skills, including attention, memory, judgment, reasoning, recognizing road signs and visual spatial skills, which means judging space and where things are [4, 6]
The road test. You drive the program’s car with the evaluator. At the same program, the drive starts in a parking lot or on quiet streets. It moves to busier roads or the highway if things go well [6]. You may be asked to follow written directions [6]. Some programs use a driving simulator for part of this step [4]. The road portion requires a current driver’s license or learner permit [6].
On the road, the evaluator can watch the skills from the table at work. That includes how you scan at a busy corner, whether a passenger’s question throws you off, and what you do when a car pulls out.
Possible results include returning to driving or taking lessons on response time, judgment or finding your way [4]. Other outcomes are car changes such as hand controls, or using other ways to get around [4]. Many people who return choose limits such as daylight driving, good weather or familiar roads [4]. If the answer is not yet, ask what would need to change and when a recheck makes sense.
The evaluator does not issue or take away your license. That decision belongs to your state’s licensing agency [6]. Rules differ by state. Some states limit driving for a period after a serious brain event or a seizure [4]. Some require an evaluation even if your license is still valid [4]. The 2026 guide to medically at risk driver laws by state has details.
Ask about cost before you book. State vocational rehabilitation agencies may help pay for an evaluation or car changes [4]. To find an evaluator, ask your rehabilitation team for a referral or search the ADED directory of certified specialists [4].
What you can do while you wait
Ask your care team about driving directly. A CDC survey asked adults describing their most serious concussion whether a doctor or nurse had talked with them about when to drive. Only about 1 in 5 said yes. Those who did have that talk were far less likely to get behind the wheel within a day of the injury [13]. Do not wait for someone else to bring it up.
Stay off the road right after any new head injury. People are slower to spot hazards in the first day after a mild head injury [10]. CDC also advises health professionals to be careful about clearing anyone to drive while attention, processing speed or reaction time is affected [14].
Keep track of what changes your thinking from day to day. Poor sleep, tiredness, pain, stress and some medicines can all make you slower. Bring a short list to your next visit. These pages can help: why memory seems worse when you are tired and how medicines, alcohol or cannabis can affect memory.
Do not use a game or quiz as your driving test. Memory games and brain apps can be fun practice, and the memory games on this site are meant as recreational or educational practice. None of them measures whether you can drive. The page on brain games and everyday memory covers what practice games can and cannot do.
Plan other rides for now. Rides from family, public transit and ride services can keep your week moving. The page on staying connected when you cannot drive has ideas.
Get help right away
Call 911 or go to an emergency department if, after a head injury, you or someone you care for has a headache that gets worse, weakness or numbness, a seizure, repeated vomiting, slurred speech, new confusion or drowsiness that will not lift [15]. A memory change that gets worse quickly also needs prompt medical care. Keep the concussion and TBI red flag checklist handy.
Questions to ask your care team
Question checklist from Safety Behind the Wheel Foundation
- Which thinking skills that matter for driving are still affected, based on my testing?
- Should I have a comprehensive driving evaluation before I drive again, and can you refer me?
- Could any of my medicines, my sleep or my fatigue be slowing my attention or reaction time?
- Does my state have rules I need to follow after my injury or after a seizure?
- If I am not ready now, what would need to change, and when should we check again?
- If I do return, would limits such as daylight only or short trips make sense for me?
- Who can help me plan rides while I am not driving?
Frequently asked questions
Can you drive with memory problems after a brain injury?
Some people can, but memory is only one part of the answer. Attention, thinking speed, judgment, reaction time and awareness of your limits matter as much or more [3, 4]. A comprehensive driving evaluation is the best way to find out where you stand [7].
How long after a concussion can you drive?
Your health care provider should decide this with you, based on your symptoms and how well you focus and react [14]. Do not drive on the day of the injury, and after that, wait until your provider says it is safe [10, 14]. Driving skills may lag even after symptoms fade, so ask whether you need testing first [11].
What happens during a driving evaluation?
You usually have a clinic visit that tests vision, movement and thinking, followed by a drive with the evaluator [4, 6]. The drive often starts somewhere quiet and moves to busier traffic if things go well [6]. You then get recommendations that are shared with your doctor.
Is a memory test enough to show I can drive?
No. Studies find that memory tests on their own predict road test results poorly, while tests of attention and processing speed do somewhat better [3]. Even those office tests cannot replace a road test [3, 12].
Who decides whether I can keep my license?
Your state’s licensing agency makes the legal decision [6]. Doctors and driving evaluators share information and advice, and the rules for reporting and retesting differ by state [4]. This is general information, not legal advice.
Will I be able to drive again after a brain injury?
Many people do. Research gathered in a federally funded fact sheet suggests about 60 to 70 percent of people with a brain injury drive again [4]. Many of them drive less or avoid heavy traffic [4]. Some people need lessons first, and some need a longer break.
The bottom line
Recommendation from Safety Behind the Wheel Foundation
Knowing the way home is a good sign for your older memories, but it is a weak test of whether you can drive safely. Driving depends on attention, thinking speed, scanning, judgment, reaction time and an honest read of your own limits. After a brain injury, ask your care team about a comprehensive driving evaluation before you drive again. Line up other rides until you have an answer.
Related articles
Sources and further reading
- 1Hart T, Sander A. “Memory and Traumatic Brain Injury.” Model Systems Knowledge Translation Center (MSKTC), 2016. msktc.org/…/memory-and-traumatic-brain-i…
- 2Kubota J, Tiwari A, Kaneko T, Lodha N, Sotokawa T. “Driving behaviour in simulator and on-road assessments in brain injury and stroke: a scoping review.” Brain Injury, 2026. Plain language summary by Headway. headway.org.uk/…/driving-behaviours-in-brain-…
- 3Alhashmi D, Lalor A, Fossey E. “Methods to evaluate driving competence for people with acquired brain injury (ABI): a systematic review.” Frontiers in Rehabilitation Sciences, 2023. frontiersin.org/…/full
- 4Model Systems Knowledge Translation Center. “Driving After Traumatic Brain Injury.” MSKTC, 2024. msktc.org/…/driving-after-traumatic-brai…
- 5Gooden JR, Ponsford JL, Charlton JL, et al. “Self-awareness and self-ratings of on-road driving performance after traumatic brain injury.” Journal of Head Trauma Rehabilitation, 2017. research.monash.edu/…/self-awareness-and-self-rati…
- 6Vanderbilt University Medical Center. “Driver Rehabilitation: What to Expect.” Vanderbilt Health, 2020. files.vanderbilthealth.com/…/Driver%20Rehabilitation_What…
- 7National Highway Traffic Safety Administration and American Association of Motor Vehicle Administrators. “Driver Fitness Medical Guidelines.” NHTSA, 2009. nhtsa.gov/…/driver-fitness-medical-guide…
- 8Association for Driver Rehabilitation Specialists. “Driving and Traumatic Brain Injury.” ADED, accessed 2026. aded.net/…/Driving-TraumaticBrainInjury
- 9Novack TA, Banos JH, Alderson AL, et al. “UFOV performance and driving ability following traumatic brain injury.” Brain Injury, 2006. msktc.org/…/ufov-performance-and-driving…
- 10Preece MHW, Horswill MS, Geffen GM. “Driving after concussion: the acute effect of mild traumatic brain injury on drivers’ hazard perception.” Neuropsychology, 2010. Research summary by Headway. headway.org.uk/…/driving-after-concussion-the…
- 11Schmidt JD, Hoffman NL, Ranchet M, et al. “Driving after concussion: is it safe to drive after symptoms resolve?” Journal of Neurotrauma, 2017. augusta.elsevierpure.com/…/driving-after-concussion-is-…
- 12McKerral M, Moreno A, Delhomme P, Gelinas I. “Driving behaviors 2-3 years after traumatic brain injury rehabilitation: a multicenter case-control study.” Frontiers in Neurology, 2019. frontiersin.org/…/pdf
- 13Daugherty J, Sarmiento K, Waltzman D, Schmidt J. “Healthcare provider influence on driving behavior after a mild traumatic brain injury: findings from the 2021 SummerStyles survey.” Journal of Safety Research, 2023. CDC Stacks. stacks.cdc.gov/…/132217
- 14Centers for Disease Control and Prevention. “Managing Return to Activities.” CDC HEADS UP, 2025. cdc.gov/…/index.html
- 15Centers for Disease Control and Prevention. “Signs and Symptoms of TBI.” CDC, 2025. cdc.gov/…/index.html
This article reflects the safety priorities of neuropsychology and driver rehabilitation. It is general education, not medical or legal advice. Check with your care team, your state licensing agency and other official sources about your own situation. Reviewed October 2026.
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