Medical Conditions

There are many medical conditions that impact driving. These conditions can affect the old and young alike, making it important to reevaluate safe driving throughout a person’s lifetime. Below are some of the medical conditions that tend to affect older drivers, but it is important to keep in mind this is not a comprehensive list. This information is not intended to take the place of advice from your medical providers.

Medications

Medications, including those available over the counter, are an often overlooked cause of impaired driving. Some medications may include warnings against driving, but many others can indirectly affect driving. Medications or medication combinations that make you drowsy or disoriented can have a negative impact on your ability to drive safely. In some cases, these effects can be minimized by simply changing the time of day the medication is taken. It is important to discuss all medications with your doctor or pharmacist, including over the counter medications you take. Together, you may be able to come up with a plan to safely address any concerns with mixing your medications with driving.

Arthritis

Because individuals with arthritis experience painful and stiff joints, many aspects of driving can be affected. Getting in and out of the car, turning to check blind spots, turning the key in the ignition, fastening your seat belt, and turning the steering wheel are some of the areas that can be impacted by arthritis. Some individuals find the pain and stiffness is manageable some days and more severe on others. Some also experience fatigue, which can further affect a driver’s ability to stay alert and respond to unexpected events.

If you suffer from arthritis, there are some modifications you may be able to make in order to maintain your safety behind the wheel. For example, you can limit your driving to days or times when the stiffness and pain are not as severe. You might select a vehicle that is easier to get in and out of, has keyless ignition and entry, thicker steering wheel, back-up camera, or blind spot assist. There are also modifications that can be made to your existing car that may prolong your ability to drive safely with arthritis. Driver Rehabilitation Specialists can work with you one-on-one to evaluate your needs and help develop a plan to maintain your safe driving.  Learn more about Driver Rehabilitation Specialists on our Driving Safely page.

Watch the National Highway Traffic Safety Administration video on Driving with Severe Arthritis below for more information.

Dementia

A diagnosis of dementia can be devastating for individuals and family alike, but it does not necessarily mean that an individual has to stop driving immediately. Dementia affects memory, reasoning, judgment, and behavior, among other things, and continues to worsen with the passing of time. While it is common for driving to be impacted as the disease progresses, it is important to remember that every individual is unique. Decisions made about driving need to consider the stage of the disease and the impact it is having on driving abilities.

Some warning signs that driving may be affected include:

• Being pulled over and given a warning or citation
• Being involved in a car crash or fender bender, even if you’re not deemed to be at fault
• Getting lost on the way to a destination or need extra help planning your route
• Forgetting the purpose of a trip or where you are going
• Finding dents or scratches on your vehicle or garage that you cannot explain
• Forgetting where you parked

Considerations for maintaining safe driving include:

• Discuss your disease progression with your doctor and how it may be impacting your driving
• Begin conversations with family early to plan for alternative transportation when the need arises and encourage them to help make decisions about driving
• Keep an eye out for warning signs that driving may be impacted
• Begin transition to being a passenger/navigator and decrease driving responsibilities over time
• Evaluate driving abilities regularly – the American Academy of Neurology recommends reassessment every 6 months
• Meet with a Driver Rehabilitation Specialist, who is specially trained to assess driving abilities and can offer individualized guidance and recommendations. Learn more about Driver Rehabilitation Specialists on our Driving Safely page.

Due to the nature of dementia, individuals struggle to recognize when it is no longer safe to drive. Because of this, it is important to discuss any signs of driving difficulty with your medical provider, family, and/or friends. While some individuals with dementia can continue to drive safely for a while, it is important to understand that the disease will eventually progress to a point where you can no longer continue to drive safely. The involvement of family and friends is needed to help decide when the disease has progressed to this point.

Watch the National Highway Traffic Safety Administration video on Driving with Alzheimer’s below for more information.

For additional resources and information on warning signs and discussing concerns with family, visit the Alzheimer’s Association’s Dementia & Driving Resource Center.

Diabetes

As people age, they are at an increased risk of developing type 2 diabetes. Complications associated with diabetes can have an impact on safe driving in the following ways:

• Loss of sensation in the feet
• Vision loss/damage
• Blood sugar spikes or dips, which can result in:
  • Confusion and disorientation
  • Dizziness
  • Drowsiness
  • Seizure
  • Loss of consciousness

Many individuals with Type 1 and Type 2 diabetes are able to drive safely. However, it is important to evaluate your symptoms and potential complications. Discuss your condition and any concerns with your health care provider. You may determine that it is safest to test your blood sugar prior to driving to be sure you are not at risk for side effects associated with high or low blood sugar. It may also be helpful to carry your medications and appropriate snacks to help regulate your blood sugar. If you notice new or changing symptoms, follow-up with your doctor. Your health care provider may be able to work with you to adjust your medication to keep you safely driving for as long as possible.

 Watch the National Highway Traffic Safety Administration video on Driving with Diabetes below for more information.

Parkinson’s

Parkinson’s disease affects movement, vision, emotion, and cognition. Individuals diagnosed with Parkinson’s disease may be able to continue driving for some time, depending on severity at the time of diagnosis. However, it is important to understand the ways in which Parkinson’s disease can impact your ability to drive safely and recognize the signs that it may be time to have your driving evaluated.

Ways that Parkinson’s disease and related medication side-effects can impact driving include:

• Slowed reaction times and movements (for example, difficulty moving between the brake and gas, as well as steering)
• Difficulty checking blind spots and backing up because of trunk and neck stiffness
• Sleepiness, which may be made even worse by medication
• Difficulty getting in and out of the car
• Difficulty estimating distance of oncoming traffic, lights, etc. as a result of vision changes
• Difficulty controlling the vehicle as a result of tremors (for example, trouble maintaining lane positioning and consistent speed)

Tips for driving safely in the early stages of Parkinson’s disease:

• Limit distractions – Parkinson’s disease can affect attention and concentration, so it’s important to limit distractions such as the radio, eating, cell phones, having conversations with passengers, etc.
• Limit nighttime driving – Parkinson’s disease can affect the ability to judge distance, which is often more pronounced in the evening and nighttime.
• Do not drive when tired – Parkinson’s disease and medication regimens can lead to fatigue, which further slows reaction times and ability to respond appropriately to unexpected traffic situations.
• Plan your route – staying on familiar roads and avoiding busy street and peak traffic can help minimize difficulties resulting from slowed reaction times and decreased attention and concentration.

It is important to discuss any signs of driving difficulty with your medical provider. Some of the difficulty could be a result of your medication regimen and can be improved with adjustments. However, as Parkinson’s disease progresses, it is important to understand that the disease will eventually progress to a point where individuals can no longer continue to drive safely.

Watch the National Highway Traffic Safety Administration video, Driving with Parkinson’s Disease, below for more information:

For more information on how Parkinson’s disease affects driving and additional tips for how to continue driving safely for as long as possible, visit the National Parkinson’s Foundation.

Stroke

A stroke is a brain injury that results from a loss of blood flow to the brain. A stroke can occur in any location in the brain and its location can impact the symptoms a person experiences. Because the symptoms can vary depending on the location of the stroke, it is important to consider each case individually. In some cases, individuals are able to continue driving while in other cases drivers may need restrictions or need to retire from driving altogether. Complete recovery from a stroke can take 6 months or longer, so if your doctor advises you not to drive in the first months after a stroke, don’t assume this means you will have to give up driving permanently.

A stroke can have an impact on safe driving in the following ways:

• Weakness, paralysis, or numbness making it challenging to handle the physical demands of driving (such as increased difficulty staying in your lane)
• Vision loss
• Slowed reaction times
• Difficulties with judgment and concentration
• Memory impairment, which can result in getting lost or confused
• Increased frustration

Drivers who have experienced a stroke may need to have their driving evaluated in order to determine if they are safe to continue or return to driving. It may be helpful to meet with a Driver Rehabilitation Specialist, who is specially trained to assess driving abilities and can offer individualized guidance and recommendations. Learn more about Driver Rehabilitation Specialists on our Driving Safely page.
The National Highway Traffic Safety Administration has prepared a video on how strokes can affect driving.

Vision Disorders

Good vision is essential for good driving health. But, as people age, everyone experiences changes in vision. Some of these changes are a result of normal changes in the way the eyes respond to light while others are a result of eye disease. Eye diseases that can affect driving include glaucoma, cataracts, and macular degeneration. It is important to have regular eye exams to identify age-related vision changes. The American Optometric Association recommends annual eye exams for those over the age of 60.

Glaucoma

Glaucoma is an eye disease that often develops slowly and has few symptoms in the early stages. Some individuals do not notice vision changes at first because they are so gradual. Glaucoma can be successfully slowed with proper treatment, so it's important to get regular eye exams and discuss any concerns with your health provider. Glaucoma can affect your vision in the following ways:

• Loss of side vision
• Increased sensitivity to glare and light
• Difficulty seeing at night, on cloudy days, or at dawn or dusk
• Blurred or dull vision

These changes in vision can have the following impacts on driving:

• Slower to anticipate and respond to traffic situations
• Difficulty matching speed when merging
• Difficulty staying in your lane
• Difficulty seeing road markings, signs, pedestrians, and bicyclists

Macular Degeneration

Macular degeneration affects your central vision. Individuals with macular degeneration may continue to have good side vision while experiencing difficulty with their central vision. With macular degeneration, vision can become distorted and less clear. Macular degeneration affects driving in the following ways:

• Central vision may become blurry or dull making your vision less crisp
• Difficulty seeing in low light, making it hard to drive at night, on cloudy days, or at dawn or dusk
• Trouble reading dashboard instruments
• Difficulty seeing road markings, signs, pedestrians, and bicyclists
• Colors may look less vivid or bright, making it difficult to see differences between objects and the background
• May have trouble adjusting to changes in lighting, such as going from bright light to low light

Cataracts

Cataracts are an eye condition that results in the clouding of the normally clear lens of your eye. This clouding gets progressively worse and can result in sudden changes to eyeglass prescriptions. Cataracts can affect driving in the following ways:

• Difficulty driving at night and low-light situations
• Increased sensitivity to glare and light
• Cloudy vision, as though you are looking through fogged up glass
• Halos around lights, which can make night driving even more challenging
• Double vision in one eye, such as seeing multiple road markings, signs, pedestrians, etc
• Difficulty reading road signs
• Colors may appear dull or faded

The National Highway Traffic Safety Administration has prepared a video on vision disorders that can affect driving. Watch the video below to learn how macular degeneration, cataracts, and glaucoma can affect driving.