Stay driving to stay independent

Consider these health issues to keep you safe on the road.

For many of us, driving is a vital component of freedom and independence. But aging brings physical changes that can jeopardize a future on the road. "Most people I see don't think they have any driving problems," says Barbara Moscowitz, a geriatric social worker at Harvard-affiliated Massachusetts General Hospital. "But even subtle changes in your health can affect your reaction time. You need to address them while you're well, so you can keep driving."

Sensory changes

Changes in eyesight may make it harder to see at night, read traffic signs, and cope with glare from oncoming headlights or sunlight reflecting on cars ahead of you. The American Academy of Ophthalmologyrecommends that people ages 65 and older have comprehensive eye exams at least every other year, though people with existing eye conditions might need more frequent follow-up.

Hearing loss can also affect your driving skills, by keeping you from noting outside noise such as sirens and horns. The American Speech-Language-Hearing Association recommends getting hearing checks every three years after age 50.

• Quick fixes: Keep noise inside the car to a minimum, and cut back on night driving.

Chronic conditions

Chronic physical challenges—such as arthritis pain, the tremors of Parkinson's disease, or the pain of chronic back problems—may cause difficulty gripping a steering wheel, turning to look for traffic, or pressing the brakes. Stay active by exercising and stretching, which can help maintain the flexibility and strength you need to operate a car.

For people with type 2 diabetes, driving skills can become impaired when blood sugar levels are less than 100 milligrams per deciliter (mg/dL), and you may lose consciousness, have blurred vision, or feel confused.

• Quick fixes: If you've been diagnosed with diabetes, check your blood sugar before you drive, and keep a blood glucose meter in the car, as well as a quick-acting source of glucose such as juice.

Thinking skills

Serious problems with thinking skills, such as mild cognitive impairment and dementia, can cause drivers to get lost, become confused in high-traffic areas, and misjudge distance and timing so crucial to driving decision-making. When this occurs, it's time to consider giving up the keys and finding an alternative means of transportation. But in general, mental sharpness fades as we age, which can affect your reaction time when a child runs into the street or a car cuts in front of you.

• Quick fixes: Avoid driving during busy times of day, such as rush hour, and find different routes to avoid high-traffic areas.

Medications and alcohol

Two big offenders that affect driving skills are medications and alcohol. Medications may cause side effects such as confusion, dizziness, and drowsiness. And remember that because you are older you metabolize alcohol differently, especially if you are taking medication.

• Quick fix: Ask your physician to evaluate all of your drugs and supplements for their potential impact on your driving skills.

Sudden emergencies

Heart attacks and strokes can cause you to lose consciousness behind the wheel. That's why it's important to become familiar with symptoms in case you need to pull over. For heart attack, you may experience chest pressure; chest pain that radiates to the left arm, neck, jaw, or back; shortness of breath; unusual fatigue; dizziness; cold sweat; and nausea (although women may have a heart attack without experiencing chest pain). The symptoms of a stroke or mini-stroke are any of the following, especially when they come on suddenly: weakness or numbness on one side of the body, dimming or loss of vision, dizziness, and confusion.

• Quick fix: If you experience any of these symptoms, stop the car in a safe place well off the road, then call 911.

Emotional check

People who are emotionally distressed may be putting themselves and others at risk when they get behind the wheel. "People who are emotionally distressed from the loss of a loved one or even a move into a new home are getting in the car and thinking about their stress and sadness more than their driving," says Moscowitz.

Quick fixes: Ask someone else to drive until you are able to manage your emotions, and seek professional help if your distress lasts longer than a few weeks. Depression symptoms include persistent feelings of hopelessness, loss of interest in activities you once enjoyed, insomnia, aches and pains, and fatigue.