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Driving allows personal freedom, control and independence. Many people with Parkinson’s disease (PD) continue to drive safely long after their diagnosis.

While Parkinson’s progression and medication side effects may affect a person’s driving ability, the diagnosis alone does not tell the whole story. The ability to drive with Parkinson’s depends on a person’s specific symptoms, as well as the presence of other age-related changes.

Though Parkinson’s may present driving challenges, there are many ways to maintain independence. If you are facing driving challenges, the below information can help you take control of your transportation needs.

How can Parkinson’s affect my driving?

Driving is a complex skill. Parkinson’s-related physical, emotional and mental changes may affect your ability to drive safely.

• Parkinson’s can cause your arms, hands or legs to shake even when you are relaxed. PD can also make it harder for you to keep your balance or start to move when you have been still.
• You may not be able to:
  • React quickly to a road hazard.
  • Turn the steering wheel, push down on the gas pedal or brake as quickly as you may need or with precision.
• Depth perception can affect your ability to change lanes, park, etc.
• Changes to cognition may affect your ability to process all the complex actions that occur in order to drive safely.

Many Parkinson’s medicines can also reduce your ability to drive safely. Common medications — including carbidopa/levodopa (Sinemet), amantadine, dopamine agonists and anticholinergics — may produce side effects such as sleepiness, dizziness, blurred vision and confusion. Not everyone experiences these side effects, and they may be decreased by simple medication adjustments.

Can I still drive with PD?

The ability to drive with Parkinson’s depends largely on your individual circumstances. Driving with PD tends to be safest in the early stages of the disease. Taking medications that control your symptoms can also improve your driving ability and staying active can help you keep the muscle strength you need to drive.

How do I know if I can drive safely?

It may be difficult to determine when, or if, you should limit your driving. Resources are available to help you better understand your own driving ability:

Ask a trusted friend or family member for honest input about your driving skills.

Take a driving assessment. Here’s how:

• Assessments are available through your local DMV.
• Your doctor also may recommend a Driving Rehabilitation Specialist’s (DRS) assessment. These professionals give on- and off-road tests to see if, and how, PD affects your driving. The specialist may offer driving skill improvement training if you can still drive safely. Call the Association for Driver Rehabilitation Specialists at 866-672-9466, check the directory for a DRS near you, or ask your doctor for a referral to a DRS.

What can I do if I have to reduce my driving?

If you must cut back on or give up your driving, you can still maintain your independence. Consult these driving alternatives to help identify which form of transportation best suits you:

• Take public transportation such as a bus, subway or train. Bus passes are often offered for a reduced fee to the elderly and people living with disabilities. Call your local public transportation office to get information on discounts and find out what routes to take.
• Take a taxi or car service, especially for quick or spontaneous errands. There are many apps you can download to your smartphone to request transportation.
• Ask family and friends to drive you. One person may be willing to take you to the grocery store weekly and another might volunteer to pick up your medications from the pharmacy.
• Ask about the ability of van service if you live in an independent or assisted living facility. Many facilities offer this service to take residents to appointments. Be sure to reserve this service in advance.
• Check for alternative transportation options with your local city/town government and the local community center. Special shuttle or van services may be available for people with disabilities.
• Contact your local religious organization to find out if they have a committee of volunteers who drive community members to different destinations.

Who can help with transportation?

Many services are available to help you locate transportation in your area. Consult these organizations to get started:

Learn More

Watch the DriveWise® program videos: Driving with Parkinson’s 1 and Driving with Parkinson’s 2, produced by Beth Israel Deaconess Medical Center, a Parkinson’s Foundation Center of Excellence. Ask about any similar programs at hospitals, driving schools, rehabilitation facilities and state motor vehicle departments in your area.

Page reviewed by Dr. Bhavana Patel, Movement Disorders Neurologist at the University of Florida, a Parkinson’s Foundation Center of Excellence.

Did you know that our bones are living tissue? To keep them strong, our bodies break down old bone and replace them with new bone. When we are young, we build more bone than we break down. But as we get older, bone can break down more often than it gets replaced. This can lead to osteoporosis.

Osteoporosis can develop if your bone mass decreases or the structure of your bones changes. Osteoporosis makes your bones weak and more likely to fracture (break).

Osteoporosis is called a “silent” disease because it doesn’t show any obvious symptoms. Many people do not know they have it until they break a bone after a minor injury or movement. Something as simple as falling from standing height, bending, lifting, or even intense coughing may cause a fracture. Osteoporosis can develop in any bone, but it’s most common in the bones of your hips, wrists, and vertebrae in the spine.

Who is at risk for osteoporosis?

While anyone can develop osteoporosis, the risk increases as you get older. Osteoporosis is more common in people with any of these risk factors:

• Sex. Women are more likely to have osteoporosis than men, especially after menopause. White and Asian women are at the highest risk. African American and Hispanic women are at a slightly lower risk. While men are less likely to have osteoporosis, White men are at a higher risk than other groups of their sex.
• Age. As you age, you lose more bone than you build. Women over age 65 are recommended to get screened for osteoporosis by their health provider. There are no official screening recommendations for men, but their risk increases after age 70.*
• Family history. Having a parent with osteoporosis or hip fracture increases risk.
• Body type. Being slim or thin-boned increases risk because there is less bone to lose.
• Hormones. Hormone levels can affect risk for both men and women. Low estrogen levels in women due to menopause, hormone disorders, or extreme physical activity can weaken bones. Low levels of testosterone in men also raises their risk for osteoporosis.
• Nutrition. A diet low in calcium, vitamin D, or protein can raise risk.
• Lifestyle factors. These include heavy alcohol use, smoking, not being physically active, or being on bedrest for extended periods of time can all raise risk.
• Medications. Long-term use of some medications may increase risk. These include corticosteroids, proton pump inhibitors, and medicines to treat epilepsy. Some cancer medications and glucocorticoid steroids can also increase risk.
• Medical conditions. Some medical conditions increase risk, including:

How is osteoporosis diagnosed?

A health care provider can usually diagnose osteoporosis with a routine screening. They may ask you about your medical and family history and whether you have ever broken a bone. They may also want to know if you have lost height or weight or if you are losing muscle strength. Talk to your doctor if your posture, balance, and gait (how you walk) have changed.

The most common test for osteoporosis is a bone mineral density test, which measures how strong your bones are and predicts your risk of bone fractures.

How is osteoporosis treated?

If you have the disease, your doctor will likely recommend treatment designed to slow or stop bone loss and help prevent fractures. They may recommend eating a balanced diet with enough calcium, vitamin D, and protein. They may also recommend other lifestyle changes or prescribe medicine to slow bone loss or rebuild bone. Medications can cause side effects, so talk to your doctor or pharmacist if you have questions about what you’re taking.

Regular physical activity is important if you have osteoporosis, but certain activities may put a strain on high-risk parts of the body. Avoid high-impact exercise and movements that twist your spine (like swinging a golf club) or heavily bend the waist (like sit-ups and toe touches). A physical therapist, rehabilitation medicine specialist, or physiologist can help you make a safe exercise program. Caregivers can also help someone with osteoporosis exercise in a safe way.

Can it be prevented?

Keeping bones strong throughout your life can help lower your risk for osteoporosis, so eat a healthy diet rich in calcium and vitamin D, get regular physical activity, limit alcohol intake, and don’t smoke. It’s also important to have regular checkups and tell your doctor if you’ve had a fall or broken a bone.

Living with osteoporosis

Whether you have osteoporosis or are trying to prevent it, proper nutrition and certain exercises are good for bone health. Strong muscles help you balance and reduce your risk of falling or breaking bones. People tend to lose muscle as they age, but a combination of weight-bearing exercises, resistance training, and balance training can help. Talk to your health care provider about what’s best for you before starting any exercise program.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases also has information on exercising for bone health.

If you have osteoporosis, talk with others who have it and reach out to family and friends for support. Learning about the disease can equip you to participate in decisions about your care and help preserve your mobility and independence!

*Editor’s note: As of this publication, the U.S. Preventive Services Task Force’s osteoporosis screening recommendations are under review. Learn more about the review process and updates here.