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Traveling to Tuscany by car from Rome

Can someone share whether we should drive the coastal route from Rome to Bolgheri, Italy (Tuscany) or the inland route?

Also we are going to CInque Terra and Elba Island. Do you recommend making reservations before hand to Elba Island? How about Cinque TErra, can we take our car there?

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It depends if you want to get there faster or not. The coastal way (Via Aurelia) is faster.
Are you taking the car on the ferry to Elba? If so reservations for the ferry are recommended if traveling there on summer weekends. But first make sure you can take the rental car on ferries. That is often prohibited by the rental contract and you need to get permission first.
Reservations for hotels in the island are recommended between mid July and end of August.
You can drive the car at the Cinque Terre, but only Monterosso has parking. If you go to Riomaggiore or Manarola, the parking at La Spezia station is recommended. However Riomaggiore has a two story parking garage.