We need to recognize that external factors can compromise age-friendly environments and better anticipate those who face greatest risk, before they lose their independence. 

For the attention of: Urban planners, age-friendly city developers and property developers.

The problem: Although age-friendly cities are on urban planning agendas globally . . .

 . . . evidence suggests that individuals in advanced age can remain in their own homes and communities longer if the right supports and services are in place.

The problem is that as long as seniors are managing well they are invisible to the health system which only responds when a crisis occurs; a reactive rather than a preventive approach. Our study emphasizes the need to include property owners, urban planners and residents as part of a collaborative team with the health system to identify individuals at risk at an early stage.

What we did: We explored the experiences of ten community-dwelling individuals 80 years of age and older who appear to be at risk. They live independently in the community but require support, particularly social support. Our study profiles healthier older-old who, by personally finding and accessing resources including helping each other, can successfully age in place.  These individuals have very little contact with the formal health system. Our study examined environmental factors that may hasten or delay loss of independence.

What our study adds: Although communities may initially be designated age-friendly, environments can change, often without input from the local population.

  • This may render the environment less age-friendly than previously.
  • Our study found that the environment might change in response to economic factors in ways that compromise its age-friendly nature.

A more integrated approach, linking property owners, urban planners and local businesses with the health system, to both design and maintain built environments, is required to promote optimal independent living for individuals in advanced age.

Implications for city policy and practice: Older adults are not a homogeneous group. Urban designers, service planners, developers and businesses play a pivotal role in creating and maintaining vibrant communities that provide a safety net to prevent crises and enable sustained independent living for the functionally diverse spectrum of older adults in advanced age. Community design that recognizes and integrates structures to support the needs of the oldest-old may provide a protective buffer to enable these individuals to remain in their homes longer.

Links to other resources and support: The Sam Katz Community Health and Aging Research Unit

Full research article: Use of community support and health services in an age-friendly city: the lived experiences of the oldest-old

Authors: Flora M. Vieira Zamora (@fvieiraz), Marita Kloseck, Deborah A. Fitzsimmons, Aleksandra Zecevic and Patrick Fleming
Editor: Marcus Grant