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Posts from the Elderly & Disabled Category


Study Links Walkable Neighborhoods to Prevention of Cognitive Decline

Older adults who live in walkable neighborhoods stay in better shape, physically and mentally, than those who live in car-dependent areas, according to a new study.

Photo: AARP

Photo: AARP

In a study presented last weekend to the Gerontological Society of America, University of Kansas assistant professor Amber Watts examined 26 subjects with mild Alzheimer’s Disease and 30 healthy control subjects. She tracked health outcomes over two years, controlling for home price, income, gender, and education.

Watts found that subjects living in walkable neighborhoods, from both groups, had lower body mass index, healthier metabolisms, and better memory and cognition. This was particularly true in neighborhoods that had complicated paths to destinations, she found.

“There seems to be a component of a person’s mental representation of the spatial environment, for example, the ability to picture the streets like a mental map,” Watts said in a press release. “Complex environments may require more complex mental processes to navigate. Our findings suggest that people with neighborhoods that require more mental complexity actually experience less decline in their mental functioning over time.”

Older adults are less likely to get regular exercise than the general population, but walking is one form of activity that is considered safe and healthy for people with Alzheimer’s. Neighborhood attributes like good sidewalks, generous crossing time at intersections, benches, and closely spaced parks and destinations can help encourage older people to walk for transportation, Watts said.

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Study: Baby Boomers Living in Cities Are More Socially Active

As Baby Boomers age, cities seems to be better places for them to get the social interaction they seek, according to a new study published in the Journal of Transport Geography.

Using special formulas meant to eliminate the “self-selection bias,” researchers from MIT compared the travel habits of Boomers who live in suburban and urban parts of Boston — controlling for factors like income, bike ownership, health, and employment status. They found, unsurprisingly, the urbanites made more total trips than their suburban counterparts, even though they car commute less.

Every week, the urban boomers made 1.34 more recreational trips, 0.77 more social trips and 4.53 more utilitarian trips than suburban boomers with similar demographic characteristics.

The disparity in social trips, in particular, stuck out to researchers, who said that “baby boomers’ preference for social activities tends to be mismatched to their environment.”

“Suburban boomers want more social opportunities than their settings enable,” they wrote.

The research also indicates Baby Boomers would generally be more active and get out of the house more if they transferred from a suburban location to an urban one. But the authors note that given Boomers’ preference for aging in place, that may be unlikely to take place at a very large scale.

Travel data was obtained through a mail survey to randomly selected addresses. Respondents included 1,422 suburban Boston residents and 745 urbanites in Boston, Cambridge, Somerville, and Brookline.


Richard Florida: Seniors Want Vibrant, Livable Cities Too

Image: Atlantic Cities

When he settled on Miami as his designated spot to escape Toronto winters, urbanist Richard Florida said he expected “all young people with a lot of gel in their hair.” What surprised him was finding a pocket of baby boomer urbanites from cities like Washington, DC, who came to Miami for its arts, diversity and walkability.

“Everyone said the same thing: We want a little bit of warmth, but we don’t want the warm, traditional Leisureville. We want an exciting community with arts and culture and mixing,” Florida said Thursday at the AARP-hosted “Conversation on Generations,” with Atlantic editor Steve Clemons.

The wide-ranging chat between the Atlantic guys (Florida co-founded Atlantic Cities) explored the trends boomers could follow as they age — and how governments should get ready.

Right now, “too many leaders are taking a ‘wait and see’ approach,” said AARP’s Nancy LeaMond, in her introduction. Half the country’s jurisdictions, she said, aren’t preparing for the so-called “silver tsunami” of aging boomers. And that can’t be very smart when over 10,000 Americans are turning 65 every day.

Florida’s take on his peers (born in 1957, he’s on the cusp of boomerhood) is that they don’t want to live in isolated homes or communities. On a fundamental level, that means seniors are choosing to live close to good airports, quality healthcare services, and, increasingly, the homes of their children and grandkids.

But there’s more to it than that. Florida and Clemons talked about an aspect of “cool” that hasn’t been traditionally associated with aging, with boomers in many ways replicating the trends of younger generations. Florida sees a craving “for a more experiential community … with coffee bars and restaurants and music clubs and street-level vibrancy,” and a diversity of ages. Losing steam is the notion that older adults only want to venture downtown for evenings at the opera.

Boomers also seem to get that walkability is key not only to creating this “interactive potential,” he said, but also to ensuring healthier lifestyles that promote longevity.

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How Rethinking the Golf Course Could Help Seniors Age in Place

This 75-acre golf course in San Jose, California, is considered a small course. Even so, it's a colossal public expense. Photo: Dave Polaschek/Flickr

The 15,753 golf courses in the United States take up more space than half the state of New Jersey. And though they devour so much land, much of it in suburbia, the sport is foundering — in part because of the enormous amount of time and distance it requires. Some real estate professionals and experts on aging have come together to suggest a solution both for the decline of the game and the land use problems posed by these massive courses: Build mixed-use development inside them.

“The simultaneous collapse in the value of homes and golf courses may make such suburban redevelopment, retrofitting, and regreening possible on an unprecedented scale,” wrote Jane Hickie of the Stanford Center on Longevity and James F. Dausch and Edward Bennett Vinson of Resolutions Real Estate Advisors in an article last month for the American Artchitectural Foundation. “Redevelopment could provide solutions for the financial problems that many homeowners associations and golf course operators are struggling to address through infill housing and retail more suitable for an older population.”

Hickie has written a book on independent living for seniors, and she knows that most seniors live in suburbia and want to stay in their own communities as they age. So here’s the challenge she laid out: “How do you transform suburbia quickly enough to deal with the coming tsunami of population change?” Repurposing golf courses, she says, could play an important role.

Many residential developments, often targeted at retirees, have grown up around golf courses, charging a premium to be near the course. But with the collapse of housing prices, especially in the drivable suburbs, and the decline in the game, homeowners’ associations are often left holding the bag for astronomical maintenance costs. By bringing retail, dining, office space, and other recreational opportunities to golf courses, Hickie suggests, developers could buoy home values and help pay for the costs of the land. These amenities could also attract a different demographic, whether or not they’re interested in golf, and the new residents could be accommodated in denser housing in the town center.

Separately, Hall of Fame golfer Tom Kite has also entertained the idea of shrinking golf courses. He’s speculated that the size of the courses may have become the sport’s Achilles heel. It can take upwards of five hours to finish 18 holes, and fewer and fewer people have that much time on their hands.

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Do Seniors Want the Livability Improvements AARP Wants For Them?

Oahu, Hawaii should be the ideal place to walk for transportation, but it has the nation’s highest pedestrian fatality rate for senior citizens – more than twice the next-highest state. So the state enacted a Complete Streets policy in 2009, seeking to “reasonably accommodate” everyone — “pedestrians, bicyclists, transit users, motorists, and persons of all ages and abilities” — on public roadways.

Simple street design improvements can encourage seniors to walk more, enhancing their mobility and their physical health. Photo courtesy of Dan Burden, Walkable & Livable Communities Institute, via AARP

California, meanwhile, seeking to reduce greenhouse gas emissions, passed a law in 2008 integrating transportation and land use planning at all levels, leading to “more transit and fewer auto-dependent communities” and less “suburban development that is far from retail and employment centers.”

AARP collected these and many, many more case studies of livability initiatives in a report it published last year on state policies and practices that enable seniors to “age in place.” The organization says nearly 90 percent of people over age 65 say they want to stay in their home as long as possible. If the graying baby boomers reject the institutionalized old age that has been the fate of so many, communities will have to do a better job accommodating the needs of older residents.

In the year since AARP published its catalogue of best practices, they’ve taken their program across the country. In conjunction with Governing Magazine, the group has held roundtables in Des Moines, Lansing, Philadelphia and Salt Lake City to talk about the challenges those cities face as they await the so-called “silver tsunami.”

Amy Levner, manager of AARP’s Home and Community program, says the common thread among rural and urban communities alike is the “pressure on local budgets.”

Luckily, very few of the best practices in AARP’s handbook have a high price tag. In fact, many of them have the potential to save money (finding multiple uses for public facilities like schools, for example) or make money (like transit-oriented development). The organization suggests everything from integrated planning and complete streets to electric cars that “chirp” to alert pedestrians that a moving car is nearby.

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As Baby Boomers Age, They Take Their Foot Off the Gas

Baby Boomers, the greatest cohort of gasoline consumers the world has ever seen, aren't driving quite so much as they age. Image: AARP

They may be remembered as the driving-est generation. Baby Boomers, who came of age in the heyday of suburbia, have always driven more than any other generation. At the height of their driving years, boomers averaged 51 miles per day. They continue to drive 17 percent more than all other age groups, according to a recent report from AARP.

But in 2009, for the first time since the National Household Travel Survey began asking Americans about their transportation habits, in 1969, driving declined among all age groups. And it was the second time the survey showed less driving among boomers, who are reaching retirement age, a period of life that typically coincides with decreased driving.

Which has everyone watching and wondering: How will the huge number of Americans in this age bracket respond to retirement? If boomers continue to drive less, which seems likely, that will have huge ramifications for American transportation policy.

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Should Doctors Play a Role in Determining Who’s Fit to Drive?

When to take grandma’s keys away: In the United States, this question treated is largely treated as a family matter.

A study from the New England Journal of Medicine found that traffic collisions declined significantly after doctors warned elderly patients about health issues that could impair safe driving. Photo: Katv

But that is not the case in Canada, where the government requires doctors to report to licensing authorities when their patients start showing signs that, behind the wheel, they might pose a danger to themselves or others. A recent study from the New England Journal of Medicine has raised the question about what role physicians should have in helping determine fitness for driving.

Researchers found that a group of 100,000 Ontario patients identified by doctors as potentially unfit to drive were involved in 45 percent fewer severe road crashes following the doctor’s warning — whether they stopped driving altogether, drove less, or simply drove more carefully. Licensing agencies revoked licenses between 10 and 30 percent of the time when alerted by a doctor.

But even the study results highlight what a sensitive matter retiring an elderly individual’s driving privileges can be, especially in a society where, in so many residential locations, losing the ability to drive can mean a near total loss in independence.

The study also found an increase in mood disorders, like depression, among those who were singled out by doctors. In addition, one in five such patients switched doctors — a fact that might help explain why U.S. doctors have not necessarily been eager to interject on this issue.

According to Transportation for America, about four in five seniors live in rural or suburban communities that are largely car dependent. But some seniors may find that alternatives to driving aren’t as insurmountable as they might seem. NPR reports that 87-year-old Benjamin Benson was unhappy when his family suggested he hand over the keys. But he soon realized it wasn’t a death sentence:
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AASHTO’s Vision of Safe Streets for Seniors: Bigger Type on Highway Signs

Last June, Transportation for America brought the nation’s attention to the fact that older Americans are increasingly stuck in the suburbs without adequate transportation options, leading them to see family and friends and even doctors less. That same month, the Senate Banking Committee held a hearing on transportation access for older Americans.

Not all mobility improvements for seniors involve getting in a car. Photo by Dan Burden via Transportation for America.

The debate raged: Was transit expansion the answer to the mobility crisis? Or should seniors be moving to more walkable neighborhoods? Could resource-starved local transportation authorities support more paratransit services? Or would driverless cars save the day, as proposed by Randal O’Toole of the Cato Institute?

Now, a transportation research group known as TRIP has teamed up with AASHTO to produce a new report on how to keep baby boomers mobile as they age [PDF]. Their solution: brighter signs and wider lanes.

TRIP and AASHTO also mention designing and operating roads to accommodate all users – “when appropriate.” They throw a few bones to pedestrians, like refuge islands and countdown signals. But they must not have been thinking about the safety of those pedestrians when they suggested widening lanes, adding left-turn lanes, and making roadway curves more gradual. As David Burwell of the Carnegie Endowment’s climate program says, those changes would just create “more pavement for those pesky walkers and bicyclists to cross.” TRIP also suggests adding rumble strips to alert drivers when they’re leaving the lane – and, of course, to leave cyclists riding on the shoulder miserably saddle-sore by the end of their ride.

And as for “clearer, brighter and simpler signage with larger lettering, including overhead indicators for turning lanes and overhead street signs” – the number one recommendation in the report? “Great idea,” said Burwell. “And how about the pedestrians, bicyclists and other road users — maybe we all should be required to carry bright signs in large letters saying ‘Please don’t hit me!’”

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Time to See Older Drivers Through Dry Eyes

“Have you cried at your desk at work yet today? Would you like to?” Time Magazine recently asked, inviting its readers to indulge in emotion on behalf of an Iowa couple whose story went viral last week. Gordon and Norma Yeager died as the result of a car crash, the same way about 630 Americans die per week but with scant media attention. The Yeagers, after seven decades of marriage, passed away holding hands in the hospital.

Norma and Gordon Yeager died following a car crash this month. Photo: Times-Republican

And while this heartwarming story (more about the couple’s sweet life than their sad death) seems unique, it is not. It is quite common for the media to miss the point in stories about crashes involving older drivers.

While we don’t know the medical facts of this particular case, the elderly are more likely to die or sustain debilitating injuries in crashes that would cause less serious harm to younger people. After age 70, drivers are twice as likely to be involved in fatal crashes, per mile driven, as they were when middle-aged; after age 85, they are nine times more dangerous to themselves and others.

Two weeks ago, Gordon Yeager failed to yield at an intersection. He and his wife died. The crash sent another couple to the hospital. Missing from most media reports was the fact that Gordon Yeager “was facing pending action by the Iowa Department of Transportation to have his license removed” at the time.

The media conversation around aging drivers tends to focus on the anguish surrounding the question of when and how to take the car keys from Grandma or Grandpa, but rarely do these stories take us all the way to a family’s decision to do so. In a landscape built for cars and a culture built on the sanctity of independence, it feels horrible to be responsible for circumscribing a loved one’s life. As hinted at by the inconclusiveness of these stories, we often avoid this responsibility. Because there’s more hand-wringing than decision-making going on, it can take several traffic crashes before a driver is barred from the road, whether voluntarily or by family members or the government.

The desirability of extending the driving life of older people is largely taken as a given. Consequently, the media tend to play up assuaging statistics showing that older drivers tend to self-regulate and drive less; they offer non-threatening solutions such as more driver education, more automotive technology, or use of car-based services.

It would be better to focus not on the means — driving the car — but the motive, which is maintaining the mobility that a landscape built around personal vehicles will inevitably deny the aged.

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T4A Responds: Yes, Bring Transit to Suburban Seniors (Within Reason)

Cross-posted at T4America’s blog. Sean Barry is a communications associate at Transportation for America.

In a Streetsblog post last Thursday, Tanya tackled a question that has been marinating since Transportation for America released “Aging in Place, Stuck without Options,” addressing seniors’ mobility challenges:

More transportation options can help Baby Boomers as they age -- wherever they live. Photo: TransLink

Is it the job of overextended transit agencies – and the responsibility of taxpayers – to expand transit to all the inefficient places people have moved to, when they knowingly were moving away from urban amenities like transit in favor of the automobile? When that arrangement no longer works for people, do we encourage them to relocate in places that can better serve their needs, or do we aim to serve everyone’s needs exactly where they are, no matter where they are?

These are good questions, but there are some underlying assumptions that deserve a closer look. First, lets be fair: Automobile-dependent development has been the default setting for at least 60 years, so many people live in such places whether or not they “knowingly” rejected urban amenities and transit. And while it might make sense for some share of seniors to relocate, there simply isn’t enough adequate housing in close proximity to transit to accommodate the surging elder population — even if we could pry them away from support networks in their existing communities.

We don’t pretend for a minute that every cul-de-sac subdivision is entitled to its own transit route. But there are myriad ways that we could help to make the situation better, whether by broadening existing transit networks, expanding the supply of appropriate housing with access to transit or supporting educational programs that help to prepare seniors for getting around without driving.

In many inner suburbs, we have a ripe opportunity to change the dynamic. Many suburban communities are getting denser and more city-like in character, with dynamic job growth and greater proximity between employment and residential areas — Northern Virginia fits this description, for example. Under these circumstances, it not only makes sense to provide increased transportation options, but would be foolish not to. Both seniors and non-seniors deserve the chance to live in places with convenient and affordable access to transit if they choose.

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