How can transport provision and associated built environment infrastructure be enhanced and developed to support the mobility needs of individuals as they age?

Mobility touches every aspect of most of our lives. Restrictions on our mobility are perceived asa loss of freedom, and we seek wherever possible to regain that mobility, or replace it with otherforms of mobility. While we immediately think of physical mobility, virtual mobility is increasinglybecoming another world that we inhabit and move around in.Older people, however, are the most likely to experience mobility deprivation. The need to bemobile and to travel is related to psychological well-being in older age, and a reduction inmobility can lead to an increase in isolation, loneliness and depression and overall a poorerquality of life. Mobility is important to older people. There are also benefits to society as a wholein increasing travel for older people, including the economic benefits of older people spendingmore in shops, of them looking after grandchildren, undertaking voluntary work, and carrying outother caring responsibilities.In order to develop a framework of the mobility of people as they age, we formulated a set ofguiding principles that underpin this Evidence Review. These principles are drawn from currentthinking in applied gerontology in the many differing fields that cover mobility issues andrepresent a shift from individual discipline-based silo thinking to person-centred thinking thatattempts to cross traditional disciplinary boundaries. The key principles are:• Adopting an ecological model of ageing.• Placing the user at the heart of mobility in order to take a person-centred approach.• Mobility behaviour and perceptions should take a life-course approach that builds uponwhole life experiences and choices.• Understanding older people’s mobility requires a relationship-centred approach.• Images of ageing can be positively changed through an inclusive design approach totransport provision and built environment infrastructure.• Mobility is multi-faceted and as such should be considered as a whole systemsapproach, moving away from traditional transport planning.• The physical environmental context in which mobility is conducted is important toacknowledge and understand.• There is a need to balance diverse requirements.• Addressing the wider societal challenges such as loneliness and isolation, civicparticipation, connectivity and health and well-being in relation to mobility is important.Underpinning the principles is user engagement – the need to involve older people in decisionsthat affect their mobility needs, desires and wants, and to work co-productively with them tounderstand the barriers and enablers to mobility from their perspective.Through this review of evidence, including both academic and grey literature, and using theabove principles to focus our study, we set out the current state of knowledge in this complex5 and diverse subject area. The scope of transport is vast, and we acknowledge that any suchsearch of evidence is limited by both time and the documentary evidence freely available to theauthors. We conclude that there are evidence gaps that require further research, that othergaps may well emerge, and that there is still much to be understood. As such, this is very muchthe start of a journey, rather than the end.We consider that the following areas require further investigation to provide evidence on howthe transport provision and associated built environment infrastructure can be enhanced anddeveloped to support the mobility needs of individuals as they age:• Transport decisions and the effect of these into older age need to be investigated acrossthe life course.• We need a better understanding of the role of virtual mobility.• Individual differences are important, and so we need to have a better understanding ofwhich mobility interventions will affect which people, and why.• Understanding train travel from the point of view of older people to help identify barriers touse.• Social capital and networks and mobility in later life and how these might enable mobility.• Future research and interventions must acknowledge that a variety of modes are used tocomplete travel and a door-to-door approach is advocated.• To gain a greater, more holistic understanding of transport in later life, future researchshould look beyond literal or corporeal mobility to include constructions of travel related tovirtual, potential, imagined, aspirational and emotive mobilities, utilising not just transportstudies, health and geography but also sociology, gerontology, and arts and humanities.• Technologies, driverless vehicles and driver support. Clearly there is a need to betterunderstand the impact of these technologies on different cohorts of older people, not justin terms of driving, but also on health, well-being and quality of life.• Transport can play a significant role in helping a person with dementia to stay active andindependent for longer, but this is an under-researched area.• We need to understand cycling among the older population, and how this affectsindependence, health and well-being.• Driver safety – rich qualitative data may be able to inform existing transport policy in amore meaningful way than quantitative data alone.• Falls, as a pedestrian and on public transport, require further research, particularly inunderstanding the impact of a fall on subsequent mobility and independence.• Segregated space between older pedestrians and other transport users is important forolder people’s mobility, but we need to better understand how sharing space affects olderpeople – which people, why, and in what ways?6• There is a need to ensure there is an awareness of the mobility, transport and builtenvironment issues of older people made by health and social care professionalsregarding the mobility of people who have returned home from hospitalisation.• Economic evaluation – there is a need for research to be able to put a cost/benefit both onstaying at home, and also on interventions that get the person out and about.• The over-emphasis on problematising older people’s mobility. More research is needed toidentify the benefits of involving older people within the context of mobility as a whole,rather than simply involving older people in identifying barriers and issues.• More research is needed to provide the evidence base for priority areas for older people’smobility in times of austerity.• We recommend that an independent robust evaluation is undertaken, examining whethercourses really improve driver skill and awareness and whether they reduce accidents