Age-Friendly Cities

Age-friendly cities are an innovative urbanization model developed in response to the demographic and social challenges brought about by global population aging. Initiated by the World Health Organization (WHO) in 2006, this concept aims to support elderly individuals in living active, healthy, and independent lives, increase their participation in social life, and improve their quality of life. Age-friendly cities are designed not only for the elderly but also to meet the needs of children, people with disabilities, disabled children, and other disadvantaged groups.

Population Aging and Urbanization

Globally, population aging is one of the most prominent demographic trends of the 21st century. According to the United Nations Department of Economic and Social Affairs (UNDESA), as of 2019, 9.1% of the world’s population is aged 65 and over; this is projected to rise to 11.7% in 2030 and to 15.9% in 2050 (UNDESA, 2019, p. 18). This increase is primarily due to the rise in life expectancy at birth (which increased by 8 years between 1990 and 2019 to reach 72.6 years) and declining birth rates (from 3.2 in 1990 to 2.5 in 2019) (UNDESA, 2019b, pp. 18–28). The UN Population Division emphasizes that declining birth rates will further intensify this trend, with the urban elderly population expected to reach 22% by 2050 (UNECE Working Group on Ageing, 2015, p. 2; Ferreira, 2010, p. 55).

The WHO defines aging as a process in which molecular and cellular damage accumulates, limiting physical capacity, increasing disease risk, and reducing individual capability (WHO, 2015, p. 25). Improvements in education, healthcare, and living conditions have accelerated this process, particularly increasing urban migration in developing countries. In Turkey, as of 2019, the elderly population reached 9.1%, with 7.9% living in urban areas and 1.2% in rural areas (TurkStat, 2020b). Life expectancy, which was 30 years for men and 33 years for women in the 1940s, has now risen to 71 and 76 years, respectively; for 2023, it is estimated at 75.8 years (men) and 80.2 years (women) (TurkStat, 2020a). This demographic shift makes it necessary for cities to become age-friendly, while also being seen as a triumph of humanity (UNDESA, 2019c).

The biological effects of aging include loss of vision, hearing, and mobility, slower walking speed, balance issues, and chronic diseases (coronary artery disease, osteoporosis, diabetes mellitus). Psychosocial aspects include income loss after retirement, social isolation, and weakening family ties. These factors may increase dependency among the elderly, but suitable environmental conditions can mitigate these effects (Tutal & Üstün, 2009, p. 2).

The Concept of Age-Friendly Cities

Age-friendly cities are defined by WHO as cities that support the active participation of the elderly, make structures and services accessible, and offer safe and livable environments (WHO, 2007, p. 1). Aslan (2015, p. 26) describes them as safe and clean environments that enable active aging, while Gorman et al. (2019, p. 2) highlight affordable and convenient transportation. The concept became a global initiative with WHO’s 2006 Global Age-Friendly Cities Guide, aiming to transform the elderly from passive service recipients into active community members (WHO, 2007). The Brazilian Declaration on Ageing (1996) emphasizes that elderly people are a resource for families, society, and the economy (WHO, 1997, p. 21).

Eight Core Domains

WHO evaluates age-friendly cities across eight domains:

1. Outdoor Spaces and Buildings: Clean, safe, and pleasant public areas; green spaces, non-slip sidewalks, wheelchair-accessible designs, adequate seating, good lighting, and accessible buildings (e.g., elevators, ramps, handrails).
2. Transportation: Affordable, frequent public transit available at night and on weekends; accessible stops, driver training, options for the disabled, safe pedestrian crossings, and bike paths.
3. Housing: Affordable, climate-appropriate housing close to services; age-appropriate interiors; safe environments and home care services.
4. Social Participation: Accessible gathering places, diverse activities (alone or with companions), programs to prevent isolation, and intergenerational events in community centers.
5. Respect and Social Inclusion: Respectful services for seniors, positive media representation, intergenerational educational activities, and easier access for economically disadvantaged elderly.
6. Civic Participation and Employment: Flexible job opportunities, encouragement for volunteering, prevention of age discrimination, and post-retirement educational programs.
7. Communication and Information: Clear and legible communication, age-friendly technology (large-button phones, internet access), one-on-one support, and regular updates.
8. Community Support and Health Services: Accessible health services, home care (including personal care and household chores), emergency planning, and volunteer encouragement.

These domains are based on Nahemow and Lawton’s ecological model, emphasizing the dynamic interaction between individual adaptation and environmental change (Van Hoof, 2018). WHO suggests integrating these domains with values like tolerance, equity, and intergenerational sustainability (Coşkun, 2019). Furthermore, Sustainable Development Goal 11 promotes age-friendly elements such as accessible housing, public transportation, and green environments (UNDESA, 2020).

Four-Phase Process

To achieve age-friendly city status, WHO recommends a four-phase process:

1. Planning (1–2 Years): Establishing mechanisms for elderly participation (e.g., advisory boards), assessing the current situation (epidemiological data and needs analysis), developing a 3-year plan, and identifying monitoring indicators (e.g., access to healthcare services).
2. Implementation (3–5 Years): Submitting and receiving approval for plans within two years, then implementing them within three years (e.g., infrastructure projects, social programs).
3. Evaluation (End of Year 5): Submitting a development report to WHO, including progress indicators.
4. Continuous Improvement: If progress is demonstrated, the cycle is renewed with new plans (up to 5 years), and global network membership continues.

Active Aging and Age-Friendly Cities

Active aging promotes elderly participation in social, economic, and cultural life (ASPB, 2014). The UN Principles for Older Persons (1991) highlight independence (capacity building, living at home, income-generating work) and participation (social relationships, political inclusion) (Buz et al., p. 391). Age-friendly cities support these principles by enhancing healthy aging, reducing dependency, and improving quality of life (WHO, 2007). While physiological changes (e.g., vision/hearing loss, reduced mobility) and chronic illnesses (e.g., coronary artery disease, osteoporosis) pose challenges, appropriate environments can help mitigate them (Tutal & Üstün, 2009, p. 2).

WHO defines "successful aging" as low disease risk, high physical and cognitive function, and active engagement in life (WHO, 1995). Age-friendly environments play a vital role in achieving this. For example, accessible sidewalks help maintain walking speed, while social programs reduce isolation. In Turkey, policies encouraging active aging positively affect the psychosocial well-being of the elderly and aim to prevent premature death (TurkStat, 2020a).

International Examples

• Manchester, UK: The 2003 "Valuing Older People" partnership developed projects to reduce social exclusion, including co-researcher programs for marginalized elderly groups (Buffel, 2016).
• La Plata, Argentina: A pilot study showed that education levels impact health perception—70.4% among the educated vs. 59.5% in the general population (WHO, 2015).
• Taiwan: Policies based on collectivism and authority prioritize public data for needs assessments (Chao & Huang, 2016).
• Quebec, Canada: Community-based solutions were developed through partnerships; "Case A" had a strong community foundation, while "Case B" was municipally led (Garon et al., 2013).
• Slovenia: Transport and housing access were key to improving the elderly's quality of life (Kerbler, 2015).
• Palo Alto, USA: WHO guidelines informed evaluations of population needs and service capacities (Ruza et al., 2014).
• Poland: Urban renewal focused on social inclusion and economic revitalization (Labus, 2012).
• Tehran, Iran: Evaluated for its potential as an age-friendly city based on green spaces, safe roads, social activities, and workplace adaptations (Sharqi et al., 2016).
• Japan: A model for accessibility and public transport for a highly aged population.
• Scandinavian Countries: Known for specialized social programs and health services.

European Cities (Amsterdam, Stockholm, Copenhagen): Recognized for age-friendly infrastructure and environmental planning.

The Concept of Age‑Friendly Airports

As the share of the aging population in tourism grows, making airports age‑friendly has become increasingly important (Frye, 2011, p. 41). An age‑friendly airport provides specialized services in areas such as wayfinding, fatigue reduction, technology, and convenience (ACRP, 2014):

• Wayfinding: Clear signage, interactive kiosks, smartphone apps, and assistance from trained staff.
• Fatigue Management: Ample seating, availability of wheelchairs, motorized carts, valet services, and low‑step shuttle buses.
• Technology: Customer support, videos explaining security procedures, and senior card programs.
• Conveniences: Spacious restrooms, volunteer assistance stations, universal design throughout the terminal, and baggage drop counters at floor level.

Examples

• Shannon Airport, Ireland: Under the Limerick Age-Friendly Strategy, improvements were made based on input from older passengers, and action plans were developed in partnership with stakeholders (Age‑Friendly Limerick, 2015).
• Portland International Airport, USA: Works with Elders in Action to pursue “Age‑Friendly” certification (Moving Toward an Age‑Friendly Portland, 2015).
• Turkey: The “Barrier‑Free Airport Project” enhances mobility for seniors with features like moving walkways with inclines under 12%, assistance buttons in restrooms, and improved waiting areas (SHGM, 2011). Under EC Regulation 1107/2006, older adults are considered passengers with reduced mobility.

Challenges and Solutions

Older travelers often encounter issues such as confusing wayfinding, fatigue from long waits, and difficulty using technology at kiosks. These challenges can be addressed through awareness initiatives (e.g., medical screenings, group tours), industry regulations (standardization), collaborative efforts (stakeholder partnerships), and national strategies with targeted measures (ACRP, 2014).

The Situation in Türkiye

With an increasing elderly population (life expectancy in 2023: 75.8 years for men and 80.2 years for women) and ongoing urbanization, Turkey’s need for age‑friendly city and airport policies has grown (TurkStat, 2020a). However, practical challenges remain—nonfunctional elevators in Istanbul’s metro stations, slippery sidewalks in Ankara, and a lack of green spaces in İzmir, as experienced by individuals like Fatma Hanım in winter and Yasin Bey with knee issues. While initiatives such as the Barrier‑Free Airport Project are promising, more targeted adjustments are needed to help seniors move independently without assistance.

Benefits and Future Strategies

Age‑friendly cities and airports reduce social isolation, improve access to healthcare, enable early diagnosis of chronic diseases, and promote sustainability. Countries like Japan, the Scandinavian nations, and various European cities serve as best‑practice examples with their accessible infrastructure and social programs. Future strategies will leverage smart city technologies (e.g., traffic management systems), sustainable infrastructure (green spaces), and the UN’s 2030 Sustainable Development Goals to expand these models. Technology will play a pivotal role in meeting the mobility and communication needs of the elderly.