Age-Friendly Cities

Age-friendly cities are an innovative urban development model created in response to the demographic and social challenges arising from the aging of the global population. This concept, launched by the World Health Organization (WHO) in 2006, aims to support older adults in leading active healthy and independent lives, increase their participation in social life, and enhance their quality of life. Age-friendly cities are designed to meet the needs of all segments of society including children people with disabilities children with disabilities and other disadvantaged groups not only older adults.

Age-Friendly Park (Image generated with AI support.)

Population Aging and Urbanization

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 as of 2019 9.1 percent of the world population was aged 65 and over; this proportion is projected to reach 11.7 percent by 2030 and 15.9 percent by 2050 (UN Department of Economic and Social Affairs 2019 p. 18). The primary drivers of this increase include the extension of life expectancy at birth which rose from 64.6 years in 1990 to 72.6 years in 2019 an increase of eight years and the decline in fertility rates which fell from 3.2 births per woman in 1990 to 2.5 in 2019 (UNDESA 2019b pp. 18-28). The United Nations Population Division notes that low fertility rates will further intensify this trend and that the proportion of older adults in urban areas is expected to rise to 22 percent by 2050 (UNECE Working Group on Ageing 2015 p. 2; Ferreira 2010 p. 55).

WHO defines aging biologically as the limitation of physiological functions due to molecular and cellular deterioration increased risk of disease and reduced individual capacity (WHO 2015 p. 25). Improvements in education health care and living conditions have accelerated this process particularly increasing urban migration in developing countries. In Türkiye as of 2019 the proportion of the older population reached 9.1 percent of which 7.9 percent lived in urban areas and 1.2 percent in rural areas (TÜİK 2020b). Life expectancy at birth which was 30 years for men and 33 years for women in the 1940s has risen to 71 and 76 years respectively today; in 2023 it is estimated at 75.8 years for men and 80.2 years for women (TÜİK 2020a). This demographic shift renders the adaptation of cities to be age-friendly not only a necessity but also a mark of human achievement (UNDESA 2019c).

Biological effects of aging include loss of vision and hearing reduced mobility decreased walking speed balance disorders and chronic diseases such as coronary artery disease osteoporosis and diabetes mellitus. Psychological and social dimensions manifest through factors such as income loss after retirement social isolation and weakening of family ties. These conditions can increase dependency among older adults; however appropriate environmental conditions can mitigate these effects (Tutal and Üstün 2009 p. 2).

The Age-Friendly City Concept

An age-friendly city is defined by WHO as one that supports the active participation of older adults by providing accessible structures and services and safe livable environments (WHO 2007 p. 1). Aslan (2015 p. 26) describes such cities as environments that enable active aging through safety and cleanliness while Gorman and others (2019 p. 2) define them as spaces offering affordable and accessible transportation. This concept became an international effort in 2006 with WHO’s Global Age-Friendly Cities Guide aiming to transform older adults from passive service recipients into active members of society (WHO 2007). The Brasilia Declaration on Aging (1996) emphasizes that older adults are a resource for families communities and economies (WHO 1997 p. 21).

Older Adults Walking on Sidewalks (Image generated with AI support.)

Eight Core Domains

WHO evaluates age-friendly cities across the following eight domains:

1. Outdoor Spaces and Buildings: Public areas must be clean safe and pleasant; this includes green spaces non-slip sidewalks wheelchair-accessible designs adequate seating good lighting and accessible buildings such as those with elevators ramps and handrails.
2. Transportation: Affordable frequent public transit operating during nights and weekends accessible bus stops driver training programs options for people with disabilities safe pedestrian crossings and bicycle lanes.
3. Housing: Affordable climate-friendly housing located near services with interiors adapted to age-related mobility needs and safe living conditions including home care services.
4. Social Participation: Accessible gathering spaces diverse activities (individual or with companions) programs that prevent social isolation and intergenerational events in community centers.
5. Inclusion and Respect: Respectful services for older adults positive media representation intergenerational educational activities and improved access for economically disadvantaged older people.
6. Civic Participation and Employment: Flexible employment opportunities incentives for volunteer work prevention of age discrimination and post-retirement education programs.
7. Information and Communication: Clear readable information in large fonts age-friendly technology devices such as phones with large buttons and internet access one-on-one support and regular updates.
8. Community Support and Health Services: Nearby and accessible health services home care including personal care and household assistance emergency planning and promotion of volunteer services.

These components are based on the ecological model of Nahemow and Lawton which emphasizes the dynamic interaction between individual adaptation and environmental change (Van Hoof 2018). WHO recommends that these domains be integrated with principles of inclusive cities (tolerance equity social justice) and sustainability (balance between current and future generations) (Coşkun 2019). Furthermore Sustainable Development Goal 11 of the 2030 Agenda for Sustainable Development supports age-friendly elements such as accessible housing public transportation and green environments (UNDESA 2020).

Four-Phase Cycle

The four-phase process recommended by WHO to achieve age-friendly city status is as follows:

1. Planning (1-2 Years): Establishing mechanisms for older adult participation such as advisory councils assessing the city’s current situation using epidemiological data and needs analysis developing a three-year plan and identifying monitoring indicators such as access rates to health services.
2. Implementation (3-5 Years): Submitting plans to WHO for approval within two years and implementing them within three years such as infrastructure projects and social programs.
3. Evaluation of Progress (End of Year 5): Submitting a progress report to WHO at the end of the first cycle including performance indicators.
4. Continuous Improvement: Renewing the process with new plans every five years if progress is demonstrated and maintaining membership in the global network.

Active Aging and Age-Friendly Cities

Active aging is a process that encourages older adults to participate in social economic and cultural activities (ASPB 2014). The UN Principles for Older Persons adopted in 1991 emphasize independence (capacity building independent living income-generating activities) and participation (social relationships involvement in political processes) (Buz et al. p. 391). Age-friendly cities support these principles by promoting healthy aging reducing dependency and improving quality of life (WHO 2007). Physiological changes associated with aging such as vision and hearing loss and reduced mobility along with chronic diseases like coronary artery disease and osteoporosis can hinder this process; however appropriate environmental conditions can mitigate these effects (Tutal and Üstün 2009 p. 2).

WHO’s definition of “successful aging” includes low risk of disease high physical and cognitive function and active engagement with life (WHO 1995). Age-friendly environments play a critical role in achieving these goals. For example accessible sidewalks help maintain walking speed while social participation programs reduce isolation. In Türkiye policies promoting active aging have positively impacted the psychosocial well-being of older adults and aim to prevent premature mortality (TÜİK 2020a).

International Examples

Age-friendly city initiatives vary globally:

• Manchester United Kingdom: The “Older People Are Valuable” partnership initiated in 2003 developed projects with older adult participation to reduce social exclusion. In 2016 the Ageing Centre encompassing ten municipalities focused on marginalized groups through a program where older adults acted as co-researchers (Buffel 2016).
• La Plata Argentina: A pilot study measuring the impact of education levels on health perception demonstrated the importance of equity; health perception was 70.4 percent among those with higher education versus 59.5 percent in the general population (WHO 2015).
• Taiwan: Age-friendly environments are shaped by collectivist and authority-based policies with public data prioritized in needs assessments (Chao and Huang 2016 pp. 87-88).
• Quebec Canada: Community-based solutions have been developed through collaborative partnerships; Case A (strong community foundation) and Case B (municipal leadership) illustrate different dimensions of participation (Garon et al. 2013 pp. 74-79).
• Slovenia: Transportation (accessible public transit safe stops) and housing (proximity to services) are prioritized to improve quality of life for older adults (Kerbler 2015 p. 42).
• Palo Alto United States: An evaluation model based on WHO guidelines analyzed population needs (prevalence of chronic diseases) and service capacity (transportation options) (Ruza et al. 2014 p. 391).
• Poland: Comprehensive urban renewal strategies have promoted social inclusion with economic revitalization and building restoration emphasized (Labus 2012 pp. 159-160).
• Tehran Iran: Potential for age-friendly development has been assessed through green spaces safe pathways social participation activities and workplace accommodation recommendations (Sharqi et al. 2016 p. 49).
• Japan: Serves as a model for accessibility and public transportation for its high proportion of older adults.
• Scandinavian Countries (Sweden Norway): Offer specially designed social programs and health services.
• European Cities (Amsterdam Stockholm Copenhagen): Recognized for age-friendly infrastructure and environmental planning.

Age-Friendly Park (Image generated with AI support.)

The Age-Friendly Airport Concept

As the share of older adults in tourism grows the need for airports to become age-friendly has become increasingly important (Frye 2011 p. 41). An age-friendly airport provides specialized services in areas such as wayfinding fatigue technology and accessibility (ACRP 2014):

• Wayfinding: Clear signage touch-screen kiosks smartphone applications and staff assistance.
• Fatigue: Seating areas wheelchairs motorized carts valet services and low-step buses.
• Technology: Customer support video explanations of security procedures and senior card programs.
• Accessibility: Spacious restrooms volunteer stations universally designed spaces and ground-level baggage drop-off counters.

Examples

• Shannon Airport Ireland: Accessibility was improved through consultations with older adults under the Age-Friendly Limerick Strategy and action plans were developed with partners (Age-Friendly Limerick 2015).
• Portland Airport United States: Collaborative efforts with Elders in Action are underway to achieve an “Age-Friendly” certification (Moving Toward an Age-Friendly Portland 2015).
• Türkiye: The Accessible Airport Project enhances mobility for older adults with features such as ramps with less than 12 percent incline handrails in restrooms and waiting areas (SHGM 2011). Under EC Regulation 1107/2006 older adults are classified as passengers with reduced mobility.

Challenges and Solutions

Older travelers face challenges such as wayfinding (confusing signage) fatigue (long waiting times) and technology use (difficulties with kiosks). Awareness (medical check-ups group tours) sectoral regulations (standardization) collective efforts (stakeholder collaboration) and national strategies (specific regulations) can address these issues (ACRP 2014).

An older adult in the city (Image generated with AI support.)

Situation in Türkiye

With the rising older population in Türkiye (75.8 years for men and 80.2 years for women in 2023) and rapid urbanization the need for age-friendly city policies has increased (TÜİK 2020a). However problems persist such as non-functional elevators in Istanbul’s metro system slippery sidewalks in Ankara and lack of green spaces in İzmir (for example Fatma Hanım’s winter difficulties and Yasin Bey’s knee problems). While initiatives such as the Accessible Airport Project offer hope more regulation is needed to address the specific needs of older adults such as the ability to walk without assistance.

(Image generated with AI support.)

Advantages and Future Strategies

Age-friendly cities reduce social isolation improve access to health services enable early diagnosis of chronic diseases and support sustainability. Japan Scandinavian countries and European cities serve as models through accessibility and social programs. In the future smart city technologies (such as traffic management) sustainable infrastructure (green spaces) and the 2030 Sustainable Development Goals will support the expansion of such cities (UNDESA 2020). Technology will play a key role in meeting older adults’ needs for mobility and communication.

Age-friendly cities offer a solution to the global challenge of aging by promoting active aging and enhancing the well-being of the entire population. Developed under WHO’s guidance this model is strengthened through international cooperation and is increasingly applicable in developing countries such as Türkiye. Age-friendly airports and cities are becoming integral components of modern societies contributing to a more inclusive and sustainable future.