Urbanization and the Oldest Old: Lessons on City Living While 85+

Background and Purpose: Rapid urbanization and rapid aging are taking place simultaneously around the world, two phenomena that together and separately have disruptive impacts on public, private, and non-profit sectors. As the percentage of “the oldest old” (people ages 85 and older) continues to grow to unprecedented levels in major cities around the globe, questions arise about how to provide services and advocate for policies that support successful aging in urban environments.

This paper expands on previous literature about age-friendly cities by focusing specifically on an MIT AgeLab “Lifestyle Leaders” panel of adults ages 85 and older. The Lifestyle Leaders offer insights about opportunities and challenges of aging in urban environments that can inform best practices in program oversight and policy development.

Methods: Focus groups were conducted with twenty-eight older adults ranging in age from 85 to 93 who are regular participants in the MIT AgeLab Lifestyle Leaders group. The sample is mixed-gender, predominantly White, and predominantly upper-middle class. Participants were recruited via MIT AgeLab volunteer database as well as through snowball sampling. Focus groups were semi-structured and included open-ended questions about housing, transportation, health and wellbeing, social engagement, and technology use and adoption. Focus groups were transcribed and coded thematically, guided by a conventional content analysis approach to qualitative analysis.

Findings: Analysis revealed that adults ages 85 and over perceived urban living to be life-saving in some ways and risky in others. For many of the Lifestyle Leaders, changes in health status translated to changes in transportation options, which made urban living ideal for reasons of proximity and accessibility. Others regarded their continued participation in volunteer activities and ongoing community programs as a testament to their urbanite lifestyle and geographic centrality. In general, continuing to live in an urban environment served as a stabilizing and empowering aspect of participants’ lives, particularly in a time when changes in health and mobility, social networks and supports, and identity and roles were common.   

Risks of urban aging were identified primarily in terms of safety and affordability. Participants expressed concern about stairs and in-home features that made navigating around the home precarious. Neighborhood safety and accessibility was another concern when navigating curb cuts and short pedestrian crossings. Findings also suggested that urban living for adults ages 85 and older is financially easier than aging in a retirement community, but that affordability of aging in place also depends on level of frailty, functional capabilities, and support network. Mobile technologies often fill pieces of these gaps to keep older adults aging in their communities.

Conclusion and Implications: Findings emphasize the importance of programs and policies that support successful aging in urban environments. By advocating for safe and affordable housing and transportation options and connecting older adults and their caregivers with vibrant local programs and resources, social workers can make aging urbanization healthier, safer, and more affordable.