How older adults experience the age-friendliness of Skopje: Results of the validation of the AFCCQ for use in North Macedonia and a representative survey.

Hundreds of cities and communities in the world have joined the WHO's Global Network for Age-Friendly Cities and Communities since 2010. In order to do quantitative assessments of the age-friendliness of cities, the Age-Friendly Cities and Communities Questionnaire (AFCCQ) was developed for the Dutch municipality of The Hague. The purpose of this study was first to translate and test the validity and reliability of the AFCCQ for use in North Macedonia and second to explore perceptions on age-friendliness of the bicultural and bilingual City of Skopje. The AFCCQ proved valid for use in North Macedonia. Overall, older adults in Skopje experience the age-friendliness of the city as neutral (in seven out of nine domains). The best score ("slightly satisfied") was found in the domain of Housing domain, which was rated positive in all ten municipalities. The lowest total score ("slightly dissatisfied") was found in the domain of Outdoor spaces and buildings scoring, which received negative scores in eight out ten municipalities. In five out of nine domains differences were observed between the Albanian and Macedonian communities. The Albanian sample has slightly higher scores in two domains: 1) Housing and 2) Civic Participation and Employment, while the Macedonian sample scored higher in three domains: 1) Communication and Information; 2) Outdoor Spaces and Buildings and 3) Transportation. A hierarchical cluster analysis further revealed the presence of six distinct age-friendly typologies that can be used for a better understanding of subpopulations in the city and draft policies and action programs on the city level.

Planning for Play? A Systematic Literature Review.

Play has well-established physical and mental benefits for people of all ages. Urban spaces, such as parks, provide important public arenas in which to play. But to what extent do planners or planning scholarship focus on facilitating play? Our systematic literature review of 3,800 articles in nineteen academic planning journals returned 126 articles related to play. We found that the planning for play literature is an emerging discourse overwhelmingly focused on children and the physical design of urban spaces in predominantly English-speaking nations. The study identifies gaps in the planning for play literature and outlines recommendations for future research.

Queering Age-Friendly NYC: A Critical Discourse Analysis.

This study employed critical discourse analysis to investigate the representation of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults in the context of New York City's age-friendly initiative. An extensive review of over 800 pages of public records was conducted to understand how LGBTQ+ older adults were depicted within the discourse and to identify the authorities responsible for their recognition. The findings highlight the unequal representation of social identities, notably the absence of transgender and queer older adults in the examined texts. Authorities wielded discourses of power and accountability to influence perceptions of LGBTQ+ older adults, focusing on their risks and vulnerabilities. This emphasis on deficits, without acknowledgment of strengths and protective factors, has implications for age-friendly initiatives and may lead to an oversight of information necessary for the development of culturally sensitive interventions. To foster communities that are not only friendly but also equitable and just, policymakers must recognize and address subgroup variations within the LGBTQ+ population. This research underscores the importance of ensuring that age-friendly initiatives are inclusive and responsive to the diverse needs of LGBTQ+ older adults.

Transgender and queer aging experiences are omitted from age-friendly NYC.Age-friendly policies need to be analyzed for who matters and benefits.Policymakers should understand the impact of language used to classify people.Age-friendly policies must address subgroup differences in risks and resiliency.

A multi-year quantitative study of the experienced age-friendliness in The Hague: A tale of four personas.

As an active member of the Global Network for Age-Friendly Cities and Communities, The Hague has been monitoring the progress over the years. In 2022, a second cross-sectional survey based on the Age Friendly Cities and Communities Questionnaire (AFCCQ) was conducted among 396 community-dwelling older citizens in the municipality. During times of the pandemic, scores for Social Participation went notably down, and scores for Respect and Social Inclusion increased. For the first time, based on survey data, four personas were found through cluster analysis. These personas ranged from the precariat and people with personal health issues with lower scores, to the silent majority without the limitations of health problems, and the upper echelon who score positively in all domains. Age-friendly policies in The Hague should focus particularly on the first two clusters through dedicated action plans, which would help steer efforts towards those most in need for support. This would help The Hague to become an age-friendly city for all, and not only for those living in good health and with sufficient financial means.

What the pandemic and its impact on the mobility and well-being of older people can teach us about age-friendly cities and communities.

From the start of the pandemic, questions were raised concerning how the pandemic could change or even transform relationships to our living environments. COVID-19 has had a disproportionate impact on the health and well-being of older people due to the increased risk of severity of the disease with both advancing age and associated co-morbidities. Restrictions on the movement of older people have also been more severe, with many countries imposing restrictions based on chronological age. In Portugal, confinement measures were targeted at older persons in terms of sheltering-at-home orders for those over 70. This paper looks at the impact of these restrictions on the lives of older people and asks what we can learn from the pandemic about the concept of age-friendly cities (WHO, 2007a). We look at the lived experience of older people to understand how their well-being and mobility were impacted during the crisis and its aftermath. The study was undertaken in four urban areas: Aveiro, Coimbra, Lisbon, and Faro. Data was collected using semi-structured interviews analysed using a process of thematic coding based on the eight pillars of the WHO's Age-Friendly City Checklist (WHO, 2007b). The results are discussed using conceptualisations from the new mobilities paradigm: existential mobility, connection and (im)mobility governance, offering new ways of thinking about age-friendliness in and out of crisis.

Locked down by inequality: Older people and the COVID-19 pandemic.

This paper develops the argument that post-COVID-19 recovery strategies need to focus on building back fairer cities and communities, and that this requires a strong embedding of 'age-friendly' principles to support marginalised groups of older people, especially those living in deprived urban neighbourhoods, trapped in poor quality housing. It shows that older people living in such areas are likely to experience a 'double lockdown' as a result of restrictions imposed by social distancing combined with the intensification of social and spatial inequalities. This argument is presented as follows: first, the paper examines the disproportionate impact of COVID-19 on older people, highlighting how the pandemic is both creating new and reinforcing existing inequalities in ageing along the lines of gender, class, ethnicity, race, ability and sexuality. Second, the paper explores the role of spatial inequalities in the context of COVID-19, highlighting how the pandemic is having a disproportionate impact on deprived urban areas already affected by cuts to public services, the loss of social infrastructure and pressures on the voluntary sector. Finally, the paper examines how interrelated social inequalities at both the individual and spatial level are affecting the lives of older people living in deprived urban neighbourhoods during the pandemic. The paper concludes by developing six principles for 'age-friendly' community recovery planning aimed at maintaining and improving the quality of life and wellbeing of older residents in the post-pandemic city.

Age Friendly Characteristics and Sense of Community of an Italian City: The Case of Macerata.

The paper presents a study about the city of Macerata, as a representative case of an urban community in the Marche Region, Italy. The aim of this paper is to assess the level of its age-friendliness by means of a quantitative analysis based on a questionnaire that relies on the well-established eight AFC domains proposed by the WHO. In addition, the sense of community (SOC) is investigated and how the older residents relate to it. Studies that analyze age-friendly Italian cities in relation to elder outcomes are limited. The paper contributes to fill this gap, and the findings reveal that the elderly respondents are not particularly satisfied about the services and the urban infrastructure of the city but show nevertheless a sense of community. It might be the combination of urban and rural features that contributes to the longevity and strong sense of community of the city despite its poor infrastructure and average services.

Instructor Social Support in the Group Physical Activity Context: Older Participants' Perspectives.

Instructors in organized physical activity classes can be a source of social support through their relationships with participants, influence on participants' interactions with each other, and design of activities. Grounded in interpretive description, the objective of this study was to examine older adults' experiences of and their perspectives on group physical activity instructors' supportive behaviors. Observations of 16 group physical activity classes (N = 295) and focus groups or interviews with N = 38 class participants aged ≥ 55 (n = 29 women) were conducted at four municipal recreation facilities in a Canadian city. Five themes shed light on how instructors provided social support: (a) supporting autonomous engagement, (b) developing caring connections, (c) fostering trust through expert instruction, (d) managing conflict directly and effectively, and (e) creating a climate where people want to go. Instructor training should consider older adults' social support needs and help instructors embody behaviors that support continued physical activity participation, thereby contributing to healthy aging.

Age-Friendly Community Interventions for Health and Social Outcomes: A Scoping Review.

To address the numerous challenges associated with aging, increased attention has been given to the development of age-friendly cities and communities (AFCC) to promote healthy aging and social participation. However, limited evidence exists for addressing both health and social needs through the AFCC framework. We address this gap by conducting a scoping review of the interventions that target both health and social outcomes within the purview of the AFCC framework. The results showed that many of the successful interventions used a partnership model and behavioral change theories to inform the program design and implementation. The results also indicated that social participation and engagement played a key role in making the interventions successful. However, the results revealed that the literature is dominated by person-focused approaches. Future research should focus more on evaluating environmental-focused interventions and develop a holistic framework that combines both person- and environment-based approaches to healthy aging.

Potential roles of occupational therapists in urban planning for age-friendly environments: A Q-methodology.

BACKGROUND: Urban planning for age-friendly environments is an important issue, and occupational therapists and occupational scientists could contribute to planning such environments; however, knowledge of the potential roles of occupational therapists is limited. AIM: To explore the potential roles of occupational therapists in urban planning for age-friendly environments in Japan from the perspectives of occupational therapists and stakeholders. MATERIALS AND METHODS: A Q-methodology study was conducted to gain viewpoints from occupational therapists and stakeholders regarding their roles in the urban planning of age-friendly environments for older people in Japan. Participants included eight occupational therapists and seven stakeholders who completed the Q-sorting process. RESULTS: Three viewpoints emerged which are interpreted as roles of occupational therapists: (1) Promote older people's participation in everyday activities in their communities, (2) Advocate for older people towards policy-making to reflect their occupational needs or perspectives, and (3) Arrange neighbourhood environments towards enhancing participation in occupation through adjustments to compensate for functional limitations. CONCLUSION AND SIGNIFICANCE: Results reveal the potential roles of occupational therapists in urban planning for age-friendly environments in Japan. These roles can be a guide in the continuing professional development of occupational therapists in the fields of urban planning for older people.

Influence of promoting an "age-friendly cities" strategy on psychological capital and social engagement based on the scenario method.

Holding large conferences and events usually encourages the corresponding government to upgrade the host city. For this process, incorporating additional costs to increase accessibility for the elderly is a feasible means for a city to develop in an age-friendly manner. Providing evidence-based reports to policy makers is conducive to implementing the policies of age-friendly cities. This study used the scenario method to simulate the effect of promoting the "age-friendly cities" strategy on residents' psychological capital and social engagement (SE). We found that promoting the construction of age-friendly cities can significantly improve residents' psychological capital and SE and that residents from all age groups can benefit. This paper provides an economical means to influence policymakers through evidence-based reports in promoting the development of age-friendly cities.

Older people perceptions on the built environment: A scoping review.

As the world ages, the built environment requires special attention to assist this growing part of society and therefore the update of urban design guidelines and urban policies is required. The goal of this study is to provide an overview of existing literature regarding emotions and perceptions from older people related to the outdoor built environment. A scoping review was performed using empirical studies in 12 scientific databases in a fourteen-year period (2007-2021) involving people at least 60 years old and outdoor built environment perceptions. Collected evidence identified 52 papers following the PRISMA procedure. Studies reported basic emotions (e.g., fear, joy) and space perceptions (e.g., walkability, accessibility) regarding the outdoor built environment as sidewalks, streets, and greenery. Our study reinforces the importance of analyzing older people perceptions regarding the outdoor built environment so that architects, urban planners, and decision makers have information to design solutions that fit older people needs.

Friendly Residential Environments and Subjective Well-Being in Older People with and without Help Needs.

Previous studies have shown that friendly environments are associated with well-being and higher quality of life in older people. This study aimed to investigate the relationship between friendly environments and subjective well-being by segmenting the population according to the need for help in performing activities of daily living (ADLs) in a representative sample of people over 55 years of age in the Basque Country (Spain) (n = 2760). To determine the predictive power of friendliness on subjective well-being, two separate linear regression models were obtained according to the need for help in ADLs. The results obtained show a greater explanatory power of the model in the case of people who required help. However, in the case of people who do not need help, subjective health had a greater weight in the predictions. This paper's findings support the greater importance of the characteristics of the physical and social environment, as people's functional status worsens, with friendliness being an explanatory factor for people's well-being as they age and their dependency increases.

SMARTAGING in Venice. Toward a Definition of Age-Friendly Neighbourhood.

The growing population over 65 years old and the process of urbanization are two of the major challenges that the contemporary city has to address urgently. These issues require a rethinking of public spaces to ensure health and well-being and stimulate active ageing. The theme of age-friendly cities emerges in this context; it's about inclusive cities harmonised with the Agenda 2030 goals and the Universal Design principles since they support people's lives regardless of age, gender, and abilities. In particular, the neighbourhood scale represents the optimal one able to implement experimentations for the sustainable development of the city. Furthermore, the neighbourhood is generally the place of the elderly's everyday life where they are encouraged to go out and maintain their daily habits thanks to the existence of a safe and good public realm. Starting from the case study of the Santa Marta neighbourhood in Venice, the author has conducted a multi-phase analysis to investigate the quality of outdoor public spaces and which activities are played in these spaces to understand how the urban experience and the quality of life of the elderlies can be improved. At the same time, both the good practices listed by the WHO for the achievement of age-friendly environments and some of the major neighbourhood sustainability assessment tools were studied, paying attention to the social dimension of sustainability, seen as an "accelerator" of urban well-being and inclusiveness. This paper aims to present the first results of an ongoing research, whose purpose is to draft a new tool able to measure the age-friendliness - called SMARTAGING protocol - of a selected neighbourhood. Specifically, the methodological framework will be better described. In this regard, the new protocol shall support administrations in the understanding of the phenomena related to ageing by directing active policies and design choices with an increasing focus on citizens and local and social issues acting complying with the principles of Universal Design.

Contextual factors influencing the urban mobility infrastructure interventions and policies for older adults in low- and middle-income countries: a realist review.

Transportation is among the key aspects that influence active ageing. This realist review intends to understand the mechanisms of urban mobility infrastructure interventions and policies in low- and middle-income countries for older adults and to identify factors, which influenced the success or failure of interventions. We followed the steps suggested by Pawson and colleagues for a realist review. Electronic databases were searched from inception until August 2020. Studies were screened based on titles, abstracts and full text. The quality of included studies was assessed based on rigour and relevance. The evidence was obtained from 36 articles with diverse study designs conducted in 36 low- and middle-income countries. Findings were validated through stakeholder consultations from three low- and middle-income countries. Of the various individual factors identified, behaviour change communication interventions were low-cost, had a long-term impact and were efficient in increasing awareness among users to improve safety, social inclusion and about transport schemes for older adults. Improved transport infrastructure resulted in a shift from private to public transportation. For a sustainable urban transport infrastructure, good governance and involvement of stakeholders for planning and implementing transport interventions were considered necessary. Lack of evaluation, experience of transport planners, and inter-sectoral coordination were key challenges to successful interventions. The review highlighted a lack of older adult-specific transportation policies, and gender-targeted interventions for older women, suggesting a need for interventions and policies based on the contextual factors existing in a region.

Aligning Policy, Place and Public Value: Planning Age Friendly Cities in Municipal Organizations.

KEY POINTS: Age-friendly planning should not fall to local departments of senior services only.Planning coordination of age-friendly policy results in more diverse outcomes.Mapping is a tool helping policy makers visualize alternative opportunities.Maps give stakeholders the ability to track and monitor progress.This approach is easily replicable for cities implementing age-friendly programs.

Convivialité des municipalités canadiennes à l'égard des aînés : portrait et facteurs associés.

OBJECTIVES: This study aimed to (1) document, globally and by domain, Canadian municipalities' level of age-friendliness, and (2) identify municipality characteristics most associated with age-friendliness. METHODS: A cross-sectional survey was sent to all Canadian municipalities (N=3406) with an online survey of 56 items from 9 domains providing age-friendliness scores. These scores were then crossed with the following municipality characteristics: percentage of adults aged 65 and older, population density, material deprivation, social deprivation, degree of metropolitan influence, implementation step of an age-friendly municipality initiative and geographic area. RESULTS: Nine hundred twenty-one municipalities completed the survey. Overall, municipalities' age-friendliness total score is good (58.4%). Four domains have high scores: Security (80.0%), Respect and social inclusion (65.0%), Outdoor spaces and building (62.2%), and Social participation (62.2%). Higher age-friendliness is associated with metropolitan municipalities, regions other than Prairies and Atlantic, higher residential density, greater proportion of older adults, greater social deprivation, lower material deprivation, and the last step of an age-friendly initiative. CONCLUSION: This portrait of Canadian municipalities' age-friendliness can be used to strengthen actions promoting active aging.

RéSUMé: OBJECTIFS: Cette étude visait à: 1) documenter, globalement et par domaine, le niveau de convivialité des municipalités canadiennes à l'égard des aînés, et 2) identifier les caractéristiques des municipalités les plus associées à cette convivialité. MéTHODE: Une enquête transversale a été soumise à l'ensemble des municipalités canadiennes (N=3 406) à l'aide d'un questionnaire en ligne composé de 56 énoncés répartis dans 9 domaines et permettant d'établir un score de convivialité à l'égard des aînés. Ces scores ont ensuite été mis en relation avec différentes caractéristiques des municipalités: pourcentage de personnes âgées de 65 ans et plus, densité de population, défavorisation matérielle, défavorisation sociale, degré d'influence métropolitaine, étape d'implantation d'une démarche Villes et communautés amies des aînés (VADA) et région géographique. RéSULTATS: Neuf cent vingt-et-une municipalités ont complété le questionnaire. En moyenne, les municipalités présentent globalement une bonne convivialité à l'égard des aînés (58,4 %). Les quatre domaines présentant les scores les plus élevés sont : Sécurité (80,0 %), Respect et inclusion sociale (65,0 %), Espaces extérieurs et bâtiments (62,2 %) et Participation au tissu social (62,2 %). Une convivialité à l'égard des aînés supérieure est associée aux municipalités métropolitaines, aux régions autres que les Prairies et l'Atlantique, à une densité de population élevée, à une proportion supérieure d'aînés, à une défavorisation sociale supérieure, à une défavorisation matérielle inférieure et à la dernière étape d'une démarche VADA. CONCLUSION: Ce portrait de la convivialité des municipalités canadiennes à l'égard des aînés peut servir à renforcer les actions favorisant un vieillissement actif.

Engaged Scholarship in Gerontology: Frank Caro's Lifetime Contributions.

Dr. Francis G. Caro, retired Professor of Gerontology at the University of Massachusetts Boston, Co-editor (1996-2005) and Editor-in-Chief (2005-2016) of the Journal of Aging and Social Policy, passed away on October 2, 2020. Caro dedicated most of his nearly 60 years of academic and professional activity to gerontology and services for older adults. This article offers a review of his contributions in four central areas of gerontology: the strengthening of long-term services and supports through integration of home care services with other domains, the expansion of how productive aging was socially understood and economically valued, the importance of rigorous program evaluation and ongoing methodological innovation, and the significance of age-friendly cities and communities, both in the United States and internationally. This review of Caro's work highlights his integral role in helping to place several topics on the gerontological agenda that are still relevant today, establishing him as an important contributor to the field. He also exemplified productive aging and how scholarship can be theoretically rigorous but also applied in meaningful ways to make a difference in individual lives and within communities.

Assessing Age-Friendliness: Individualistic vs. Collectivistic Cultures.

A major task ahead for South Korea is to create age-friendly communities and environments that can support older residents' health, well-being, and quality of life. To that end, international partnerships have emerged to share information, assess need, and develop response strategies. In this study, the transferability of a US-developed age-friendly community resident survey, based on the WHO framework, was tested in two South Korean cities by comparing results to the same survey conducted in a US city. Descriptive, relational, and predictive analyses revealed the survey items were a better fit for the US city than the South Korean cities. Limited response variances collected in the Korean cities challenged the comparison of data between the Korean sites. Thus, a cultural lens was used to explain response patterns that reflect their understanding of social norms including avoiding disagreement and conflict in order to maintain social equilibrium and five cultural dimensions found in Western and Eastern societies (Individualism vs. collectivism, universalism vs. particularism, low vs. high power distance, low vs. high context, and inner vs, outer control). Recommendations for future assessments in South Korea include shifting focus away from the individual to the individual's social network and community to improve understanding of need.

Co-creating inclusive spaces and places: Towards an intergenerational and age-friendly living ecosystem.

Introduction: Evolving aging societies, ongoing digitalisation and circumstances of COVID-19 are changing living conditions for growing older. There is an increased urgency to view public health with a focus on integrating people of all ages into the matrix of opportunities afforded in their communities. This study initiates the conceptualization of an intergenerational, age-friendly living ecosystem (AFLE) to enhance public health planning. Methodology: A participatory study was conducted using a multi-methods approach. Six virtual co-creation sessions (n = 35-50 participants), alongside a mainly open-ended INTERGEN survey designed specifically for this study (n = 130) were conducted to conceptualize multilevel ideas for building intergenerational age-friendly places using Bronfenbrenner's ecological systems model. At the height of COVID-19, virtual applications (Zoom, Moodboard) and case studies, creative methods (drawing, photography, storytelling and spotlight sessions) were applied to engage academic and non-academic participants between ages 5 - 80+ years, across eight countries. Sessions were video-recorded with visual themes captured by a graphic facilitator. The survey covered issues of multigenerational interactions; intergenerational and age-friendly place features; place safety; and necessary stakeholders required for creating intergenerational and age-friendly places. Data were reflexively analyzed using a team approach to thematic analysis. Results: Findings present both the thematic analysis of Virtual Co-creation Camps (VCCs) and the INTERGEN survey results. These findings are addressed in three overarching categories that highlight the necessary characteristics of AFLEs as suggested by the VCC participants and survey respondents: (i) Sensory factors: feeling and emotion as starting points for physical design; (ii) Physical and digital factors in designing AFLE spaces and places; and (iii) Socio-cultural factors: tackling ageism and exclusion as part of the solution. Discussion: The analysis resulted in a pathway toward enhanced understandings on how multi-generations can better interact with fluctuating organizational domains (industry, voluntary, academic and public sectors) in urban and rural settings to facilitate intergenerational connectivity. Through processes of co-creation, an AFLE proof of concept and roadmap for public health planning was developed to support and provide opportunities for people as they age to reap the socioeconomic benefits of their local and virtual communities and help them become well integrated, valued and contributory members of society.