Mobility is essential if we are to take an active part in society today. For older people, transport and the ability to get around are important from both an individual and a societal perspective. Being mobile means being able to participate in activities outside the home; it means better health, functional capacity and autonomy, and measures promoting the mobility of older people will be increasingly important in the future. The present report is part of a larger project about mobility and its impact on older people’s well-being and welfare: Mobile age: The impact of everyday mobility for elderly people’s welfare and well-being. The heterogeneity of older people is emphasised, not only with respect to physical age but also with respect to the specific resource situation and social context of everyday life. The geographical context of the project is Denmark, Norway and Sweden. The report is a literature review examining and evaluating measures designed to improve the independency of mobility among older people. While a few good examples of “best practice” in the Scandinavian area (Denmark, Norway and Sweden) have been highlighted, gaps and weaknesses remain. The areas which are examined in the present report are private car, public transport, cycling, walking and to some extent other transport modes defined by motorized wheelchairs, scooters, four-wheeled mopeds/motorcycles, etc. Measures to increase travel with public transport are on the agenda in all three countries, i.e. accessible vehicles and increased accessibility to the interchanges. Also, often small amendments through the travel route could make difference, such as pavements without stairs and benches on the way to the bus stop. Furthermore, strategies and measures for improving public transport concern not only issues such as accessible vehicles, wind shelters and plain pavements at bus stops, but also frequency and routes in relation to the mobility needs of a new generation of older people. However, lack of information and knowledge about public transport services is often rife among older people, which results in them travelling less than they might have done or shying away completely from using public transport. Information campaigns could be synchronised consciously to meet older people’s travel trajectories. New ways of providing information using the latest technology could be found to meet the needs of older people. Actually, sometimes the problem is not lack of information but too much of it or the wrong kind. More research, trials and evaluations are needed here, too. Measures introduced to improve public transport bring to the fore questions about the whole journey concept). The outcome from previous research is that public transport measures promoting older people’s mobility are not possible without the entire journey being considered. There remains a lot to be improved, e.g. more than 200—300 metres constitute a too long walking-distance for many elderly people, and the environment at many interchanges is uncomfortable and stressful. Moreover the information before and during the trip should be visual and audible, timetables easy to read, it should be easy to buy a ticket and handle the ticket machine, low floor vehicles would be desirable as well as vacant seats on board, and the driver should not start before passengers get seated. Public transport always also includes some walking or bicycling. Safety and mobility are closely related. Safety measures are most promising when they lead to increased physical activity, e.g. provision of practical aid and by making pedestrian infrastructure less complex, less demanding and more attractive. Older people appreciate prepared pedestrian crossings and signal-regulated intersections. Pavements are important. The future building of urban environment can benefit from the experiences and expectations of an older population influencing the project right from the beginning of the planning process. Wide bicycle paths or cycle streets separated from main streets are greatly appreciated by older bicyclists, according to the studies reviewed. High kerbstones and steep gradients are to be avoided. There is potential for more technical support systems addressing older bikers’ comfort and safety; for example, detectors well in advance of signal-regulated intersections to give cyclists the green light without their having to slow down or dismount, signals or lights warning cyclists of approaching motor vehicles or vice versa at intersections, and better guidance at night time, e.g. leading lights in pavements or stronger street lightening at times when cycle traffic is present. Also questions of design were highlighted and especially the concept of universal design in public transport and urban areas. The most challenging question is about coming up with improvements for coping with winter conditions. In the present review, a lack of financial resources was pointed out as a barrier to the process of improving accessibility for older and disabled people. Previous evaluations have indicated that when an area is renewed it is not always properly integrated with the surrounding environment, thus a new accessible area can become ‘an inaccessible accessible island’. A memo in Sweden targeted at older drivers highlights vehicle design as important for all car owners/drivers, and especially older drivers. It was for example stated that to facilitate driving in darkness the headlights must be of good luminous quality. An antiskid system and other technical safety support systems are mentioned, as well as good, well-designed, boot space for the ease of lifting heavy luggage. Automatic gearbox and hill-hold control (HHC), which is a technical support mechanism that holds the brake until the clutch is at friction point (making uphill starts easier), as well as a sun protection systems are also preferred equipment for older drivers. Questions about the drivers renewing their license in old age and about campaigns promoting car-driving among older, healthy people have also been highlighted in the present literature review. No study has been able to demonstrate that cognitive screening is worthwhile. Recent test studies could not predict accident involvement among older drivers. Rather, tests of all drivers over a certain age seem to be inefficient for society, in relation to security. Instead the focus should be on specific diseases (not on specific age) and also on how information promoting older drivers’ skills and willingness to continue driving could be produced and evaluated. To some extent, drivers can compensate for functional limitations by using in-car technical support systems. One conclusion from this literature review is that there is a need for thorough study of technical support systems based on the experiences of older drivers — not least the oldest drivers (75+). The driver support systems discussed in the present report shown considerable potential to promote safe mobility among older drivers, e.g. in-vehicle information and communication systems (IVIS), and advanced driver assistance systems (ADAS). Another conclusion, one that can be drawn from a Swedish study reviewed in the present report, is that cars with automatic gearbox are advantageous in prolonging safe driving among older people. Further research is needed in this regard. Norway has a tradition in arranging courses for older drivers. “Driver 65+” is open to all Norwegians from 60 years and organised by the Norwegian Public Roads Administration (Statens vegvesen) in collaboration with authorized driving schools. The aim of these courses is to improve traffic safety and to keep up/improve the mobility of older people. The results from a Norwegian evaluation of education for older car drivers indicate that the refresher course has a beneficial effect on safe mobility given that the driver completes the course before turning 75 years of age. Similar courses are organised in Sweden and Denmark. In Denmark, the Danish Road Directorate (Vejdirektoratet, VD) decided in 2010 to draw attention to the situation of older drivers and therefore to provide subsidies for courses for this target group. In Sweden there are no subsidies from the government and the courses are now organised and developed by NGOs (pensioners’ associations and traffic safety organisations) on non-profit basis. There is a great need for coordination of the courses, and more evaluation is needed concerning both the practical and theoretical moments in the courses across all the Scandinavian countries. More research and evaluations are needed in almost all the reviewed areas, and also more cooperation between different actors. Transport authorities in Scandinavia have not fully adopted the characteristics of the heterogeneity within the group of so-called “older people”, i.e. pensioners from younger old (about 60—65 years) to older old (80+). Measures often lack an overall view and few of them are evaluated. They are often carried out as pilot projects or small tests, and are always limited in time and resources. New projects often start as well before the “old” projects are properly evaluated. More continuity and permanent measures would be preferable. (Author/publisher)
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