Barriers and facilitators to urban mobility for older adults in LMICs: A scoping review

Abstract

The number of people aged 65 and older is projected to double by 2050, with the highest increases expected in Low and Middle-income countries (LMICs). This study aims to examine the main barriers and facilitators affecting older adults' mobility in urban areas of LMICs. A scoping review of peer-reviewed scientific literature and grey literature was conducted between January and March 2024. We screened five major databases (PubMed, Web of Science, Scopus, ProQuest, and Google Scholar) for studies reporting barriers and facilitators affecting older adults' access to mobility in LMICs. Using deductive content analysis and the Theoretical Domains Framework (TDF), barriers and facilitators were categorized into behavioral determinant domains spanning four overarching categories: individual, socioeconomic, place-based, and institutional. Forty-four articles from Asia, Africa, and Latin America met the inclusion criteria and were retained for data extraction. Safety concerns, exacerbated by inadequate infrastructure and unsafe road user behavior, represent significant barriers, while gender norms specifically restrict older women's mobility. Conversely, key facilitators include familial support and intergenerational solidarity, subsidized transport, and specific government interventions. Older adults' mobility in urban areas of LMICs is affected by safety concerns, especially for women, and a lack of appropriate infrastructure and reliable public transportation options. These barriers result in limited outdoor mobilities, potentially leading to social isolation and exclusion. These challenges can be overcome through specific interventions that promote more affordable, reliable, and safer public transportation and improved walking options.