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As a general comment, I'd like to say that getting out of the house is a hell of a lot easier when you don't have to drive everywhere to participate in daily life. So and so family member sits at home and watches TV all day is a phenomenon caused primarily by our car-centric culture which, for the elderly, is a barrier to staying healthy both mentally and physically.
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I do think that once an elderly person loses the ability to drive, it's often a big tipping point towards their decline. I would suspect that losing the ability to drive usually (but not necessarily) comes before losing the ability to navigate public transit.

But I don't immediately believe the link that 'car culture' -> 'earlier cognitive decline'. Car culture, for example, is usually associated with living on larger plots of land, which comes with its own set of tasks and chores that can keep someone older occupied. A smaller apartment requires much less ongoing work.

I think a lot depends on the individual and how they best stay active. More dense living probably provides easier opportunities to do things, whereas less dense living sort of forces you to perform ongoing tasks.

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If the additional area is used for new hobbies, hosting guests, or something fulfilling and interesting, then sure it can help keep the mind active. But people don't usually retire so they have more time for vacuuming or dusting. Many elderly people simply don't have the energy or interest to maintain their homes, it slowly falls into disrepair.
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There is a specific smell for old person homes.
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Heavy confounding there. If they’re declined enough to not drive, they’re declined in a ton of other ADLs too
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I'm no fan of car culture but I think to say it's the primary cause of living a sedentary life at home is an overstatement. I deliberately moved somewhere where I could walk to everything I needed including a fantastic central train station, I no longer even own a car, and yet... over the years my habits changed and I now spend a ton of time at home. My motivation to go out has simply declined.

There is a relevant concept in psychology called activation energy, James Clear provides a good introduction to it. Certainly in recent years screens seem to be incentivizing more stay at home behavior. People used to not own a TV, many quite intentionally, before our other screens were invented. But it is a very complicated topic.

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Of course our activity levels change and in some cases go down as we age, but I'd like to submit that is a given, and that car-only infrastructure is an additional barrier on top of those natural tendencies.

It's simply much easier to walk to a coffee shop, or park, or wherever for those who have maintained their mobility (probably in part by living in a walking-centric environment) than it is to hop in a car, sit in traffic, for small things. It's less of a barrier.

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Respectfully but strongly disagree. I'll argue you don't have to be a victim and can choose where you live if you plan ahead a little.

There's plenty of places where a car is not necessary and even if people think a car's necessary I'm often the only one on a bicycle in many places.. It's doable if you're willing to put in the effort.

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I think that suggesting that an octogenarian either uproot their life to a less car-centric place or start riding a bike everywhere is a bit unreasonable.
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> suggesting that an octogenarian either uproot their life to a less car-centric place or start riding a bike everywhere is a bit unreasonable

It is. But looking ahead, knowing what we know now, choosing to age in a car-centric place comes with known health effects.

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It's a cart and horse problem.

You can choose to live where you don't need a car, but those places become fewer and fewer because of the distances needed for cars. (as in parking space minimums mandated by the city).

"Not just bikes" on Youtube goes into this a lot. Car-centricism is self-reinforcing. Eventually you have no such thing as a mid-density neighbourhood.

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Please dont minimize disasterous societal policies, it is not respectful
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As far as I’m aware, every US city where it’s at all common (let’s say 10%+ of households) to live without a car, it’s extremely expensive to live. Are there gems that I’m unaware of?
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There are cities in the Midwest with a large carfree share by necessity (income) but as far as by choice/design, Philly and Baltimore appear to hover around 25-30%
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New Orleans
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Probably not a great place to move to right now.

https://news.ycombinator.com/item?id=48015218

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It's hard to really say from anecdotes. My uncle retired early and was sharp as a whip until 86 or so. Then decline hit him hard. There was no change in life circumstances, he just got old.

Also, I think you'll find that taking care of someone who can't take care of themselves is a lot of work. I had to do it for my mom for 6 months and its a ton of stuff. Talking to doctors. Arranging appointments. Etc.

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"I think you'll find that taking care of someone" => I know you were writing this generically. And I'm just replying to this for the sake of all of us who do actually know what it's like taking care of someone.

But yeah. Holy shit this is hard. I've been doing this too. Had to move my mom and dad to a place a block from me when my mom was going through her final few months with Alzheimers. That was so hard. So gross. And then now with this descent of my dads. You are catching me fresh from yet another aorta aneurism surgery of his last week. This is bananas. Just endless worry, driving, appointments, cleaning, pills, macgyvering the endless broken down things in his life: the tv, the remote, the blood pressure monitor.

OMG. I see you. I feel you. :) This is a rough part of life y'all.

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Maybe a little consolation but still - you are doing an amazing and wonderful thing that you can be proud of for rest of your life. Extremely hard and taxing, no doubt there. Think about some nice moment from childhood when things are rough.

Respect to you and all others doing similar service.

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From my pool of anecdotes I can only say that moving around - not necessarily doing sports or anything - affects things tremendously.

My maternal grandmother lived to 97, while my grandfather is still with us at 99. Interestingly, their next door neighbours are also alive and in their late 90s.

The one thing they had in common was living four floors up without an elevator. Curiously, in that block, people started dying starting from the lower floors.

Realistically I think they were born in an unique moment in history, which allowed them to have a childhood of running around barefoot, barely ever seeing a motor vehicle[0] and an adulthood with modern sanitation and post-war healthcare.

[0] Grandpa recalls how bewildered everyone was by the arrival of the nazis, with their tanks, motorcycles and, closer to the end of the war, bicycles(that part he found hilarious). They've never seen such a huge motorcade in their lives.

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Saw similar with my grandmothers. One had a busy social live and volunteer schedule for 20+ years, the other.. did not.

A reminder that you cannot simply retire FROM something (work, commuting, etc) but must retire TO something (hobbies, social life, second career, volunteering, etc).

There's always more opportunities in the community than there are volunteers, so look around.

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>A reminder that you cannot simply retire FROM something (work, commuting, etc) but must retire TO something (hobbies, social life, second career, volunteering, etc).

Yeah, my guess is that someone retiring early to pursue their hobbies and interests is going to be much better off than a blue collar worker made redundant or disabled in his 50's. I always see these sort of studies used to slam the idea of FIRE, but I very much have my doubts that these findings apply equally to everyone.

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Retiring TO something is important, but ideally it needs to involve a lot of in-person socializing, which many hobbies do not have. Golfing, for example, is pretty much the platonic ideal of a hobby that involves both socialization and old-person-friendly exercise.
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I think it's good advice even if anecdotal. At least I do not think it hurts. My own observation is that almost everyone gets hit hard by the 80s. A lot of people in their 70s are spry, but it seems like damn near everyone gets significant decline in their 80s. A few people make it to the 90s, and some are even relatively spry, but my own anecdotal observations are that it is fairly rare. My grandparents both made it into their mid-90s before the decline really took hold (and then it was fast) but they were outliers. Both of my own parents made it to their mid-80s and that was it.
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my mother's dementia diagnosis this year started as severe ADHD symptoms 4 years ago. but many years before that she enjoyed her retirement and pension as her last boss was abusive, and she was a bit traumatized by this that merely suggesting the idea of working again would make her anxious. the symptoms started from the stress of taking care of my dad, who suddenly found his workplace extremely stressful due to an incident with his boss snapping at him. this led to fainting incidents where he had to be rushed to ER and a after an extended disability leave he was let go. he has never been so relieved. however this just worsened my mom's condition, and the need to move out of their home of 20 years escalated it (moving stress syndrome as confounding catalyst). after only 1 year she forgot about this home and that she ever lived in it. She thinks she still lives in an earlier house. my father is much much happier, even when taking care of mom and they still get to travel. mom simply forgets what happened an hour ago, but my dad's happy just getting to travel the world with her while she can. So.. more of sample size of 2 abusive bosses in the workplace leading to significant mental and physical health improvements upon leaving such bosses. mom enjoyed kdramas, dad enjoyed reading more of world history, they regularly do everything together everywhere. they love the same music that my mom remembers every word and dance to.
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> But in his 80s he was working at Menards as a greeter and stocker.

> He had to stop to help take more care of my mom, and quickly, he just fell out of all these things. Cognitively. Health. Ability to do anything decision wise or to better himself just tanked.

It's a nice "just so" story, but when you're in your 80s, you are already in multiple stages of decline across the board. One small injury can cause a cascading failure of systems.

> The poor health came after being forced to quit.

I don't know how you can so authoritatively state this about a man in his 80s. (e.g. - past the average life expectancy). 80 is just really really old. How fast the decline gets you at that point is really mostly a genetic lottery.

But if the anecdote helps you be more active personally - more power to you.

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"how you can so authoritatively state this" => because that is the exact order of events :) A happened. Then B happened. i didn't say A caused B. just like we're all discussing here in this thread. just another datapoint that we are sharing here where it seems like there could be a causation not just correlation. but i didn't authoritatively state anything other than I know what happened on one date, and then what happened on another date.
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