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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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