"I love public transport, but now I'm too afraid to use it": a qualitative study of public transport use cessation among older adults.

Abstract

Background and objectives: Mobility is a hallmark of functional aging and a major health determinant in older adults. Mobility is known to decline with age, yet, except for research on driving cessation, little is known about the role of giving up other transport modes in this decline. This exploratory qualitative research focusses on public transport use, and aims to describe the process of ceasing to use public transport, its causes, and its effects on health and mobility.

Research design and methods: This is a qualitative study, using semi-structured in-depth interviews. Participants were 23 older adults living in urbanized areas in Israel, aged 67-88 (mean 80.4 ± 6.5), in various stages of public transport use cessation. Interviews were recorded and transcribed verbatim, with transcripts thematically analyzed inductively and deductively.

Results: Public transport use cessation is described in terms of a semi-linear process beginning with slow mobility declines that lead to difficulties using particular public transport services. Coping mechanisms are sometimes used to maintain or regain public transport use, but eventually are not enough. Public transport use cessation then leads to a further decline in mobility and loss of independence.

Discussion and implications: Public transport use cessation is an important aspect of age-related mobility decline among older adults who use public transport. It has significant detrimental mobility outcomes, and in some cases leads to complete loss of independence, potentially accelerating age-related health decline. Future research should focus on quantitative analyses and investigate interventions to maintain independence further into the aging process.