Last year, Miryam Liberman retired from her internal medicine practice in Westlake Village, California, where she had worked for more than 30 years. But before she left, Liberman, 65, was issuing subtle prescriptions to her patients by example. Every day, she would commute back and forth to her office, over 12 miles away from where she lives, on an electric bicycle. Doing so improved her health and quality of life so much that she started to tell her older patients to do the same, and some of them now ride e-bikes, too.

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Not only did the pain she lived with from a car crash over 20 years ago subside, the bike grew to fit in all parts of her life. “It wasn’t just the bike in getting to work, it was the bike in going shopping, in meeting up with friends, in going to the movies,” Liberman says. “And I started to see things I’d never seen before in my community; I could literally smell the flowers because there was no closed window of an air-conditioned car. It opens you up to your community, your body, to other friends, to continuing to learn.” Liberman is not alone. There’s growing interest among older Americans in cycling: Between 1995 and 2009, the number of people aged 60 to 79 who bike increased by 320%, and the recent boom in electric bicycle technology is creating more opportunities for older Americans to consider biking as a mode of transportation. E-bike sales are growing across demographics, and bike-share companies like Motivate and Jump have rolled out e-assist versions of their bikes in the last year. E-bikes are especially capturing the older market, many of whom have found that e-bikes enable them to ride much later in life than they previously imagined. That’s because the extra push from the motor makes pedaling far less strenuous than traditional bikes. The Seattle-based e-bike company Rad Power Bikes has found that 82% of its customer base falls between the ages of 45 and 84. Those numbers may only grow. Right now, the proportion of Americans over the age of 65 hovers around 15%; by the year 2040, one in five Americans will fall into that category. While not a complete solution–cities and communities still must provide robust and accessible public transportation and ride-hailing for people for whom biking is not an option–e-bikes are increasingly a promising transportation method for older Americans. They encourage an active lifestyle, which is crucial for supporting overall health and may even alleviate symptoms of later-in-life diseases like Alzheimer’s and Parkinson’s. And as e-bikes make it easier for older people to get around, they might, in turn, urge cities and communities to implement better, more people-centric designs to support them–which in turn could benefit all of us now and as we age. The need to get around Older people in the United States often face limited transportation options. Research from the American Association of Retired People in 2018 found that 90% of adults over the age of 50 drive themselves places, but 21% of people over the age of 65 do not drive, and that proportion climbs as people age. Even for those who can drive, though, driving is not always an ideal option. The experience of driving alone can be isolating, and sometimes daunting if people age into vision loss or other physical impediments. (Not to mention the fact that driving alone is also terrible for the environment.) Beyond solo driving, older adults generally have three transportation options: public transportation, paratransit, and ride-hailing. Some cities–like Washington, D.C., and Eugene, Oregon–have worked to make public transportation more accessible to older adults. Other places lean more on paratransit–shared vans that must be scheduled in advance to transport people to appointments or functions–but its limitations, according to a report from TransitCenter, make “it impossible for paratransit riders to use the service for spontaneous travel, contributing to social isolation.” Since the advent of Uber and Lyft, ride-hailing has become more popular. Companies like Roundtrip are catering specifically to older people and those who need to access medical appointments, and Lyft is rolling out programs specifically to help seniors get to the doctor. But it may still be some time before ride-hailing scales as a real option for older Americans. AARP finds that just 29% of Americans aged 50 and older have ever used ride-hailing apps, and the majority are unlikely to try them. As for autonomous vehicles, which have been hailed in tech circles as a way to meet mobility needs for older people, they are not landing with that demographic. AARP found that 88% of seniors are unwilling to ride in them, citing safety concerns. Don Anair, deputy director of the Union of Concerned Scientists’ Clean Vehicle Program, has found that holds true in his research. “The number-one priority for new technology is it has to be safe for people to have any confidence in it,” he says. While autonomous vehicles could, he says, potentially ease the need for older people to own their own cars and transport themselves places, they have yet to be fully proven out as safe at scale.

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The shift to e-bikes E-bikes could solve many of the problems that current transportation options for seniors pose. Liberman’s purchase of an electric bike “came after years of searching for how I could ride again.” She, like many people, grew up biking as a child and in college. But around 20 years ago, she was in a car crash that resulted in back issues and constant pain. She tried to ride a conventional road bike during her recovery, but found that the strain on her body was too much. A little over three years ago, the Irvine, California-based company Pedego, which sells its own e-bikes, opened a shop near Liberman. Pedego was founded in 2008 by friends Don DiConstanzo and Terry Sherry, both in their 60s, with a mission to get more older people biking, and had exactly what Liberman was looking for. “My dream was to be able to ride to work,” she says, but her commute was littered with hills. On the new e-bike, she barely noticed them. Timothy Kling, who is 59 years old and lives in Brea, California, had a similar experience. He bought an e-bike from Rad Power Bikes around a year and a half ago to be able to keep up with his teenage son on rides through their hilly community. The e-bike has helped with that, but for Kling, it has also eased how he navigates his daily life–it allows him to skirt infamous Southern California traffic, and he has begun to use it on errands like grocery shopping for the sake of convenience, and the benefits it delivers to his health. Biking to better health But what about older people with health problems that could limit their balance and range of motion–two important skills for manipulating a bike? A growing body of research actually suggests that biking could alleviate the symptoms of diseases like Parkinson’s and Alzheimer’s, as well as support overall health. E-bikes are a critical component of extending these benefits as they enable older people to ride longer and more regularly. In 2003, Jay Alberts, a researcher and physician at the Cleveland Clinic, was participating in an annual bicycle ride across Iowa on a tandem bike: He was in the front, and a friend who had been diagnosed with Parkinson’s was in the back. Alberts, who studies the disease and other neurological conditions, notice a change in his co-rider over the course the trip: As they rode more and more, her handwriting, as she wrote postcards home to loved ones, and overall motions became more controlled. That experience led Alberts to look more closely at what about cycling can alleviate Parkinson’s symptoms. “There’s a whole host of research that shows exercise has benefits for Parkinson’s patients,” he says. On the tandem bike, because he was also pedaling, the woman was able to move her legs at a quicker rate without having to exhaust herself–and that faster rate of motions is what helped alleviate her symptoms. Such movement, Alberts found, improves motor functioning in Parkinson’s patients by around 35%. E-bikes, because they allow riders to pedal quickly and move without overexerting, could deliver similar benefits. “The e-bike has great potential to enable and empower older adults, even those with neurological impairment to retain an active lifestyle,” Alberts says.

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“I think we’ve demonstrated that this type of exercise is medicine,” Alberts says, and emphasized that while his research focuses specifically on people with diseases like Parkinson’s, the benefits extend to older people in general: Active transportation like cycling can prevent the onset of diabetes and heart disease, and keep people’s joints healthier for longer. Creating safer communities to support mobility Alberts does emphasize, though, that attaining these health benefits requires tackling the problem of poor street design and infrastructure in America. In the United States, cities and communities mainly prioritize the movement of vehicles over the movement of people, or people on bikes. To Emiko Atherton, the director of Smart Growth America’s National Complete Streets Coalition, it’s telling that in the United States, older people are disproportionately likely to be killed or injured in traffic. In a report released in January, NCSC calculated the “pedestrian danger index” for various age groups by dividing the number of pedestrian deaths by the total population measured, and multiplying by 100,000. While the average PDI in America is around 14, for people aged 65 and over, it’s 20.7, and for those aged 75 and older, it’s 28. “There’s a huge differential in the vulnerability of the population,” says Jana Lynott, senior strategic policy advisor with AARP Public Policy Institute’s Livable Communities team. Everything from high-speed limits to wide roads to light timing that prioritizes the flow of vehicles poses a threat to older people walking in their communities, Atherton says, and also creates barriers to people participating in cycling. Poor cycling and pedestrian infrastructure is a particular issue in parts of the southeast like Florida and Georgia, and in states like Arizona–significantly, places where older people are still very likely to move when they retire. As the U.S. population gets older, cities and smaller communities will have to reassess how they enable older people to get around. “When people are not able to drive anymore, or don’t want to because they’d prefer to walk or bike, they have to be able to,” Atherton says. Through NCSC, she frequently consults with the AARP, which she says is very supportive of their work “because frankly, their members are asking for it.” They want to live in the types of communities NCSC advocates for: Those with densely located amenities, through which they can navigate on wide, well-maintained sidewalks, or on regular, accessible public transportation, or a complete network of protected bike infrastructure. “They want to feel safe, and they want choices,” Atherton says. “They want to remain engaged in their community, but they don’t want to have to drive to all the time to reach what they need.” Plus when communities prioritize the safety of an older person on a bike or on foot, they make the streets better for all of us–especially as we all age. Ultimately, the benefits of a community that prioritizes mobility and access for the most vulnerable generation will radiate out to everyone. As Liberman says, while the concern, as people age, is often the walls closing in on their lives, being out in the community on a bike “opens up your world.”