Enhancing Urban Mobility for All: The Role of Universal Design in Supporting Social Inclusion for Older Adults and People with Disabilities

Abstract

As urban environments pose significant challenges to people of all ages and abilities, ensuring equal accessibility is essential for achieving social inclusion in cities. Authors claim that universal design, initially developed to assist people with disabilities, can also benefit older adults. Despite common assumptions, there is limited evidence to support this claim. This study examines whether the urban mobility needs of people with disabilities (physical, sensory, and cognitive) align with those of older adults, both with regular physiological ageing or age-related diseases. Using an integrative review methodology, this study synthesized 56 references on urban mobility measures and 121 references on the specific urban requirements and mobility profiles for both groups and subgroups. The findings reveal significant overlaps in the mobility requirements of people with disabilities and older adults, particularly regarding inclusive features such as barrier-free crossings, intermediate seating, noise reduction, and improved wayfinding. These measures benefit both groups, with universal design strategies supporting the mobility of people with disabilities while also addressing the needs of the ageing population, which is rapidly increasing. The findings offer valuable insights for urban planners, policymakers, and designers to create inclusive, accessible, and high-quality urban spaces that support people of all ages and abilities.

1. Introduction

Improving urban sustainability has become one of the main objectives of many international entities, including the European Commission (EC) [1] and the United Nations (UN) [2].

To achieve urban sustainability, a balanced approach across environmental, social, and economic dimensions is crucial. However, studies highlight that urban social sustainability requires significant structural changes to enhance accessibility for all, particularly vulnerable groups, such as people with disabilities (PwD) and older adults [1,3]. Social and physical barriers in urban environments, often due to inadequate infrastructure and limited social support, significantly affect how individuals experience and interact with public spaces [4].

Environmental, social, and economic balance is key for complete urban sustainability, although several studies show that urban social sustainability needs redesigning and structural changes to make cities more accessible for everyone [1,3]. The interaction between individuals with certain health conditions and city factors, including inaccessible infrastructure and limited social support, affects how the space is perceived and experienced [4]. Wylde et al. [5] estimated that approximately 90%, regardless of age or ability, face social and physical barriers within the built environment at some point in their lives, typically due to urban policies that fail to address diverse needs [6,7,8].

Historically, models addressing the relationship between people and their environment have focused on disability from either a medical or social perspective. The medical model, which frames disabilities as conditions to be treated or fixed [6,9], has been widely criticized for neglecting social factors [6,10,11], although it has been settled as the predominant model in numerous healthcare disciplines [12]. In contrast, the social model views disability as a result of societal barriers that exclude individuals from full participation [13]. More recently, the biopsychosocial model has been adopted, incorporating both perspectives to address the diverse needs of populations, including both PwD and older adults, and to examine how the urban environment limits their participation [6,13,14].

While the biopsychosocial model provides a framework for integrating diverse needs, planners risk creating segregated infrastructure tailored to specific groups, potentially reinforcing social isolation [6,15,16]. In response, Ronald Mace developed the concept of Design for All (or universal design), aiming to create urban spaces that are inclusive for people of all ages and abilities [17]. These seven principles (equitable use, flexibility in use, simple and intuitive use, perceptible information, tolerance for error, low physical effort, and appropriate size and space) can lead to “Universal Design”, in which no dedicated infrastructure or assistance provision is present thanks to “Design for All” techniques [18]. It is often interchangeably referred to as “Inclusive Design”, which aims to integrate accessibility from the outset of the design process, ensuring solutions that cater to everyone, regardless of age or ability [19,20].

While universal design principles have been predominantly applied to PwD, studies suggest that these measures can also address the mobility requirements of other vulnerable groups, including older adults, children, and parents with prams [7,21,22,23,24]. In fact, due to the ageing population, urban accessibility for older adults has garnered increasing attention [24,25,26]. Projections indicate that the older adult population in Europe will double by 2080 due to increased life expectancy and demographic shifts [27,28]. Most people over the age of 65 may present different health conditionings, not only born or acquired ones but also because of health deterioration due to normal ageing [29], such as cognitive changes [30], body systems misfunctioning [31,32], or sense deterioration [33,34]. Urban infrastructure has the potential to worsen the situation by limiting independent living [35,36] or social integration [35,37,38].

However, despite the growing interest in urban accessibility, there remains a significant gap in the literature regarding the specific and shared urban mobility challenges faced by PwD and older adults. Some authors have presented general behavioural analysis addressing urban needs from varied study groups [39,40,41], while most studies and guidelines directly imply their convenience for every group [21,28,42,43,44,45,46,47,48,49]. Other studies have explored hinders and facilitators in varied urban contexts separately for older adults [25,50,51] and people with disabilities [1,52,53]. Although they offer similar outcomes, most of them claim the convenience of the results for people of different ages and abilities without approaching the disability-ageing comparison. This gap in knowledge is critical, as it overlooks the nuanced and integrated nature of the mobility challenges that both populations face, which may require more comprehensive, cross-cutting solutions rather than separate ones. This study fills this gap by offering a novel approach to understanding how universal design can address the common mobility needs of both groups, emphasizing the overlap in urban challenges faced by PwD and older adults. Specifically, it explores how universal design can enhance urban accessibility by examining shared mobility barriers, as well as providing insights into how integrated design solutions can address the diverse needs of both groups simultaneously.

The objectives of this study are as follows:

• To identify key urban mobility requirements addressed by universal design in the existing literature.
• To examine the urban interaction profiles of PwD, including those with physical, sensory, and cognitive impairments, and establish connections to universal design requirements.
• To explore the mobility needs of older adults, categorized by (A) age-related health conditions, (B) chronic diseases that may or may not appear due to ageing, and (C) non-age-related impairments due to congenital or acquired conditions not related to age, and relate these to the urban mobility requirements identified.
• To identify intersections between the urban mobility needs of PwD and older adults while delivering policy recommendations to achieve inclusive urban scenes.

By addressing this underexplored area, this study not only contributes to the growing body of knowledge but also challenges the conventional view that PwD and older adults require the same solutions although solutions are commonly addressed separately, offering a more integrated framework for urban mobility design. It provides scientific evidence by running a thorough analysis based on the existing literature on the matter.

2. Materials and Methods

This study employs an integrative review methodology, which enables the synthesis of both theoretical and empirical research to explore the urban mobility requirements of two distinct yet interconnected groups: PwD and older adults. The integrative methodology focuses on addressing both theoretical and experimental information [54] from a balanced position [55], which aims to bridge the disability and ageing gap through urban universal design. Other literature review methodologies were considered, yet discarded, such as the scoping review [56] for its limitations in studying the practical applications of theoretical knowledge and the systematic review or meta-analysis for providing a limited reflection on sensitive information [57].

2.1. Adapted Integrative Methodology Approach

This research will follow the 5 steps presented by Whittemore and Knafl [54] for the integrative methodology (1. Problem identification, 2. Literature research, 3. Data evaluation, 4. Data analysis, and 5. Presentation) plus an additional step (6. Conclusion):

• Step 1: Problem Identification—Identification of the research gap concerning the urban mobility requirements of PwD and older adults under universal design.
• Step 2: Literature research—Collection of the main urban barriers that people of different ages and abilities face and their translation into infrastructure requirements to solve them.
• Step 3: Data evaluation—Systematic organization of collected references into charts, linking disabling and ageing conditions to their specific urban mobility requirements.
• Step 4: Data analysis—Utilization of figures and tables to summarize the relationship between urban mobility requirements and the prevalence of different conditions among older adults. A counting analysis is used to measure the frequency of each urban mobility requirement, ensuring that minority groups are not overlooked but weighted equally to grant universal design.
• Step 5: Presentation—Presentation of findings and discussion of results in comparison with the existing literature on urban mobility and universal design.
• Step 6: Conclusion—Key findings, contributions, limitations, and suggestions for future research.

The methodology is visualized in Figure 1, which outlines the sequence and connection between each stage of the review process:

2.2. Sources and Materials

To gain a comprehensive understanding of the connections between universal design for people with disabilities and older adults, this study drew on both the scientific and grey literature. Sources were collected from a range of academic databases, including Google Scholar, Web of Science (WoS), IEEE Xplore, and PubMed, as well as institutional repositories from universities, government bodies, and relevant organizations (e.g., research groups and institutional websites). The following selection criteria were applied to ensure a broad and relevant range of the literature:

• Keywords: Multiple combinations of terms such as universal accessibility, universal design, design for all, inclusive design, disabling conditions, disability, sensory disability, cognitive disability, physical disability, urban mobility requirements, older adults, elderly, physiological ageing, urban environment, chronic disease conditions, and normal ageing conditions.
• Fields of Expertise: Studies were selected from disciplines including Urban Design, Urban Mobility and Transportation, Inclusive Design, Universal Design, Accessible Architecture, Disability Studies, Health and Nursing, and Gerontology.
• Languages: Only publications in English and Spanish were considered to ensure the accessibility of relevant research.
• Types of References: Both empirical studies and theoretical works were included, as well as guidelines for universal design and academic productions related to urban mobility and accessibility.
• Date Framework: This study focused on the literature published between January 1995 and June 2023 to ensure the inclusion of both consolidated and contemporary research and design practises.

A total of 56 references were selected to elaborate the definition of the main accessibility and inclusion measures in the urban environment by universal design (Step 2). Additionally, 121 references were used for the analysis of specific urban interactions and requirements of people with disabling conditions and older people’s conditions (Step 3).

3. Results

3.1. Main Urban Mobility Requirements Considered by Universal Design in the Urban Literature

People of different ages and abilities encounter various challenges where the urban environment hinders their participation, mobility, and interaction with the city. Such barriers prevent them from fully enjoying urban life independently and inclusively [58]. As a result, individuals often require assistance, whether in the form of supervision or companionship, to navigate the urban space [59]. It is vital to implement and foster universal design measures that could grant access to all to promote an autonomous lifestyle [6].

3.1.1. Physical Mobility and Accessibility

Physical mobility or “ease of motion” [60,61] is one of the most influential factors for urban inclusivity. It refers to the ability to move through urban spaces without difficulty, particularly concerning lower body activity [62,63]. Removing physical obstacles at various scales—ranging from large structural barriers to small, intricate details [64,65,66]—benefits a broad spectrum of the population, enabling people with diverse conditions to access public spaces [67].

Key mobility measures for ensuring accessibility include the stability of pavements, proper maintenance, and an adequate level of roughness, which are crucial for individuals with balance issues, reduced sight, or those using wheelchairs [65,68,69]. Steep gradients and level changes can be mitigated with vertical mechanical transportation such as elevators or escalators, reducing physical effort and enhancing mobility for all city residents [70].

Protection against level changes, sidewalks, slope edges, etc., is required for people who may have problems identifying the edge of a step or curb or who may fall due to stability problems [63,71]. People using assistive mobility devices can also find them useful as a protection to maintain control over them [72].

3.1.2. Safety Against Other Means of Transportation

The proper segregation of transport modes is critical for ensuring street safety [73]. In urban areas where roads are expanded due to car prioritization [74], or where large road connections are prevalent, safety becomes a concern, particularly for vulnerable pedestrians [70,71]. Key safety features include clear visibility and readability at intersections where pedestrian and vehicle traffic meet. This helps prevent accidents involving individuals with slower walking speeds, impaired reflexes, or reduced vision [75,76,77,78]. Speed reduction, particularly in pedestrian-heavy areas, enhances safety by giving individuals more time to react [79,80].

Inclusive crossings play a central role in promoting pedestrian safety and connectivity. These crossings should be designed with visual and acoustic signals, proximity sensors, and pushbuttons that prioritize pedestrians over vehicles. Other important features include countdown timers, non-slippery materials, and road elevation that aligns with the sidewalk [71,75,81]. Some specific systems have been developed as part of the smart-city concepts, which include several of the mentioned features [82]. Smart city technologies have begun incorporating such features to enhance walkable connectivity and ease of transit, for instance, for older adults who may walk at slower speeds or to foster more sustainable means of transportation, including walking [78,83].

3.1.3. Wayfinding and Signalling

Wayfinding tools are essential for enhancing urban mobility, particularly for people with visual, cognitive, or sensory impairments. Wayfinding refers to a set of tools that help individuals navigate urban environments by making signage and directions accessible and understandable. These tools include visual, acoustic, physical, and cognitive elements [84]. The term was first used in 1960 to explain how a person managed to orient without assistance, naturally and effortlessly [85]. Ever since, it has evolved into including elements such as reinforced signalling (e.g., normalized signage, the mix of written and iconographic messages, etc.) or patchwork guiding elements (e.g., totems, recognizable branding, etc.) [86]. Wayfinding normally relies on a combination of signalling techniques put together coherently and effectively, including Easy English, colour coding or haptic information.

Easy English or Easy To Read (E2R) techniques facilitate comprehension for individuals with literacy challenges or cognitive impairments [87,88,89]. Mobile phone assistive technologies, such as “beep-con” systems, can further assist blind or even foreign individuals [90] in navigating urban spaces [90,91].

Colour coding and chromatic contrast are effective for people with partial sight loss, helping them identify potential hazards such as steps, slopes, or obstacles or call attention to relevant public transport elements or building entrances [92,93]. This method is particularly beneficial for individuals with cataracts or glaucoma [94,95], although special care needs to be taken to work with certain sight conditions, such as colour blindness [96]. Similarly, individuals with hearing impairments can rely on visual cues, as their primary interaction with the environment may be through sight [97].

Tactile paving, commonly found around pedestrian crossings and leading to building exits, aids navigation for individuals with low vision or blindness [81,98]. This type of signalling can also provide cognitive benefits by guiding pedestrians through urban spaces [99]. Furthermore, haptic information, such as that found on handrails or maps, can convey additional information that cannot be included at the pavement level [67,80]. However, this must be built together with a clear outline of the urban configuration for a better understanding of the city [7,100].

3.1.4. Environmental Comfort

“Environmental comfortability” embraces a number of measures that foster longer trips by creating more comfortable spaces, and it can include not only physical elements like intermediate seating or resting equipment but also thermal, visual, acoustic, and olfactory comfort, all of which contribute to a positive urban experience [101].

The provision of urban furniture plays a vital role in promoting accessibility and comfort for all. For example, providing benches and resting spots along walking routes enables older adults or those with mobility challenges to pause during their journey, which encourages longer-distance trips [64,102]. Public toilets are another essential aspect of urban comfort, particularly for older adults or individuals with chronic conditions. These facilities support active mobility by providing accessible spaces for individuals with temporary or permanent impairments, such as those who have given birth or experience incontinence [103,104]. Ostomate toilets, for instance, are designed to accommodate people using “stoma” bags, promoting inclusion for a broader range of users [105], while allowing their use by all people [106].

Poor environmental conditions and the incorrect handling of these may deter people from spending time outdoors to avoid uncomfortability. Ageing normally leads to body temperature instability that may be highly affected by extreme temperatures [107], which can be fixed through elements casting shade and/or shelter. People with disadvantageous hearing conditions may find discomfort in noise pollution, which may be reduced by deploying adequate transport segregation or integrating mitigation elements like vegetation [108,109]. Proper lighting in the urban environment can make streets more attractive, reduce glare and reflection problems on sunny days, and improve night safety [80].

While urban furniture and vegetation enhance comfort, they can also create obstacles for individuals with limited mobility or assistive devices. Ensuring ample space for movement, particularly on sidewalks, is essential to accommodate wheelchairs, canes, and guide dogs, and to allow pedestrians to change directions comfortably [110,111]. Sufficient width and obstacle-free spaces are critical to maintaining continuity and accessibility throughout urban areas [112].

3.1.5. Mental Health

The design of urban spaces has a direct impact on mental health and social well-being. According to previous studies, attractive urban environments can foster social interactions [113], open and green spaces can reduce the impact of climate change and, therefore, improve our mood [114], and both provide meeting points for people to engage in their community activities and develop a sense of belonging [115]. These spaces are particularly beneficial for individuals experiencing stress, loneliness, or mental health challenges, offering quiet, calming spaces for reflection and socialization [116,117,118].

3.1.6. Key Urban Measures for Universal Design

After considering all the previous urban measures, the following list presents a compilation of the most necessary ones to achieve universal design:

• Adequate artificial lighting regulation (risk of creating flat scenes without volume distinction);
• Appropriate lighting throughout the day;
• Appropriate night lighting;
• Avoid reflecting materials;
• Colour contrast;
• Continuous and stable pavement;
• Digital guidance systems;
• Easy English techniques;
• Enough maneuvering space on the sidewalk;
• Green spaces;
• Improving space readability;
• Inclusive crossings;
• Intermediate seats;
• Multiple itineraries;
• Noise pollution reduction;
• Ostomate, accessible public toilets;
• Protected level changes, even short slopes;
• Protected pedestrian sidewalks;
• Removal of visual obstacles from crossing surroundings;
• Safe spaces;
• Steep slope removal;
• Steps and small obstacle removal;
• Sufficient spacing between roads and pedestrian areas;
• Tactile paving;
• Thermal stability;
• Vegetation with seasonal variation management;
• Vertical travel mechanisms;
• Wayfinding.

These are the needs or requirements that would be considered in the following steps.

3.2. Key Disabling Conditions, Their Urban Interaction and Requirements, and the Relation with Ageing Conditions

Since some disabilities imply different conditions, this study was conducted under the disabling condition perspective rather than disabilities alone. These were positioned under the general classification of the following [119]:

• Physical (including motor and organic conditions);
• Sensory (including visual, auditory, and other related conditions);
• Cognitive conditions (including development and behavioural conditions).

Additionally, these conditions have been differentiated from a “disability” classification as one condition may be placed under different disability categories (such as the lack of balance, which can be caused by hearing disability, neurological disorders, physical disability or cognitive disability).

Regarding traditionally low-disabling-impact conditions, such as overweight, they have been recently included in updated classifications [120,121], which include aspects such as function and corporal structure, capacities, performance and context factor evaluations. However, we considered that being overweight could lead to other disabling conditions like unbalance or stiffness [122], so it has not been added separately. Additionally, very specific diseases or diseases that may derived from multiple disabling conditions were dismissed, as the different individual conditions had been analyzed individually.

Based on the classification provided by the INEGI [123] and complemented by other relevant references [14,67,124,125,126], a total of 39 key conditions that lead to disability were identified, including 13 physical and organic, 15 sensory, and 11 cognitive conditions.

For the different conditions, a profile of urban interaction has been outlined based on the literature review, by exploring them or extrapolating the gathered information with the criteria presented in the different references defining their needs and consequent requirements. In this regard, a third column has been set to identify the urban mobility requirements of the different profiles in the built environment based on the list of 28 from the previous step.

For each detected condition that may lead to disability, its prevalence amongst older people was studied under three different condition categories:

• A: Conditions that are related to normal physiological ageing (cognitive changes, body systems misfunctioning, muscle loss, sensory deterioration, etc.).
• B: Conditions that may be present in older adults because of an age-related or more prevalent illness in older adults, but not due to normal ageing, for example, chronic and non-communicable diseases (NCDs).
• C: If the conditions are not prevalent or related to older adults. Most of these are hereditary, congenital, or acquired by some unforeseen life event, so they are not related to ageing.

In the following subsections, we illustrate this analysis categorized by physical (Table 1), sensory (Table 2) and cognitive conditions (Table 3).

Physical Conditions

Table 1. Physical condition analysis.

Physical Disabling Conditions	Urban Interaction	Urban Mobility Requirements [64,65,67,81,127]	Relation to Ageing Conditions
Upper limb paresis (muscle strength loss in the upper body part) or lack of them	Ease of motion. Potential difficulties interacting with hand elements [128] (e.g., crossing push buttons [129]). May present balance trouble [130].	Intermediate seats	A (sarcopenia) [131] B (stroke, diabetes, arthritis, fibromyalgia, chronic fatigue syndrome, etc.) [132,133]
		Continuous and stable pavement
		Inclusive crossings (see Section 3.1)
Lower limb paresis (muscle strength loss in the lower body part) or lack of them	Required assistive devices to move (e.g., wheelchair, mobile walker, crutches or orthoses) [134,135]. Small obstacles or steps may be possible to overcome but not with any wheeled device [65].	Vertical travel mechanisms	A (sarcopenia) [131] B (diabetes, fibromyalgia, chronic fatigue syndrome, etc.) [133]
		Intermediate seats
		Step and small obstacle removal
		Steep slope removal
		Enough maneuvering space on the sidewalk
		Continuous and stable pavement
Hemiplegia or hemiparesis (one side of the body paralysis)	Required assistive devices to move (e.g., wheelchair, mobile walker, crutches or orthoses) [136]. Potential difficulties even with small obstacles [136].	Vertical travel mechanisms	B (stroke, brain and nervous disorders) [136]
		Steep slope removal
		Step and small obstacle removal
		Enough maneuvering space on the sidewalk
		Continuous and stable pavement
Paraplegia (lower body paralysis)	Required assistive devices to move (e.g., wheelchair, mobile walker, crutches or orthoses) [137]. Potential difficulties even with small obstacles [138]. May present balance trouble [139].	Vertical travel mechanisms	B (spinal cord injuries, stroke, falls) [140]
		Steep slope removal
		Step and small obstacle removal
		Enough maneuvering space on the sidewalk
		Continuous and stable pavement
		Intermediate seats
Quadriplegia (full-body paralysis)	Required electric wheelchair to move [141]. Potential impossibility to interact with hand elements [141,142] (e.g., crossing push buttons). May need respiratory-assistance devices [141]. Potential impossibility to overcome even small obstacles [143].	Vertical travel mechanisms	B (spinal cord injuries, stroke, falls) [140]
		Steep slope removal
		Step and small obstacle removal
		Enough maneuvering space on the sidewalk
		Inclusive crossings (see Section 3.1)
		Continuous and stable pavement
Achondroplasia (limb dwarfism) and short stature	Mobility is partially restricted to long distances, short flights of stairs and short and/or low-gradient slopes due to decreased muscle tone and apnea [144].	Vertical travel mechanisms	C
		Steep slope removal
		Intermediate seats
Overweight	May require a wheelchair or other assistance devices [145]. Regular stops may be needed [145]. Potential impossibility to overcome even small obstacles [145].	Vertical travel mechanisms	A (metabolic syndrome, insulin resistance) [146] B (hypothyroidism, depression, some medication for diabetes, schizophrenia, antidepressants, Cushing’s syndrome) [147]
		Intermediate seats
		Step and small obstacle removal
		Steep slope removal
		Continuous and stable pavement
		Enough maneuvering space on the sidewalk
Arthritis (joint hypersensitivity)	Medium ease of motion [148]. Potential difficulties with even small obstacles [148]. Slower pace of movement [149]. Short trips may be needed.	Vertical travel mechanisms	A (rheumatoid arthritis) [150,151]
		Intermediate seats
		Step and small obstacle removal
		Inclusive crossings (see Section 3.1)
		Thermal stability
		Steep slope removal
		Continuous and stable pavement
Ostomy, urinary, and excretory system incontinence	Ease of motion [152]. Short trips may be needed [153]. Excessive core stress should be avoided [152,153].	Intermediate seats Continuous and stable pavement Ostomate, accessible public toilets [106,154]	A (cystocele) [155] B (prostate and colon cancer, diabetes, nervous system diseases) [156,157,158,159]
Balance disorders	Ease of motion for autonomous people. In advanced stages, they may not be able to interact with the public scene [68]. Difficulties with small obstacles [68].	Intermediate seats	A (degradation of the circulatory system) [68] B (vestibular system affections, neurologic, cardiovascular, visual, vestibular) [68,160]
		Continuous and stable pavement
		Step and small obstacle removal
Limb tremor, ataxia, or stiffness (SPS)	Reflexes may be reduced [161]. Potential difficulties with movement [161,162,163]. Poor stability while wandering [161,163].	Intermediate seats	A [164] B (Parkinson’s, hyperthyroidism, fragile X-associated tremor/ataxia syndrome) [129,164,165]
		Inclusive crossings (see Section 3.1)
		Continuous and stable pavement
		Step and small obstacle removal
		Steep slope removal
		Remove visual obstacles from crossing surroundings
Physical impossibility to communicate (lack/paresis/deterioration of vocal cords/tongue…)	Ease of motion [166]. Difficulties in interacting with other people [166].	Wayfinding	A (presbyphonia) [167]
		Noise pollution reduction
Breathing difficulties (lung problems, allergies, pollution, oxygen assistance…)	Regular stops may be needed [168]. Incorrect provision of seasonal and permanent vegetation can trigger breathing problems [169].	Intermediate seats	B (lung cancer, sleep-disordered breathing, Alzheimer’s, Parkinson’s) [170,171,172]
		Vegetation with seasonal variation management
		Sufficient spacing between parking lots and pedestrian areas

Table 1. Physical condition analysis.

Physical Disabling Conditions	Urban Interaction	Urban Mobility Requirements [64,65,67,81,127]	Relation to Ageing Conditions
Upper limb paresis (muscle strength loss in the upper body part) or lack of them	Ease of motion. Potential difficulties interacting with hand elements [128] (e.g., crossing push buttons [129]). May present balance trouble [130].	Intermediate seats	A (sarcopenia) [131] B (stroke, diabetes, arthritis, fibromyalgia, chronic fatigue syndrome, etc.) [132,133]
		Continuous and stable pavement
		Inclusive crossings (see Section 3.1)
Lower limb paresis (muscle strength loss in the lower body part) or lack of them	Required assistive devices to move (e.g., wheelchair, mobile walker, crutches or orthoses) [134,135]. Small obstacles or steps may be possible to overcome but not with any wheeled device [65].	Vertical travel mechanisms	A (sarcopenia) [131] B (diabetes, fibromyalgia, chronic fatigue syndrome, etc.) [133]
		Intermediate seats
		Step and small obstacle removal
		Steep slope removal
		Enough maneuvering space on the sidewalk
		Continuous and stable pavement
Hemiplegia or hemiparesis (one side of the body paralysis)	Required assistive devices to move (e.g., wheelchair, mobile walker, crutches or orthoses) [136]. Potential difficulties even with small obstacles [136].	Vertical travel mechanisms	B (stroke, brain and nervous disorders) [136]
		Steep slope removal
		Step and small obstacle removal
		Enough maneuvering space on the sidewalk
		Continuous and stable pavement
Paraplegia (lower body paralysis)	Required assistive devices to move (e.g., wheelchair, mobile walker, crutches or orthoses) [137]. Potential difficulties even with small obstacles [138]. May present balance trouble [139].	Vertical travel mechanisms	B (spinal cord injuries, stroke, falls) [140]
		Steep slope removal
		Step and small obstacle removal
		Enough maneuvering space on the sidewalk
		Continuous and stable pavement
		Intermediate seats
Quadriplegia (full-body paralysis)	Required electric wheelchair to move [141]. Potential impossibility to interact with hand elements [141,142] (e.g., crossing push buttons). May need respiratory-assistance devices [141]. Potential impossibility to overcome even small obstacles [143].	Vertical travel mechanisms	B (spinal cord injuries, stroke, falls) [140]
		Steep slope removal
		Step and small obstacle removal
		Enough maneuvering space on the sidewalk
		Inclusive crossings (see Section 3.1)
		Continuous and stable pavement
Achondroplasia (limb dwarfism) and short stature	Mobility is partially restricted to long distances, short flights of stairs and short and/or low-gradient slopes due to decreased muscle tone and apnea [144].	Vertical travel mechanisms	C
		Steep slope removal
		Intermediate seats
Overweight	May require a wheelchair or other assistance devices [145]. Regular stops may be needed [145]. Potential impossibility to overcome even small obstacles [145].	Vertical travel mechanisms	A (metabolic syndrome, insulin resistance) [146] B (hypothyroidism, depression, some medication for diabetes, schizophrenia, antidepressants, Cushing’s syndrome) [147]
		Intermediate seats
		Step and small obstacle removal
		Steep slope removal
		Continuous and stable pavement
		Enough maneuvering space on the sidewalk
Arthritis (joint hypersensitivity)	Medium ease of motion [148]. Potential difficulties with even small obstacles [148]. Slower pace of movement [149]. Short trips may be needed.	Vertical travel mechanisms	A (rheumatoid arthritis) [150,151]
		Intermediate seats
		Step and small obstacle removal
		Inclusive crossings (see Section 3.1)
		Thermal stability
		Steep slope removal
		Continuous and stable pavement
Ostomy, urinary, and excretory system incontinence	Ease of motion [152]. Short trips may be needed [153]. Excessive core stress should be avoided [152,153].	Intermediate seats Continuous and stable pavement Ostomate, accessible public toilets [106,154]	A (cystocele) [155] B (prostate and colon cancer, diabetes, nervous system diseases) [156,157,158,159]
Balance disorders	Ease of motion for autonomous people. In advanced stages, they may not be able to interact with the public scene [68]. Difficulties with small obstacles [68].	Intermediate seats	A (degradation of the circulatory system) [68] B (vestibular system affections, neurologic, cardiovascular, visual, vestibular) [68,160]
		Continuous and stable pavement
		Step and small obstacle removal
Limb tremor, ataxia, or stiffness (SPS)	Reflexes may be reduced [161]. Potential difficulties with movement [161,162,163]. Poor stability while wandering [161,163].	Intermediate seats	A [164] B (Parkinson’s, hyperthyroidism, fragile X-associated tremor/ataxia syndrome) [129,164,165]
		Inclusive crossings (see Section 3.1)
		Continuous and stable pavement
		Step and small obstacle removal
		Steep slope removal
		Remove visual obstacles from crossing surroundings
Physical impossibility to communicate (lack/paresis/deterioration of vocal cords/tongue…)	Ease of motion [166]. Difficulties in interacting with other people [166].	Wayfinding	A (presbyphonia) [167]
		Noise pollution reduction
Breathing difficulties (lung problems, allergies, pollution, oxygen assistance…)	Regular stops may be needed [168]. Incorrect provision of seasonal and permanent vegetation can trigger breathing problems [169].	Intermediate seats	B (lung cancer, sleep-disordered breathing, Alzheimer’s, Parkinson’s) [170,171,172]
		Vegetation with seasonal variation management
		Sufficient spacing between parking lots and pedestrian areas

Sensory Conditions

Table 2. Sensory condition analysis.

Sensory Disabling Conditions	Urban Interaction	Urban Mobility Requirements [64,65,67,81,127]	Relation to Ageing Conditions
Blindness (complete absence of eyeballs or microphthalmia)	Required technical assistance to wander (e.g., canes or guide dogs) [173]. Potential difficulties interacting with hand elements (e.g., crossing push buttons) [174]. Irregularities and deficiencies in the pavement may be dangerous [175].	Inclusive crossings (see Section 3.1)	B (glaucoma, diabetic retinopathy) [176,177,178]
		Tactile paving
		Digital guidance systems
		Continuous and stable pavement
		Step and small obstacle removal
		Protected level changes, even short slopes
		Protected pedestrian sidewalks
Presbyopia (proximity sight loss)	Ease of motion [179]. Signs and directions may not be perceived [179].	Colour contrast	A [178]
		Wayfinding
		Appropriate lighting throughout all-day
Scotoma or visual auras (diminishing or loss of visual acuity in shaped areas)	Difficulties to perceive depth, distances or unevenness [180]. Irregularities and deficiencies in the pavement may be dangerous [180]. Signs and directions may not be perceived completely [181].	Wayfinding	A (age-related macular degeneration) [178] B (some drugs for heart failure, glaucoma, diabetic retinopathy) [178,182]
		Step and small obstacle removal
		Protected level changes, even short slopes
		Protected pedestrian sidewalks
		Inclusive crossings (see Section 3.1)
		Colour contrast
Cataracts, macular degeneration (blurred vision)	Difficulties to perceive depth, distances or unevenness [183]. Irregularities and deficiencies in the pavement may be dangerous [183]. Signs and directions may not be perceived [184].	Colour contrast	A (age-related macular degeneration) [178] B (diabetic retinopathy) [178]
		Tactile paving
		Digital guidance systems
		Continuous and stable pavement
		Step and small obstacle removal
		Protected level changes, even short slopes
		Inclusive crossings (see Section 3.1)
Macular dystrophy (impossibility to see detail)	Associated with photophobia. Discomfort in very luminous spaces [185]. Signs and directions may not be perceived [184].	Vegetation with seasonal variation management	A (age-related macular dystrophy) [186]
		Avoid reflecting materials
		Sufficient spacing between roads and pedestrian areas
		Inclusive crossings (see Section 3.1)
		Protected pedestrian sidewalks
Stereoblindness (lack of 3-dimensional vision)	Ease of motion in continuous, clear paths [187]. Difficulties to perceive depth, distances or unevenness [187,188]. Irregularities and deficiencies in the pavement may be dangerous [189].	Adequate artificial lighting regulation (risk of creating flat scenes without volume distinction)	B (glaucoma, cataract and retinal operations, Alzheimer’s) [190]
		Tactile paving
		Colour contrast
		Protected level changes, even short slopes
		Step and small obstacle removal
		Continuous and stable pavement
Simultanagnosia (inability to perceive more than a single object at a time)	Over-stimulating environments or complexity may hamper their wander [191]. Ease of motion in continuous, clear paths [191].	Wayfinding	B (stroke, dementia, Alzheimer’s) [192]
		Improving space readability
		Tactile paving
Nyctalopia (night blindness)	Lack of appropriate night lighting may hinder the wander [193].	Appropriate night lighting	B (diabetic retinopathy, glaucoma, cataract, vitamin A deficiency, diabetes) [178,194]
		Digital guidance systems
Tunnel vision or Peripheral Visual Field Loss (PVFL)	Ease of motion [195]. Irregularities and deficiencies in the pavement may be dangerous [195,196]. Reflexes may be reduced [196].	Inclusive crossings (see Section 3.1)	A (choroideremia) [195,197] B (glaucoma) [198]
		Step and small obstacle removal
		Protected level changes, even short slopes
Achromatopsia (black and white vision) and colour blindness	Ease of motion [96]. Some difficulties interpreting signs [96].	Inclusive crossings (see Section 3.1)	C
		Wayfinding
Auditory agnosia (sound misperception and misidentification)	Ease of motion in continuous, clear and well-referenced paths [199]. Difficulties in low-visibility or non-regulated crossings [200]. Potential oral miscommunication problems [201].	Remove visual obstacles from crossing surroundings	B (dementia) [202]
		Inclusive crossings (see Section 3.1)
		Wayfinding
		Improving space readability
		Noise pollution reduction
Deafness and hearing loss (reduction in auditory sensitivity)	Ease of motion in well-referenced paths [109]. Difficulties in receiving acoustic signals [203]. Potential miscommunication problems [203]. Overlapping noises may be problematic [109].	Remove visual obstacles from crossing surroundings	A (presbycusis) [204] B (diabetes) [205]
		Inclusive crossings (see Section 3.1)
		Wayfinding
		Improving space readability
		Noise pollution reduction
Diplacusis (one sound is perceived as two)	Ease of motion. Overlapping noises may be problematic [206,207].	Improving space readability	A (presbycusis) [208] B (caused by medications) [209]
		Noise pollution reduction
		Remove visual obstacles from crossing surroundings
Otosclerosis (abnormal ear fabric regeneration)	Potential dizziness and motion sickness while wandering [210]. Irregularities and deficiencies in the pavement may be dangerous [210].	Wayfinding	C
		Continuous and stable pavement
		Intermediate seats
Tinnitus (constant buzzing, hissing, or roaring)	Ease of motion [211]. May produce dizziness and motion sickness while wandering [212].	Intermediate seats	A [211] B (obesity, diabetes, cardiovascular diseases, arthritis) [211,213,214]

Table 2. Sensory condition analysis.

Sensory Disabling Conditions	Urban Interaction	Urban Mobility Requirements [64,65,67,81,127]	Relation to Ageing Conditions
Blindness (complete absence of eyeballs or microphthalmia)	Required technical assistance to wander (e.g., canes or guide dogs) [173]. Potential difficulties interacting with hand elements (e.g., crossing push buttons) [174]. Irregularities and deficiencies in the pavement may be dangerous [175].	Inclusive crossings (see Section 3.1)	B (glaucoma, diabetic retinopathy) [176,177,178]
		Tactile paving
		Digital guidance systems
		Continuous and stable pavement
		Step and small obstacle removal
		Protected level changes, even short slopes
		Protected pedestrian sidewalks
Presbyopia (proximity sight loss)	Ease of motion [179]. Signs and directions may not be perceived [179].	Colour contrast	A [178]
		Wayfinding
		Appropriate lighting throughout all-day
Scotoma or visual auras (diminishing or loss of visual acuity in shaped areas)	Difficulties to perceive depth, distances or unevenness [180]. Irregularities and deficiencies in the pavement may be dangerous [180]. Signs and directions may not be perceived completely [181].	Wayfinding	A (age-related macular degeneration) [178] B (some drugs for heart failure, glaucoma, diabetic retinopathy) [178,182]
		Step and small obstacle removal
		Protected level changes, even short slopes
		Protected pedestrian sidewalks
		Inclusive crossings (see Section 3.1)
		Colour contrast
Cataracts, macular degeneration (blurred vision)	Difficulties to perceive depth, distances or unevenness [183]. Irregularities and deficiencies in the pavement may be dangerous [183]. Signs and directions may not be perceived [184].	Colour contrast	A (age-related macular degeneration) [178] B (diabetic retinopathy) [178]
		Tactile paving
		Digital guidance systems
		Continuous and stable pavement
		Step and small obstacle removal
		Protected level changes, even short slopes
		Inclusive crossings (see Section 3.1)
Macular dystrophy (impossibility to see detail)	Associated with photophobia. Discomfort in very luminous spaces [185]. Signs and directions may not be perceived [184].	Vegetation with seasonal variation management	A (age-related macular dystrophy) [186]
		Avoid reflecting materials
		Sufficient spacing between roads and pedestrian areas
		Inclusive crossings (see Section 3.1)
		Protected pedestrian sidewalks
Stereoblindness (lack of 3-dimensional vision)	Ease of motion in continuous, clear paths [187]. Difficulties to perceive depth, distances or unevenness [187,188]. Irregularities and deficiencies in the pavement may be dangerous [189].	Adequate artificial lighting regulation (risk of creating flat scenes without volume distinction)	B (glaucoma, cataract and retinal operations, Alzheimer’s) [190]
		Tactile paving
		Colour contrast
		Protected level changes, even short slopes
		Step and small obstacle removal
		Continuous and stable pavement
Simultanagnosia (inability to perceive more than a single object at a time)	Over-stimulating environments or complexity may hamper their wander [191]. Ease of motion in continuous, clear paths [191].	Wayfinding	B (stroke, dementia, Alzheimer’s) [192]
		Improving space readability
		Tactile paving
Nyctalopia (night blindness)	Lack of appropriate night lighting may hinder the wander [193].	Appropriate night lighting	B (diabetic retinopathy, glaucoma, cataract, vitamin A deficiency, diabetes) [178,194]
		Digital guidance systems
Tunnel vision or Peripheral Visual Field Loss (PVFL)	Ease of motion [195]. Irregularities and deficiencies in the pavement may be dangerous [195,196]. Reflexes may be reduced [196].	Inclusive crossings (see Section 3.1)	A (choroideremia) [195,197] B (glaucoma) [198]
		Step and small obstacle removal
		Protected level changes, even short slopes
Achromatopsia (black and white vision) and colour blindness	Ease of motion [96]. Some difficulties interpreting signs [96].	Inclusive crossings (see Section 3.1)	C
		Wayfinding
Auditory agnosia (sound misperception and misidentification)	Ease of motion in continuous, clear and well-referenced paths [199]. Difficulties in low-visibility or non-regulated crossings [200]. Potential oral miscommunication problems [201].	Remove visual obstacles from crossing surroundings	B (dementia) [202]
		Inclusive crossings (see Section 3.1)
		Wayfinding
		Improving space readability
		Noise pollution reduction
Deafness and hearing loss (reduction in auditory sensitivity)	Ease of motion in well-referenced paths [109]. Difficulties in receiving acoustic signals [203]. Potential miscommunication problems [203]. Overlapping noises may be problematic [109].	Remove visual obstacles from crossing surroundings	A (presbycusis) [204] B (diabetes) [205]
		Inclusive crossings (see Section 3.1)
		Wayfinding
		Improving space readability
		Noise pollution reduction
Diplacusis (one sound is perceived as two)	Ease of motion. Overlapping noises may be problematic [206,207].	Improving space readability	A (presbycusis) [208] B (caused by medications) [209]
		Noise pollution reduction
		Remove visual obstacles from crossing surroundings
Otosclerosis (abnormal ear fabric regeneration)	Potential dizziness and motion sickness while wandering [210]. Irregularities and deficiencies in the pavement may be dangerous [210].	Wayfinding	C
		Continuous and stable pavement
		Intermediate seats
Tinnitus (constant buzzing, hissing, or roaring)	Ease of motion [211]. May produce dizziness and motion sickness while wandering [212].	Intermediate seats	A [211] B (obesity, diabetes, cardiovascular diseases, arthritis) [211,213,214]

Cognitive Conditions

Table 3. Cognitive condition analysis.

Cognitive Disabling Conditions	Urban Interaction	Urban Mobility Requirements [64,65,67,81,127]	Relation to Ageing Conditions
Aphasia (language disorder caused by brain damage)	Ease of motion [215]. Difficulties in interacting with other people [216].	Wayfinding	B (stroke, dementia) [217,218]
		Improving space readability
General agnosia (inability to process and identify sensory information)	Ease of motion in continuous, clear and well-referenced paths [219]. Easy English techniques may be needed for visual information [87].	Wayfinding	B (Alzheimer’s, dementia) [220]
		Improving space readability
		Easy English techniques
Agraphia (inability to communicate through writing)	Ease of motion [221].	No accommodation needed	B (dementia) [222]
Alexia (inability to comprehend written messages)	Ease of motion in continuous, clear and well-referenced paths [223]. Easy English techniques may be needed for written information [87].	Wayfinding	B (dementia, stroke) [223]
		Improving space readability
		Easy English techniques
Dyslexia (reading disorder)	Ease of motion in continuous, clear and well-referenced paths [224]. Easy English techniques may be needed for written information [87,224].	Wayfinding	A [225] B (dementia) [226]
		Easy English techniques
Dysarthria (inability to articulate messages)	Ease of motion [227]. Preventive measures are required to prevent people from having to ask others for information [227]. Overlapping noises may be problematic [227].	Wayfinding	B (Parkinson’s) [228]
		Improving space readability
		Easy English techniques
		Noise pollution reduction
Memory loss	Ease of motion [229]. Confusion and disorientation may be present [229].	Wayfinding	A [230] B (dementia including Alzheimer’s) [202]
		Improving space readability
		Easy English techniques
		Intermediate seats
Developmental and intellectual disability	Ease of motion in continuous, clear and well-referenced paths [231]. Confusion and disorientation may be present [59]. Easy English techniques may be needed for written information. Required urban relief spaces [59].	Easy English techniques	C
		Wayfinding
		Intermediate seats
		Safe spaces
		Green spaces
		Inclusive crossings (see Section 3.1)
		Remove visual obstacles from crossing surroundings
Social or interaction anxiety and chronic stress	Ease of motion [232]. Required urban relief spaces [232]. Needed clear guidance through the city [232]. Difficulties in interacting with other people [232].	Wayfinding	B (depression, schizophrenia) [233,234,235]
		Green spaces
		Inclusive crossings (see Section 3.1)
		Safe spaces
		Multiple itineraries
		Improving space readability
		Easy English techniques
Sensory processing disorder (hypersensitivity)	Ease of motion [236]. May need frequent stops [237]. Required urban relief spaces [236]. Excessive lighting may be uncomfortable [237]. Extreme temperatures may cause thermal stress [238].	Green spaces	A [239] B (fibromyalgia, osteoarthritis, rheumatoid arthritis, lupus) [150,240]
		Inclusive crossings (see Section 3.1)
		Multiple itineraries
		Intermediate seats
		Safe spaces
		Vegetation with seasonal variation management
		Thermal stability
		Noise pollution reduction
Reality distortion and psychoses	Ease of motion [241]. Safety zones are required [116]. Confusion and disorientation may be present [241].	Wayfinding	B (dementia) [242]
Reality distortion and psychoses	Ease of motion [241]. Safety zones are required [116]. Confusion and disorientation may be present [241].	Wayfinding	B (dementia) [242]
		Improving space readability
		Easy English techniques
		Digital guidance systems
		Intermediate seats
		Safe spaces
		Noise pollution reduction

Table 3. Cognitive condition analysis.

Cognitive Disabling Conditions	Urban Interaction	Urban Mobility Requirements [64,65,67,81,127]	Relation to Ageing Conditions
Aphasia (language disorder caused by brain damage)	Ease of motion [215]. Difficulties in interacting with other people [216].	Wayfinding	B (stroke, dementia) [217,218]
		Improving space readability
General agnosia (inability to process and identify sensory information)	Ease of motion in continuous, clear and well-referenced paths [219]. Easy English techniques may be needed for visual information [87].	Wayfinding	B (Alzheimer’s, dementia) [220]
		Improving space readability
		Easy English techniques
Agraphia (inability to communicate through writing)	Ease of motion [221].	No accommodation needed	B (dementia) [222]
Alexia (inability to comprehend written messages)	Ease of motion in continuous, clear and well-referenced paths [223]. Easy English techniques may be needed for written information [87].	Wayfinding	B (dementia, stroke) [223]
		Improving space readability
		Easy English techniques
Dyslexia (reading disorder)	Ease of motion in continuous, clear and well-referenced paths [224]. Easy English techniques may be needed for written information [87,224].	Wayfinding	A [225] B (dementia) [226]
		Easy English techniques
Dysarthria (inability to articulate messages)	Ease of motion [227]. Preventive measures are required to prevent people from having to ask others for information [227]. Overlapping noises may be problematic [227].	Wayfinding	B (Parkinson’s) [228]
		Improving space readability
		Easy English techniques
		Noise pollution reduction
Memory loss	Ease of motion [229]. Confusion and disorientation may be present [229].	Wayfinding	A [230] B (dementia including Alzheimer’s) [202]
		Improving space readability
		Easy English techniques
		Intermediate seats
Developmental and intellectual disability	Ease of motion in continuous, clear and well-referenced paths [231]. Confusion and disorientation may be present [59]. Easy English techniques may be needed for written information. Required urban relief spaces [59].	Easy English techniques	C
		Wayfinding
		Intermediate seats
		Safe spaces
		Green spaces
		Inclusive crossings (see Section 3.1)
		Remove visual obstacles from crossing surroundings
Social or interaction anxiety and chronic stress	Ease of motion [232]. Required urban relief spaces [232]. Needed clear guidance through the city [232]. Difficulties in interacting with other people [232].	Wayfinding	B (depression, schizophrenia) [233,234,235]
		Green spaces
		Inclusive crossings (see Section 3.1)
		Safe spaces
		Multiple itineraries
		Improving space readability
		Easy English techniques
Sensory processing disorder (hypersensitivity)	Ease of motion [236]. May need frequent stops [237]. Required urban relief spaces [236]. Excessive lighting may be uncomfortable [237]. Extreme temperatures may cause thermal stress [238].	Green spaces	A [239] B (fibromyalgia, osteoarthritis, rheumatoid arthritis, lupus) [150,240]
		Inclusive crossings (see Section 3.1)
		Multiple itineraries
		Intermediate seats
		Safe spaces
		Vegetation with seasonal variation management
		Thermal stability
		Noise pollution reduction
Reality distortion and psychoses	Ease of motion [241]. Safety zones are required [116]. Confusion and disorientation may be present [241].	Wayfinding	B (dementia) [242]
Reality distortion and psychoses	Ease of motion [241]. Safety zones are required [116]. Confusion and disorientation may be present [241].	Wayfinding	B (dementia) [242]
		Improving space readability
		Easy English techniques
		Digital guidance systems
		Intermediate seats
		Safe spaces
		Noise pollution reduction

3.3. Main Urban Mobility Requirements for People with Different Disabling Conditions

The previous literature analysis was transformed into numerical data to facilitate comparison across different classifications. The number of times that each urban requirement was needed by the different conditions that may lead to disability (from now on referred to as “mentions”) was assessed for the 39 conditions from conditions (Table 1, Table 2 and Table 3). For this purpose, each disability condition counted as one, regardless of the number of citizens affected by it. This helps reduce the invisibility of some conditions, considering all of them as important.

These analyses showed that, out of a total of 39 disabling conditions (Table 1, Table 2 and Table 3), there are five most recurrent requirements to improve the urban interaction of all collectives from a universal design perspective (Figure 2): wayfinding (17 mentions), intermediate seats (16 mentions), inclusive crossings (15 mentions), continuous and stable pavement (14 mentions) and step and small obstacle removal (13 mentions).

First, the implementation of proper wayfinding measures (17 mentions) resulted in the most conditioning requirement, making almost half of the conditions benefit from it. It highlights the demand for making the urban environment comprehensive and navigable for everyone, especially for people relying on cognitive accessibility but also for sensory conditions. Although it affects physical accessibility to a lesser extent (one mention), it is relevant to remark that the most recurrent need addresses all three types of accessibilities.

Then, the lack of intermediate seats (16 mentions) and inclusive crossing (15 mentions) seem to be the next most threatening aspects of urban or street design. They both answer to the requirements of all three categories, physical, sensory, and cognitive, as wayfinding does. Thus, having spaces to make pauses and safe crossings that grant sufficient time, an elevated road zebra crossing area, proper crossing light visibility and sound signals.

It is worth mentioning that some requirements such as the “Removal of visual obstacles from crossing surroundings” (5) and “Noise pollution reduction” (7) could help the three types of conditions, although they do not present many mentions in the literature revision. While some requirements were highly mentioned, such as the continuous and stable pavement (14 mentions), and step and small obstacle removal (13 mentions), this can lead to better physical and sensory accessibility but were not mentioned for cognitive conditions.

Although these five requirements stand out over the rest of them, the other requirements presenting fewer mentions also work in favour of more inclusive environments and are favourable for all users. Figure 2 shows the proportion of mentions out of the total of detected disabling conditions, first by category, and, lastly, out of the sum of physical, sensory, and cognitive conditions.

3.4. Main Urban Mobility Requirements for Older Adults’ Conditions

For each physical, sensory, or cognitive condition that may lead to disability, its prevalence amongst older people was assessed (Table 1, Table 2 and Table 3). After a careful literature collection, each condition that may lead to disability was associated with older people’s conditions depending on whether these are related to normal physiological ageing (category A), result from age-related diseases (category B), or are unrelated to ageing (category C).

Then, the urban mobility requirements that arose from the urban interaction profile were assigned to those different categories of the older adults’ analysis (Table 1, Table 2 and Table 3). The resulting analysis shows how many times each requirement is mentioned for the different ageing conditions (Figure 3). The total of mentions was summed and compared, to define the most prevalent requirements for older adults’ conditions.

After applying the urban interaction profile to the affections of older adults, five requirements sum more than 15 mentions: intermediate seats (22 mentions), wayfinding (18 mentions), inclusive crossings (19 mentions), continuous and stable pavement (19 mentions), and step and small obstacle removal (18 mentions).

As older adults tend to present lower stamina levels [132], it is coherent to find the need for intermediate seating (22 mentions) in the first position. In fact, most of the mentions are related to normal physiological ageing (10 mentions), just followed by those related to common diseases in older adults (12 mentions).

Inclusive crossings (19 mentions) and continuous and stable pavement (19 mentions) are in the same position, with only a little difference between requirements related to normal physiological ageing (9 and 8 mentions, respectively) and those related to common diseases in older adults (11 and 9 mentions, respectively). This is also the case of step and small obstacle removal (18 mentions), with 8 mentions related to normal physiological ageing and 10 mentions related to common diseases in older adults.

Wayfinding (18 mentions), on the other hand, presents 6 mentions related to normal physiological ageing and 12 mentions related to common diseases in older adults, representing one of the wider gaps between categories A and B.

These five requirements represented the most frequent ones for categories A and B (Figure 3); thus, it becomes clear that there is little difference, in general terms, between urban mobility requirements for older people with physiological ageing or illness-related affections.

3.5. Analysis of Similarities and Differences in Main Urban Mobility Requirements Between People with Disabling Conditions and Older Adult Conditions

Among all the collected urban mobility requirements, people with conditions that may lead to disabilities and older adults’ conditions share the top five most mentioned requirements with almost the same order of importance (

Table 4. Top 5 of the most mentioned needs for disabling conditions and older adults.

People with Disabling Conditions		Older Adult Requirements
Need	Mentions	Need	Mentions
Wayfinding	17	Intermediate seats	25
Intermediate seats	16	Wayfinding	21
Inclusive crossings	15	Inclusive crossings	21
Continuous and stable pavement	14	Continuous and stable pavement	20
Step and small obstacle removal	13	Step and small obstacle removal	18

):

This comparison shows that older adults not only benefit from the inclusive measures proposed by the universal design theory but also require them on an equal basis to those people presenting disabling conditions in general terms. Figure 4 shows this information in a supporting graphic.

4. Discussion

4.1. Assessment of Common and Specific Urban Mobility Requirements for the Different Categories of Older Adults’ Conditions

4.1.1. Common Urban Mobility Requirements for Older Adults with Normal Ageing

As shown in Figure 4, 26 out of the 28 urban mobility requirements are relevant for older adults experiencing normal ageing. This supports the frequently made assertion that universal design, initially conceived for people with disabilities [7,24], also benefits the majority of older adults. It also highlights that not only older adults suffering from diseases—commonly associated with disability—benefit from most universal design solutions but also those naturally ageing.

Notably, one of the most crucial urban features for older adults ageing naturally is intermediate seating. This underscores the importance of maintaining an adequate pedestrian band on sidewalks to accommodate longer walking distances by providing midway resting stops [64]. These intermediate seating areas allow individuals to walk further, enhancing active mobility, independence, and comfort while exploring the city [36,102]. Such features benefit older adults with decreased stamina due to natural ageing, making the city more accessible and inviting [131,243]. The inclusion of intermediate seating in urban planning encourages older adults to explore urban spaces for longer periods, fostering a healthier, more inclusive environment. This, in turn, enhances social interaction among individuals, promoting well-being and mitigating early cognitive decline [244].

The connectivity between various sections of pedestrian infrastructure also emerged as a key priority. The presence of inclusive crossings, continuous and stable pavements, and the removal of steps and small obstacles were among the highest-ranking criteria. As reflexes and walking speed tend to decline with age [78,83], along with balance and coordination challenges [160], these improvements are essential to ensure an uninterrupted journey, enhancing overall mobility [245].

Furthermore, wayfinding is another critical element. It enables people, particularly older adults with lower visual acuity [92] to navigate the urban environment confidently. The experience of “feeling lost” is not exclusive to individuals with cognitive impairments but is common among all individuals, particularly when unfamiliar with their surroundings [246]. This demonstrates that wayfinding systems, typically associated with cognitive disabilities, benefit all pedestrians [86].

4.1.2. Specific Urban Mobility Requirements for Older Adults Suffering from Age-Related Diseases

As illustrated in Figure 4, 26 out of the 28 urban mobility requirements are also relevant for older adults suffering from age-related diseases.

While a substantial overlap exists between the needs of older adults with normal ageing and those with age-related diseases, some key differences must be highlighted:

• Adequate artificial lighting regulation and appropriate night lighting are particularly important for conditions like glaucoma [190], while no reference was found for natural ageing.
• Conversely, avoiding reflecting materials and appropriate lighting throughout the day are crucial for older adults with normal ageing [178,186] but no previous studies emphasize them for people suffering from age-related illnesses.

Despite these four differences, 24 out of the 28 requirements are shared by both groups, representing about 85% of common needs. This suggests that universal design features can address the mobility requirements of both ageing populations, regardless of their specific health conditions.

Examining the five most crucial criteria for older adults with age-related diseases reveals similarities to those identified for naturally ageing individuals, although their prioritization differs based on the type and extent of ageing conditions.

First, wayfinding emerges as the top priority for those with age-related diseases, likely due to the high proportion of older adults experiencing cognitive decline and mainly disorientation [220,226,247,248].

Second, pedestrian infrastructure’s connectivity helps older adults facing age-related conditions by reducing sensory, cognitive and physical barriers. Thus, features like continuous and stable pavement, as well as inclusive crossings, are ranked second and fifth, respectively, addressing conditions such as stroke [249], falls or other injuries [140,250].

Also connected with inclusive crossings, improving space readability, particularly around squares and crossings, is also critical for older adults suffering from diseases like glaucoma [176] or diabetes [205], which often result in significant visual and auditory loss. Sensory aids, such as clear signage and tactile paving, are essential for ensuring safe independent mobility. Squares and crossings tend to be critical points in this regard [251].

Finally, intermediate seating also plays a role, although with slightly lower priority than for those with normal ageing. For older adults facing reduced strength, balance, or orientation, these seating areas provide necessary rest stops, allowing individuals to recover and continue their journey or return home [149,151,243,252].

Overall, these urban design features, particularly when applied collectively, can help mitigate two prevalent mental health challenges among older adults: loneliness and depression. Enhancing the urban environment can create spaces that are not only physically accessible but also socially supportive, contributing to improved mental health and overall well-being [117]. Additionally, elements like urban greenery have been reported to offer “sedative” and “uplifting” effects, which can be especially beneficial for individuals managing chronic illnesses [253].

4.2. Connections Amongst People with Disabling Conditions and Older Adults’ Conditions

As shown in Figure 4, all selected criteria were matched by both general disabling conditions and older adults. This demonstrates that urban mobility features designed for people with disabilities can also benefit older adults, enabling both groups to live more independently within the urban environment, as many scholars have previously suggested [24,59,254].

The minimal divergence in requirements between people with disabling conditions (Figure 2) and older people (Figure 3) further highlights the importance of considering a broad range of conditions that may require from different inclusivity measures. The low frequency of “no accommodation needed” suggests that most individuals with these conditions face urban barriers to varying extents, reinforcing the need for inclusive urban planning that addresses the needs of all. This has been particularly emphasized in studies focusing on cognitive and hearing impairments [59,77,99].

4.3. Policy Implications

The findings of this study offer valuable insights for policymakers and urban planners seeking to foster inclusivity and improve urban mobility for both older adults and individuals with disabilities. By emphasizing the importance of universal design and active transport policies, this paper contributes to bridging the knowledge gap and provides actionable recommendations for creating more accessible and supportive urban environments. The 28 identified urban mobility requirements serve as a comprehensive guide for implementing these changes in public policies, ultimately promoting a more inclusive, sustainable, and active urban future.

These findings can be transformed into actionable guidelines:

• Ensure Adequate Artificial Lighting Regulation: Design lighting systems that create well-lit urban spaces with sufficient contrast and volume distinction, avoiding flat or uniformly lit areas that may hinder navigation for people with visual impairments.
• Provide Consistent Daytime Lighting: Use appropriate and consistent natural or artificial lighting throughout the day to ensure clear visibility and ease of navigation in all weather conditions.
• Ensure Appropriate Nighttime Lighting: Install well-distributed, energy-efficient, and non-glare lighting to enhance safety and visibility during night hours, considering the needs of pedestrians, cyclists, and people with disabilities.
• Avoid Reflective Materials: Use non-reflective and matte materials in urban design to prevent glare that can impair vision, especially for those with visual impairments, age-related vision loss or hypersensibility.
• Utilize High-Contrast Colours: Employ colour contrast in surfaces, signage, and pathways to aid individuals with visual impairments in differentiating between various elements (e.g., sidewalks, crossings, and obstacles).
• Maintain Continuous and Stable Pavement: Ensure that sidewalks and pedestrian paths are free of cracks, holes, or obstructions and are consistently smooth to provide safe walking environments for all users, especially individuals with mobility challenges.
• Integrate Digital Guidance Systems: Incorporate digital tools such as mobile apps or digital signage to provide real-time navigation assistance, helping users with varying mobility needs to find their way through urban spaces.
• Implement Easy-English Techniques: Use clear, simple language and visual aids (such as pictograms or symbols) on signage and instructions to accommodate individuals with limited literacy or non-native speakers.
• Provide Sufficient Maneuvering Space on Sidewalks: Design wide, unobstructed sidewalks that allow for easy movement, especially for individuals with wheelchairs, strollers, or mobility aids, ensuring space for others to pass safely.
• Include Green Spaces in Urban Design: Prioritize the creation and maintenance of accessible green spaces, such as parks and community gardens, to promote health and well-being while also offering resting places for pedestrians.
• Improve Spatial Readability: Make spaces easy to understand and navigate by using clear landmarks, logical flow, and consistent signage to guide users in urban environments, minimizing confusion or disorientation.
• Incorporate Inclusive Crossings: Design pedestrian crossings with accessibility in mind, ensuring features such as ramps, audible signals, and extended crossing times to accommodate all users, including those with physical, sensory, or cognitive impairments.
• Provide Intermediate Seats: Install benches or resting areas at regular intervals along walking routes, particularly for older adults, individuals with limited stamina, or those using mobility aids.
• Offer Multiple Travel Routes: Design multiple paths for pedestrians that vary in difficulty or length, allowing individuals to choose routes based on their specific needs or preferences (e.g., avoiding slopes for people with mobility challenges or providing different paving options to foster walkability).
• Mitigate Noise Pollution: Implement noise-reducing strategies such as sound barriers, quieter road surfaces, and green buffers to create more peaceful and comfortable urban environments, especially near pedestrian areas.
• Ensure Accessible Public Toilets for All Needs: Provide ostomate-accessible toilets alongside standard accessible public restrooms.
• Design Protected Level Changes, Including Gentle Slopes: Ensure that any level changes (e.g., curbs, ramps) are gradual, protected, and designed for easy access by all, including people with mobility challenges.
• Protect Pedestrian Sidewalks: Create dedicated, safe pedestrian sidewalks that are separated from traffic, using barriers, furniture, or landscaping to protect users from moving vehicles.
• Remove Visual Obstructions from Crossing Areas: Free the areas around crossings from obstacles (such as street furniture, signage, or vegetation) near pedestrian crossings to improve sightlines and ensure safe, unobstructed crossings.
• Design Safe Spaces for All Users: Create safe zones in public spaces that offer shelter, security, and accessible design for people with disabilities, older adults, and other vulnerable groups. These safe spaces must include sensory design to provide non-stimulating areas for people with hypersensibility.
• Eliminate Steep Slopes: Replace steep gradients with gentler slopes or ramps (<6% preferably) to ensure safe mobility for people using wheelchairs, walking aids, or strollers.
• Remove Steps and Small Obstacles: Ensure that all public pathways are free from steps and small obstacles that may impede access for people with limited mobility, neurologic affections or vision loss.
• Ensure Sufficient Space Between Roads and Pedestrian Areas: Maintain an adequate distance between roadways and pedestrian pathways to minimize exposure to vehicle-related hazards and improve pedestrian safety.
• Use Tactile Paving for Orientation: Implement tactile paving (raised patterns) at key points, such as crossings and edges of platforms, to guide individuals with visual impairments in their environment.
• Ensure Thermal Stability of Public Spaces: Use materials and design strategies that help moderate temperature extremes, shade for heat and shelter for cold and humidity, creating comfortable spaces for pedestrians and reducing the risk of thermal stress or discomfort.
• Manage Vegetation for Seasonal Variations: Use plants that provide seasonal variety, ensuring that green spaces are appealing and usable throughout the year, while considering accessibility and the needs of different user groups.
• Incorporate Vertical Travel Mechanisms: Design accessible elevators, lifts, and escalators even in public spaces to accommodate people who cannot use stairs and in contexts of high steepness.
• Implement Wayfinding Systems: Design comprehensive, user-friendly wayfinding systems with signage, maps, and digital tools that help individuals navigate public spaces easily, regardless of their abilities or age.

Although these reflect basic actions, they will help urban planners, designers, and policymakers understand how to implement inclusive measures at various stages of urban planning, ensuring better access and mobility for everyone. These actionable measures, along with illustrative examples, can be incorporated directly into urban planning projects by technicians. However, adaptations should be made, for example, for different scales and cultural and socio-economic backgrounds. For instance, understanding how mobility needs differ between high-density urban centres, which may also be low-income, and more affluent suburban or rural areas. Moreover, cultural and socio-economic factors also play a role in how these design strategies can be implemented. In multicultural urban areas, for example, wayfinding systems may need to account for diverse linguistic groups, while, in lower-income neighbourhoods, cost-effective solutions for barrier-free design may be more critical. A one-size-fits-all approach should be avoided; urban planners should consider the unique characteristics of each area when implementing universal design features, adjusting strategies as needed.

5. Conclusions

This study provides an integrated analysis of the role universal design plays in improving the integration of older adults into the urban environment. It presents a novel perspective to the understanding of mobility challenges by intersecting the needs of people with disabilities, encompassing physical, sensory, and cognitive conditions, and older adults’ health-related conditions, such as physiological ageing and age-related diseases. The findings offer a comprehensive framework that connects the urban mobility requirements addressed by disabling and ageing conditions, providing evidence to support the growing consensus for the need of “disability-inclusive” and “age-friendly” cities. This study provides substantial evidence for this under-explored merging.

The results of this study demonstrate that universal design benefits not only individuals with disabilities—its primary target—but also the rapidly growing population of older adults. Policies that promote inclusivity for people of all ages and abilities are critical to improving urban livability for all. Urban mobility requirements, such as wayfinding, intermediate seating, inclusive crossings, continuous and stable pavements, and the removal of steps and small obstacles, should be prioritized to address the diversity of needs of these groups. The 28 urban mobility requirements identified in this study are essential for creating accessible urban environments that provide independence, mobility, and social inclusion while mitigating the risk of health issues.

The integration of accessible infrastructure enhances mobility, independence, and social inclusion while reducing the risk of both mental and physical health issues among people with disabilities and older adults. Beyond individual benefits, promoting autonomous mobility contributes to cost savings in healthcare systems. Inclusive design can help reduce isolation and foster active mobility.

In light of increasing life expectancies and advances in the medical field, urban design must accommodate today’s needs while anticipating future mobility challenges derived from prolonged lifespans and the management of chronic health conditions. This research emphasizes the importance of inclusive urban interventions, which will be even more critical as social ageing continues to rise.

In practical terms, the findings of this research provide a valuable foundation for policymakers, urban planners, and practitioners to prioritize inclusivity, independence, physical activity, and social participation for individuals of all ages and abilities. Implementing universal design principles will create accessible cities that can foster intergenerational and intercultural interactions, ensuring that all members of society feel included and valued, regardless of their age or physical condition.

Limitations of This Study and Future Research

While this paper contributes to expanding the existing body of knowledge, the complexity of individual mobility needs, both personal and external, calls for further research to refine the defined urban mobility requirements. Future studies should explore how different profiles are influenced by urban settings, bridging the gap between the medical and urban research fields.

Parallelly, implementing universal design in low-resource settings often faces unique constraints. Limited financial resources, insufficient infrastructure, and competing policy priorities may require specific analysis and projects. Research should explore how urban mobility requirements can be adapted to these environments, ensuring that universal design principles are not only applied in well-resourced cities but also in underserved areas where the need for inclusivity is often most acute. A more detailed examination of rural areas, which face distinct mobility challenges as well, could provide important insights into how universal design principles can be adapted to rural contexts.

Moreover, the integration of universal design principles with transport planning and policies, including emerging solutions like Mobility as a Service (MaaS), presents a key area for further exploration and support for inclusivity. Addressing the intersection of universal design with public transport systems and other mobility services could create more cohesive, accessible urban environments. Future research should also explore how urban spaces can be designed to accommodate a wider range of health conditions, particularly those that are less visible, such as cognitive impairments.

Finally, one of the most significant issues identified during the literature review was the limited number of studies that analyze different disabilities and ageing conditions individually through the lenses of urban design and universal design. Most of the sources reviewed (as shown in Table 1, Table 2 and Table 3) originate from the medical field, and no specific references were found in the urban field considering specific mobility requirement profiles. This highlights a need for more in-depth research on people’s specific needs in the context of urban spaces, particularly in terms of how urban design can create fully inclusive pedestrian environments. Further studies should emphasize specific urban requirements to better inform strategies for achieving inclusive cities for all people, regardless of age or ability.