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Loneliness has become a global crisis affecting people of all ages, with growing recognition of its impact on mental and physical health (Garcia et al. Reference Garcia, Hunter and Anderson2025). Global efforts to raise awareness of and address this issue are gaining momentum. For example, in Australia, Loneliness Awareness Week is observed annually to build public understanding and promote strategies to combat loneliness across communities. While loneliness can affect anyone, it is particularly important to consider how it affects older adults, as for them, social isolation and loneliness are a significant health concern (Bashar et al. Reference Bashar, Begam, Gnansekaran and Ahmed2025). Although often used interchangeably, social isolation and loneliness are distinct constructs: social isolation denotes an objective lack of social contact, whereas loneliness captures the subjective distress arising from perceived absences in social relationships (Veazie et al. Reference Veazie, Gilbert, Winchell, Paynter and Guise2019).

Lockdowns during COVID-19 caused a dramatic spike in loneliness, especially during periods of physical distancing and social isolation (Vasan et al. Reference Vasan, Lambert, Eikelis and Lim2022). Estimates suggest that loneliness affects almost 3 in 10 older adults aged 60 years and over (Chawla et al. Reference Chawla, Kunonga, Stow, Barker, Craig and Hanratty2021). These are regarded as one of the greatest global challenges in public health due to their detrimental impact on the wellbeing and quality of life, particularly in ageing populations (Hong et al. Reference Hong, Nakamura, Berkman, Chen, Shiba, Chen, Kim and VanderWeele2023; O’Sullivan et al. Reference O’Sullivan, Leavey and Lawlor2022). This is especially important given that experiencing social isolation or loneliness is associated with an increased risk of cardiovascular diseases, anxiety, depression, suicide and dementia, with significant implications for life expectancy and quality of life (Holt-Lunstad Reference Holt-Lunstad2018).

Emerging concerns have prompted rising attention to interventions aimed at reducing social isolation and loneliness, with recent studies advocating targeted strategies for older people (Gyasi et al. Reference Gyasi, Mariwah, Boateng, Adjei Mensah, Kwabena-Adade, Dramani, Osafo, Hajek, Abass and Phillips2025). An expanding body of evidence supports the mental and physical health benefits of nature-based interventions, which are structured activities conducted outdoors in green or urban spaces (Houlden et al. Reference Houlden, Weich, Porto de Albuquerque, Jarvis and Rees2018). Recent systematic reviews have established that such interventions can reduce loneliness, improve mood, and overall wellbeing and enhance the value of urban nature (Coventry et al. Reference Coventry, Brown, Pervin, Brabyn, Pateman, Breedvelt, Gilbody, Stancliffe, McEachan and White2021; Lavelle Sachs et al. Reference Lavelle Sachs, Kolster, Wrigley, Papon, Opacin, Hill, Howarth, Rochau, Hidalgo, Casajuana, Siebert, Gerhard, Daher and Litt2024; Tong et al. Reference Tong, Thompson, Carin-Levy, Liddle, Morton and Mead2025). Despite this, urban health strategies frequently underutilise nature-based activities, even though such interventions have the potential to be particurarly beneficial for older adults and individuals with limited mobility or visual impairments.

One example is the Cycling Without Age programme which offers bike rides for people who may not be able to cycle independently. Using specially designed trishaws (electrically powered adapted bicycles which can seat two passengers), trained volunteers or staff (referred to as pilots) lead the rides, allowing participants to explore local areas (Gray and Gow Reference Gray and Gow2020). Since the inception of this non-profit programme in 2012 in Denmark, Cycling Without Age has grown into a global movement. As of 2025, the programme operates in 41 countries. Numerous chapters have been established in cities and towns, both large and small, adapting the model to local contexts.

Empirical studies conducted in the UK, US, Denmark and Australia (Ahrensberg et al. Reference Ahrensberg, Eghøj, Rasmussen, Jørgensen, Toftager and Petersen2025; Cyarto et al. Reference Cyarto, Dickins, Meyer and Lowthian Judy2022; Gray and Gow Reference Gray and Gow2020; Lange et al. Reference Lange, Stig, Eghøj and Petersen2024; McNiel and Westphal Reference McNiel and Westphal2020; Schnor et al. Reference Schnor, Linderoth and Midtgaard2019) report consistent improvements in mood, life satisfaction and social engagement for participants. This initiative has been shown to foster connections and help improve wellbeing and mental health, particularly for individuals facing social isolation and loneliness. Staff and families have observed reduced distress and increased engagement of the passengers.

A fundamental component of Cycling Without Age is its facilitation of older adults’ involvement with outdoor environments and urban spaces within a safe and supportive framework. These opportunities can provide psychological stimulation and contribute to restoring participants’ sense of agency and visibility. Across diverse cultural and geographical contexts, the most consistent evidence points to Cycling Without Age’s exceptional strength in fostering social connections. Additionally, the shared experience of a trishaw ride, including dialogue, exchanging greetings with neighbours and reminiscing about the past, can lift the veil of isolation and invisibility that so often surrounds older adults. That said, the relational aspect, including the empathy and attention of volunteers, is at the heart of Cycling Without Age’s impact.

Another key factor contributing to the success of Cycling Without Age is its flexible grassroot model. Each chapter adapts to local needs, whether partnering with care homes, municipalities or community groups allowing Cycling Without Age to thrive in settinfs, from urban centres to rural villages. Given its emphasis on community-based participation, wellbeing and social connection, Cycling Without Age aligns naturally with the principles underpinning social prescribing. By addressing the social determinants of health and connecting individuals to comunity-based activities, social prescribing interventions seek to reduce loneliness while attending to non-clinical needs affecting their overall health and wellbeing (Khan et al. Reference Khan, Giurca, Sanderson, Dixon, Leitch and Cook2023; Paquet et al. Reference Paquet, Whitehead, Shah, Adams, Dooley, Spreng, Aunio and Dubé2023). Embedding initatives such as Cycling Without Age into social prescribing frameworks could enhance access and long-term sustainability while also helping individuals strenghten social connections, become more involved in their communities, and experience a greater sense of purpose and belonging (Vidovic et al. Reference Vidovic, Reinhardt and Hammerton2021).

Despite the promising findings outlined here, there remains a notable absense of robust research using large-scale, peer-reviewed research on Cycling Without Age. Without more rigorous published studies, with larger samples, longer-term follow-up, and the use of validated outcome measures, it may be challenging to secure sustainable funding, achieve policy adoption or fully integrate Cycling Without Age into mainstream community or social prescribing initiatives. This lack of empirical evidence is particularly unfortunate given the potential of Cycling Without Age to serve as a scalable, person-centred intervention for healthy ageing, inclusion, and community participation in urban and rural environments. Yet, without stronger data, it risks remaining a highly regarded but marginal programme. Funders, researchers and policymakers should prioritise investment in high-quality research to unlock the full potential of Cycling Without Age and similar nature-based interventions.

To conclude, connecting individuals with community-based activities helps foster social bonds and strengthen relationships, vital for improving the quality of life and creating sustainable communities. Outdoor urban activities like Cycling Without Age have proven to be particularly effective, by offering both emotional support and practical benefits. By providing a social activity, this programme has the potential to address social isolation by creating an opportunity for older adults to participate in regular outdoor experiences and build interpersonal connections. The positive impact of this programme, as observed in the small-scale studies currently available, hold promise as an effective intervention for reducing feelings of loneliness and enhancing social engagement, highlighting the value of person-centred and holistic interventions in addressing loneliness. Maximising the potential of nature-based, person-centred interventions such as Cycling Without Age requires sustained multidisciplinary collaborations between public health professionals, urban planners and researchers, in order to advance conceptual understanding and strenghten the evidence base for their implementation.