More older adults than ever are choosing to stay put rather than move into assisted living, and the numbers back up that instinct. Recent surveys show that roughly three out of four adults over 55 consider aging in place a top priority, a shift that has quietly reshaped how cities plan housing, sidewalks, and healthcare access.
The catch is that not every city makes that goal realistic. Only about one in ten American homes currently have the step-free entries, main-floor bedrooms, and accessible bathrooms that make staying home practical long term. That gap is exactly why location matters so much, and why we pulled together data from housing researchers, AARP’s Livability Index, and WalletHub’s retirement rankings to see which cities actually set older residents up for success.
1. Boise, Idaho: The nation’s top age-in-place score
Boise currently holds the top spot on Choice Mutual’s 2026 age-in-place index, Boise, ID, leads with an age-in-place index of 71.77 out of 100, where 75% of homes include a bedroom on the first floor. That single detail matters more than it might sound. Stairs are a leading cause of falls among older adults, so a city where the housing stock already skips that hazard has a real head start.
Three-quarters of homes there include a primary bedroom on the first floor, reducing or eliminating the daily stair-climbing that poses real fall risks for older adults. The city’s ranking wasn’t built on housing alone, either. Researchers weighted the score using 40% for first-floor primaries, 40% for walkability, and 20% for climate, meaning Boise earned its position by scoring well across the board, not just on one metric.
2. Sacramento, California: Walkability meets accessible housing
Sacramento lands in second place nationally, and it gets there through a slightly different formula than Boise. Sacramento comes in second with a score of 67.71, where strong walkability scores of 81.94 out of 100 complement a high percentage of accessible homes. In other words, even where fewer homes have first-floor bedrooms, the city compensates with streets and neighborhoods that are genuinely easy to navigate on foot…