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Engaging local residents with dementia is key in planning dementia-friendly neighbourhoods

Gan DRY, Chaudhury H, Mann J, Wister AV. Dementia-friendly neighborhood and the built environment: A scoping review The Gerontologist. 2021. 

Review question

• What are the characteristics of existing dementia-friendly neighbourhoods and communities and how can they be improved?

Background

• 
People who live with dementia have differing needs when it comes to living independently. The neighbourhood environment is very important in supporting their independence, access to health services and social engagement. 
• Since the majority of people living with dementia live in the community rather than in health facilities, their communities and neighbourhoods must be accommodating to their condition. 
• Certain aspects of dementia-friendly neighbourhoods such as social participation, familiarity and accessibility have shown positive effects in the behaviour of people living with dementia. 
• This review aims to summarize the characteristics of existing dementia-friendly communities and determine which characteristics are linked to positive behavioural and psychosocial outcomes.

How the review was done

• A detailed search of six electronic databases for literature published up to June 2020 was conducted. Studies that discussed the behavioural and psychosocial outcomes of dementia-friendly communities or neighbourhoods were included. 
• A total of 275 studies were identified in the initial database search, and 29 studies were included in the final review. 
• No financial support was provided for the publication of this review.

What the researchers found

• The studies included in this review examined the built environment of dementia-friendly neighbourhoods in various ways. Half of the studies focused on the physical features of the neighbourhood and the other half examined the experiences of people living with dementia in these communities. 
• Common concepts in dementia-friendly communities included going outdoors, neighbourhood experiences, public space participation, social support, and accessibility. Common aspects of the built environment included the use of landmarks to increase familiarity, public art and recreational facilities. 
• Walking and going out for short trips for routine tasks was found to be very important for the development of connections and the maintenance of independence. 
• The use of meaningful landmarks, distinctive places and clearly designed shopping streets were found to be more effective in supporting people living with dementia than using maps. 
• The engagement of local residents with dementia in the planning of new dementia-friendly neighbourhoods was recommended since they bring lived experiences and perspectives on the meaning of infrastructure, social activities and recreation.

Conclusion

• This review found certain key principles of planning and design of dementia-friendly neighbourhoods such as accessibility for walking, reassurances for limited movement in the neighbourhood (benches as rest spaces), more accessible resources for rural contexts, and the engagement of local residents in the planning process. One important limitation is the urban and suburban settings that these findings were derived from. This may limit the generalizability of the findings for rural environments since rural areas have fewer service amenities, less public transportation and infrastructure.