A2CT Assessment Alzheimer Centre Tool: evaluation tool of structures for people with dementia

Background. The increasing number of elderly population (17,4% over 65 in Europe in 2009 and 20,3% in 2019) is following by the progressive growth in diseases related to age. One of them is dementia that afflicts 8% of over 65s, of which 60% with Alzheimer. Patients with progressive cognitive deterioration often need to leave their houses and move to nursing homes but in many cases, these aren't suitable for hosting them because based on regulations and standards that are exceeded. Aim of the study is to evaluate if those territorial structures are suitable for patients. Methods. The study addressed a systematic literature review, in the relationship between built environment and patients with dementia, different case studies, and existing evaluation tools. The evidence that emerged allowed to develop of a rating tool divided into 4 macro-areas (quality, spaces, activities, and wayfinding) and composed by different criteria and indicators. The tool was applied in 5 facilities in Northern Italy and strategies were provided. Results. The facilities differ in type and age of construction and the results of the evaluation tool show that 2 are inadequate (<60%) 2 sufficient (<80%) and 1 excellent (>80%). The best one is the newest and is conceived based on analysis of evidence in the relationship between Alzheimer's and built environment and facts this scored the maximum (100%) for spaces than the other older structures, made by the reuse of existing spaces, results as inadequate (every structure obtained <65%). For each criticality found implementation strategies were provided. Conclusions. The investigation highlights that the design of territorial structures must be based on evidence to create better spaces for the well-being of patients. It also shows that existing buildings are not able to respond to the need of patients affected by dementia. To get a broader view of the situation, the tool could be applied in other structures both in other regions and abroad.