Assessing the quality of the built environment in dementia: a framework to evaluate long-term care facilities

Introduction: Life expectancy worldwide is raising fast, with a correlated increase in Non-Communicable Diseases (NCDs) and years lived with disability. Dementia is one of these, with about 7 million people affected in Europe and the number is set to double by 2050. These patients are complex due to the serious changes in the cognitive sphere, altering perceptions of the space. They are the most frequent users of healthcare facilities, but these structures often are not suitable for them. For this reason, rethinking is now urgent to create safe and suitable environments. Materials and Methods: This study aims to develop an evaluation framework of the main aspect of the design of a built environment for people with dementia. To this end, a systematic literature review has been conducted on scientific databases using meaningful keywords. The review was useful to outline the main characteristics that the environment dedicated to the dementia patient must possess to be inclusive and prosthetic. Results: The research has allowed defining a set of requirements that the space must have to be prosthetic for the patient. These findings have been identified and were divided into three main macro-areas (physical, cognitive, and social aspects) 7 criteria, and 31 related sub-criteria. The results were also validated through the involvement of stakeholders and experts in the topic, both from the architectural and medical field to establish the relationship between physical factors and patient outcomes. Conclusion: The results of this research can be used as guidelines to assess and design proper facilities for people with dementia and cognitive disabilities. This is because there is an urgent need to create and renovate the existing buildings to make them as therapeutic and prosthetic as possible. The priority also in research must be to investigate which aspects of architecture can impact patients’ health and well-being.