Abstract

ABSTRACTThe built environment can be a home to compensatory strategies aimed at increasing the independence of elderly people with Alzheimer’s disease, by mitigating the cognitive impairment caused by it.Objective: The aim of this study was to find out which interventions were performed in indoor environments and observe their impacts on the relief of behavioral symptoms related to the disorientation of elderly people with probable Alzheimer’s disease.Methods: A systematic review was carried out using the preferred reporting items for systematic review and meta-analyses criteria in the MEDLINE/PubMed database. Two researchers carried out the selection of the studies, following the same methodology. The third author contributed during the writing process and in the decision-making.Results: Of note, 375 studies were identified and 20 studies were included in this systematic review. The identified interventions were classified into environmental communications and environmental characteristics.Conclusions: Environmental communications had positive results in guiding and reducing agitation. In contrast, while reducing behavioral symptoms related to orientation, environmental characteristics showed improvements mainly in social engagement and functional capacity.

Highlights

  • Dementia is an umbrella term for several diseases which affects the brain in a way that compromises one’s cognitive processes, behavior, and ability to carry on daily tasks.[1]It is claimed to be the “major cause of disability and dependency among older adults worldwide.”[2]

  • The role that the built environment plays in supporting people with dementia can be either therapeutic or debilitating: it can be a home for compensatory strategies designed to bypass the cognitive impairment caused by the disease or a barrier for their independent functioning.[4]

  • The first author reviewed all keywords, titles, and abstracts of articles from the search results and identified which met the criteria for further review. Both first and second authors reviewed the full articles and reached an agreement in which to include, based on the question “What interventions were made in the interior environment to lessen the behavioral symptoms related to disorientation and to improve social engagement on older persons with probable Alzheimer’s disease?” The third author contributed during the writing process and decision-making

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Summary

Introduction

Dementia is an umbrella term for several diseases which affects the brain in a way that compromises one’s cognitive processes, behavior, and ability to carry on daily tasks.[1]It is claimed to be the “major cause of disability and dependency among older adults worldwide.”[2]. Different professions are researching in this field, adding new levels to the understanding of the needs of elderly people with dementia in their relationship with the surrounding environment. Architects, such as Margaret Calkins, and sociologists, such as John Zeisel, carried out the reviews of the studies in this area and achieved certain principles, or therapeutic objectives,[4] and design elements such as “exit control, walking paths, common spaces, privacy and personalization, garden access, residential-ness, sensory comprehension, and support for capacity” were correlated with reduced behavioral symptoms.[3]

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