Social and physical environments in dementia-inclusive societies: A scoping review of the dementia-friendly cities and communities' literature

Abstract

Introduction

Dementia-friendly societies are an essential development as the global population ages. The physical and social environments shape and support the independence, safety, and quality of life of people living with dementia. The World Health Organization developed a framework comprising ten domains that guide dementia-friendly initiatives, but to date operational definitions are missing which limit its applicability. Therefore, the aim of this study was to define and operationalise the ten domains defined by the World Health Organization by synthesizing empirical and conceptual literature on people living with dementia, their carers, and communities.

Methods

This study conducted a large-scale scoping review following the PRISMA-ScR protocol. Using tailored search strategies across multiple academic databases, the literature was systematically synthesised. In addition to traditional database searches, a linguistic search strategy using AI-driven tools was employed to identify relevant studies that might not have surfaced in conventional keyword-based searches; these tools supplemented, not replaced, hand screening. The review focused on the lived experiences of people living with dementia, their carers, and community members.

Results

This scoping review shows how the ten WHO domains can be operationalised and how they interact, emphasising safety beyond infrastructure, housing as identity, and meaningful social participation. Two cross-domain barriers proved crucial for translating these domains into effective, inclusive strategies: ‘stigma’ and ‘constrained accessibility‘: (i) the physical environment (transport, buildings, wayfinding) and (ii) access to communication, information and technology.

Conclusion

Policymakers, urban planners and healthcare providers can use these operational features to design, implement and evaluate targeted interventions. Implementation brings challenges in capacity, coordination and equity; accordingly, the features are presented as a flexible basis for context-appropriate adaptation and staged evaluation.