Outdoor environments for people with dementia: an exploratory study using virtual reality

Abstract

Few studies have investigated how outdoor environments might disable people with dementia. The issue is rarely considered in planning and design guidelines and not at all in regulations, despite dementia being within the scope of disability discrimination legislation in the United Kingdom and other countries. This article reports a study that involved older people with mild to moderate dementias taking two walks, one in a real town centre and one in a virtual reality (VR) simulation. Adaptations were made to the VR simulation to test possible design improvements. Overall, the town centre posed relatively few problems for the 38 older people with dementia who participated, although more difficulty was evident with greater impairment. Some features of particular places were liked more than others, particularly the segregation of spaces from motor traffic. There were measurable benefits from using clear textual signs to support wayfinding and to identify objects and places in the environment. Diminished outdoor activity is likely to be experienced as a decrease in quality of life and may accelerate the progression of dementia. We conclude that older people with mild to moderate dementia should be encouraged to be active outdoors and that this can be facilitated by small environmental modifications. Some limitations of the VR technology used for the study are also reported.

Managing critical incidents in grocery shopping by community-living people with Alzheimer's disease

“…Many of the critical incidents described in this study confirm findings from earlier studies, for example difficulties in distinguishing between a road and a pedestrian path, difficulties in observing changes in levels (25), and being exposed to heavy traffic, difficulties in using maps for navigation (4,25) and in using everyday technology (26).…”

Neighbourhoods and dementia in the health and social care context: a realist review of the literature and implications for UK policy development

“…Another study concerned with way-finding and urban design by Blackman et al 57 and Van Schaik et al 68 used a virtual environment to assess how different environmental features affected how people with dementia journeyed through a city setting. The research demonstrated that such technology can be used to support people with dementia in evaluating urban environments.…”

“…[54][55][56] There is also work that suggests that 'walking' helps to (at least) maintain cognitive functioning in those with dementia 19,56 and that the practicalities of getting 'out and about' in neighbourhoods, such as through navigating local environments, plays a pivotal role in maintaining a person with dementia's sense of self and well-being. 1,19,[57][58][59][60][61] Such environmental issues are important dimensions of neighbourhood living. The review on promoting cognitive health and vitality by Yevchak et al 62 clearly demonstrated the importance of older people maintaining social engagement, contacts and stimulation.…”

Technology and Dementia: The Future is Now

“…Smart phones with GPS and map functions, offer functionality to support wayfinding [50], including identifying indicators of disorientation to support navigation prompting [51]. For those who have difficulty getting out or participating in regular exercise, virtual cycling [52] and navigating virtual environments [53] can offer enjoyable alternatives.…”