Age and Dementia Friendly Design Considerations for Physical Infrastructure

Inclusive design can address functional needs arising from dementia.

by Massachusetts Advisory Council on Alzheimer’s Disease

The physical environment plays a critical role in promoting quality of life for people living with dementia by partially compensating for lost abilities. When physical infrastructure includes design elements that are “dementia friendly,” and communities spread dementia awareness among its residents, people living with dementia and their families experience numerous benefits. Those benefits include reduced agitation and distress, improved safety, greater independence, opportunities for social engagement, and an overall improved ability to engage in activities of daily life.

As we age, cognitive and physical changes can make it difficult to navigate both internal and external spaces – our built environment. Dementia involves a loss of cognitive function, such as reasoning; and physical symptoms often include growing problems with movement or balance as the illness progresses. Design features described in the attached report help improve an aging person’s ability to navigate both inside and outside environments, and these considerations are
especially helpful for people living with dementia.

This document by the Age and Dementia Friendly Physical Infrastructure Team of the Massachusetts Advisory Council on Alzheimer’s Disease and All Other Dementias was created to assist anyone involved in designing buildings and outdoor spaces across the Commonwealth, whether you are architects, engineers, designers, builders, city/town planners, regional planners, financiers, municipal and state government officials, or Council on Aging directors. The ideas in this document just scratch the surface of the many ways our built environment can meet changing cognitive and physical abilities. As you consider the recommendations, we hope these ideas will also stimulate innovation and other examples to showcase in future publications.

Attached document published September 2022

About the Author


The Massachusetts Advisory Council on Alzheimer’s Disease and All Other Dementias was established in August 2018 when Governor Baker signed Chapter 220 of the Acts of 2018 into law. The Council is charged with advising the Executive Office of Health and Human Services and the Legislature on Alzheimer’s disease policy. The Council is comprised of the Secretary of the Executive Office of Elder Affairs and a diverse panel of public health professionals, clinicians, health care providers, researchers, legislators, dementia advocates, and caregivers.

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