Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-28T21:10:57.442Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  25 October 2007

TIM BLACKMAN ,
PAUL VAN SCHAIK  and
ANTHONY MARTYR
TIM BLACKMAN*
Affiliation:
School of Applied Social Sciences, Durham University, Durham, UK.
PAUL VAN SCHAIK
Affiliation:
School of Social Sciences and Law, University of Teesside, Middlesbrough, UK.
ANTHONY MARTYR
Affiliation:
Dementia Research Group, School of Psychology, University of Wales, Bangor, UK.
*
Address for correspondence: Tim Blackman, School of Applied Social Sciences, Durham University, 32 Old Elvet, Durham City, DH1 3HN, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

dementiaenvironmentvirtual realitywalking
Type
Research Article
Information
Ageing & Society , Volume 27 , Issue 6 , November 2007 , pp. 811 - 825
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbott, R. D., White, L. R., Ross, G. W., Masaki, K. H., Curb, J. D. and Petrovitch, H. 2004. Walking and dementia in physically capable elderly men. Journal of the American Medical Association, 292, 12, 1447–53.CrossRefGoogle ScholarPubMed
Audit, Commission 2000. Forget Me Not: Mental Health Services for Older People. Audit Commission, London.Google Scholar
Blackman, T., Mitchell, L., Burton, E., Jenks, M., Parsons, M., Raman, S. and Williams, K. 2003. The accessibility of public spaces for people with dementia: a new priority for the ‘open city’. Disability and Society, 18, 3, 357–71.CrossRefGoogle Scholar
Bucks, R. S., Ashworth, D. L., Wilcock, G. K. and Siegfried, K. 1996. Assessment of activities of daily living in dementia: development of the Bristol Activities of Daily Living Scale. Age and Ageing, 25, 2, 113–20.CrossRefGoogle ScholarPubMed
Burton, E., Mitchell, L. and Raman, S. 2004. Neighbourhoods for Life: A Checklist of Recommendations for Designing Dementia-friendly Outdoor Environments. Oxford Centre for Sustainable Development and the Housing Corporation, Oxford. Available online at http://www.brookes.ac.uk/schools/be/oisd/sue/wise/resources/NeighbourhoodsforLife-Checklist.pdf! [Accessed 26 August 2006].Google Scholar
Flynn, D., Van Schaik, P., Blackman, T., Fencott, C., Hobbs, B. and Calderon, C. 2003. Developing a virtual reality-based methodology for people with dementia: a feasibility study. CyberPsychology and Behavior, 6, 6, 591–611.CrossRefGoogle ScholarPubMed
Folstein, M., Folstein, S. and McHugh, P. 1975. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychological Research, 12, 3, 189–98.CrossRefGoogle Scholar
Gross, J., Harmon, M., Myers, R., Evans, R., Kay, N., Rodriguez-Charbonier, S. and Herzog, T. R. 2004. Recognition of self among persons with dementia: pictures versus names as environmental supports. Environment and Behavior, 36, 3, 424–54.Google Scholar
Larson, E. B., Wang, L., Bowen, J. D., McCormick, W. C., Teri, L., Crane, P. and Kukull, W. 2006. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine, 144, 2, 73–81.CrossRefGoogle ScholarPubMed
Lawton, M. P. 1980. Environment and Aging. Brooks-Cole, Belmont, California.Google Scholar
Lawton, M. P. 1982. Competence, environmental press, and the adaptation of older people. In Lawton, M. P.Windley, M. and Byertss, T. (eds) Aging and the Environment: Theoretical Approaches. Springer Publishing Company, New York, 33–59.Google Scholar
Lawton, M. P. 1989. Three functions of the residential environment. Journal of Housing for the Elderly, 5, 1, 35–50.CrossRefGoogle Scholar
Lawton, M. P. 1998. Environment and aging: theory revisited. In Scheidt, R. and Windley, P. (eds) Environment and Aging Theory. Greenwood, Westport Connecticut, 1–32.Google Scholar
Sheehan, B., Burton, E. and Mitchell, L. 2006. Outdoor wayfinding in dementia. Dementia, 5, 2, 271–81.CrossRefGoogle Scholar
Scheidt, R. J. and Windley, P. G. (eds) 2003. Physical Environments and Aging: Critical Contributions of M. Powell Lawton to Theory and Practice. Haworth, New York.Google Scholar
Scherder, E. J. A., van Paasschen, J., Deijen, J.-B., van der Knokke, S., Orlebeke, J. F. K., Burgers, I., Devriese, P.-P., Swaab, D. F. and Sergeant, J. A. 2005. Physical activity and executive functions in the elderly with mild cognitive impairment. Aging and Mental Health, 9, 3, 272–80.Google Scholar
Sweden, National Board of Housing, Building and Planning 2006. Legislation: The Planning and Building Act; The Act of Technical Requirements for Construction Works etc.; The Environmental Code with Ordinances of Relevance. Boverket, Karlskrona, Sweden.Google Scholar
United Nations, Committee on a Comprehensive and Integral International Convention on the Protection and Promotion of the Rights and Dignities of Persons with Disabilities 2006. National Institutional Frameworks and Human Rights of Persons with Disabilities. United Nations Organisation, New York.Google Scholar
Weuve, J., Kang, J. H., Manson, J. E., Breteler, M. M. B., Ware, J. H. and Grodstein, F. 2004. Physical activity, including walking, and cognitive function in older women. Journal of the American Medical Association, 292, 12, 1454–61.CrossRefGoogle ScholarPubMed
Zeisel, J., Silverstein, N. M., Hyde, J., Levkoff, S., Lawton, M. P. and Holmes, W. 2003. Environmental correlates to behavioral health outcomes in Alzheimer's special care units. The Gerontologist, 43, 4, 697–711.Google Scholar