# The Physical Environment and the Quality of Life and Behavior in People With Dementia: A Systematic Meta-Review

## TL;DR

This review explores how the design of care environments affects the quality of life and behavior of people with dementia, finding that while many design features are beneficial, the evidence supporting them is weak.

## Contribution

The study systematically evaluates the strength of evidence for environmental design specifications in dementia care.

## Key findings

- A wide range of architectural features are associated with improved quality of life and behavior in dementia patients.
- The evidence supporting these design features is generally of low quality.
- Balancing sensory stimulation and deprivation is a key challenge in dementia care environments.

## Abstract

The environmental design of care settings is increasingly recognized as an important factor that can support reducing neuropsychiatric symptoms and improving quality of life in people with dementia. This review provides a comprehensive overview of consensual knowledge of specifications of the environmental design that are found to be associated with quality of life and behavior, that includes evaluation of the strength of evidence. Seven databases were searched, yielding 410 unique reviews. Assessment of relevance to the subject and assessment of the evidence level of those specifications. The selection process yielded 11 systematic reviews. The results show that a broad range of architectural features are beneficiary to quality of life and behavior, but the level of evidence is low. There is a large body of consensual knowledge on environmental design that is associated with quality of life and behavior, but the quality of evidence is low. Finding a balance between overstimulation of senses and sensory deprivation is a challenge in designing environments for people with dementia. Providing variation in ambiance of spaces may have beneficiary effects on behavior and quality of life.