# Neighbourhood-built environment and cognitive or social health in older adults with mild cognitive impairment or dementia: an umbrella review

## TL;DR

This umbrella review explores how neighborhood environments affect the cognitive and social health of older adults with mild cognitive impairment or dementia, emphasizing the need for dementia-friendly design.

## Contribution

The study integrates objective and subjective perspectives on neighborhood environments to guide dementia-friendly urban design.

## Key findings

- Green spaces and transportation infrastructure positively influence cognitive functioning and social participation.
- Subjective experiences of people with dementia and their caregivers are important for designing dementia-friendly neighborhoods.
- Further research is needed to explore specific neighborhood features impacting social health and lived experiences.

## Abstract

Recent studies underscore the importance of the neighbourhood-built environment (NBE) for the cognitive and social health of older people with mild cognitive impairment (MCI) or people living with dementia (PlwD). While previous overview reviews have provided valuable insights, they often focus narrowly on either objective environmental features or subjective experiences and typically lack an integrated perspective. This umbrella review addresses this gap by systematically examining how specific NBE aspects (a) influence the cognitive and social health of older people with MCI or PlwD, and (b) subjective experiences by PlwD and their caregivers. By combining these perspectives, the review aims to support the development of dementia-friendly neighbourhood design and planning.

To answer these questions, an umbrella review was performed. Scopus, MEDLINE (Pubmed), APA PsychINFO (Ebesco), CINAHL Complete (Ebesco), Cochrane Library, and Epistemonikos databases were used for the systematic literature research. We included peer-reviewed reviews or meta-analyses (quantitative, qualitative, or mixed-method studies) in German or English.

Ten reviews with 364 primary studies were identified. Reviews predominantly included quantitative studies, but also qualitative studies. The primary focus of the reviews was on the positive and negative influences of the NBE on MCI and/or dementia. Subjective experiences on social health targets were also addressed, but received less attention.

The results of the reviews, although heterogeneous, highlight potential relationships between various NBE aspects and the cognitive and social health of older people with MCI or PlwD. Clear associations were identified for certain NBE features—such as green spaces and transportation infrastructure—which demonstrate positive influences on both cognitive functioning and social participation. These findings emphasise the importance of considering both objective environmental characteristics and the subjective perceptions of PlwD and their caregivers when designing dementia-friendly neighbourhoods. By doing so, this umbrella review contributes evidence-based guidance to support autonomy and independent living for people with MCI or dementia. Further research is needed to explore the specific influence of individual NBE aspects on social health and the lived experiences of PlwD and their caregivers.

The online version contains supplementary material available at 10.1186/s12877-025-06693-z.