The Effect of Physical Environment on Social Participation in Persons with Alzheimer's Disease and Related Dementias

The purpose of this systematic literature review was to examine the current evidence on changes to the physical environment and its impact on social participation for individuals with Alzheimer's disease and related dementias (ADRD). Studies in this review were within the occupational therapy scope of practice and contained intervention strategies that addressed changes to the physical environment and outcome measures related to social participation. Only studies found in peer-reviewed journals, with levels of evidence between Level I-IV were included. Eight studies met inclusion criteria. Results suggest that the design of the physical environment of special care facilities may have a positive impact on social participation for individuals with ADRD when compared to traditional care facilities. More specifically, changes to the design of the physical environment implemented by special care facilities may increase social engagement, time spent in communal living areas, interest in the environment, and interaction with surroundings. Three themes emerged from this review that addressed the unique characteristics of design and structure of the physical environment, characteristics of residents, and differences in staffing between special care facilities and traditional care facilities. Results from this review suggest that design characteristics unique to special care facilities may account for increases in meaningful social participation for individuals with ADRD. Therefore, occupational therapists and healthcare practitioners should consider design of the physical environment as a means to increase social participation in individuals with ADRD.