Dementia-Friendly Communities: The Role of Built Environment and Implementation Challenges in the U.S

Background and Objectives The growing aging population has intensified public health concerns, particularly regarding dementia. Dementia-Friendly Communities have gained global attention as a response to the increasing number of people with dementia and the associated societal care burden. However, empirical research to inform policy briefs, design guidelines, and implementation strategies remains limited. This study explores expert perspectives on key neighborhood built environment features that support aging in place for people with dementia and identifies challenges to implementing dementia-friendly communities in the U.S. Research Design and Methods A nationwide online expert survey was conducted in 2023 and a total of 51 experts specializing in environment and aging research or practice provided complete responses and were included in data analysis. Results Quantitative ratings indicate that “land use & accessibility” and “safety” are the two most critical neighborhood-scale built environment domains for dementia-friendly community design. Open-ended responses on environmental features highlight five key themes: (1) safety first, (2) clear space for better memory support, (3) balance between easy access and stimulation, (4) comfort by design with environmental context in mind, and (5) tailored design for different stages of dementia. Experts also identified financial challenges and knowledge barriers as two major barriers to implementing dementia-friendly communities in the U.S. Discussion and Implications This study provides valuable insights to help policymakers, researchers, and design professionals better understand critical considerations for dementia-friendly community design and facilitate the development of more feasible and effective solutions to promote dementia-friendly environments and support healthy aging in place.