Understanding environmental perception in community elderly care facilities: A systematic review

As population ageing accelerates globally, community elderly care facilities (CECFs) have become critical spatial infrastructures supporting “ageing in place” and sustainable urban development. While existing research has predominantly focused on objective spatial indicators such as accessibility and resource distribution, limited attention has been paid to older adults’ subjective perceptions of the environmental conditions across the community spatial continuum. This study conducts a systematic review of 58 peer-reviewed articles following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement to examine the multidimensional structure of older adults’ environmental perception in CECFs and its relationship with built environment elements. Through dual-coder directed content analysis (Cohen’s κ = 0.76), four core perceptual dimensions are inductively derived: functional cognition and perceived accessibility, sensory comfort and aesthetic experience, perceived safety, and place attachment and identity. In parallel, 16 categories of environmental attributes are synthesised across three interconnected spatial layers: community streets, outdoor public and landscape spaces, and building interiors. The review systematically maps the relationships between environmental elements and perceptual dimensions, revealing that environmental experiences emerge through interactions across multiple spatial scales rather than within isolated settings. Based on these findings, two complementary conceptual propositions are advanced: spatial synergy, which explains the cross-dimensional influence of environmental attributes, and perceptual accumulation, which describes how these influences develop progressively along older adults’ spatial journeys. Building on these insights, the study proposes a perception-oriented analytical framework that integrates landscape, public space, and care facility environments within a continuous community system. The framework provides a foundation for designing age-friendly and sustainable community care environments that better support older adults’ well-being, participation, and quality of life.