La ciudad para personas con demenciaMetodología para integrar el diseño y la calidad de vida en las ciudades europeas

Abstract

The ageing of the population is transforming almost all sectors of society; however, living longer is not synonymous with living well. Although dementia is not an inevitable consequence of ageing, there is an increased risk in older adults, especially from the age of 85 onwards. Dementia is a syndrome caused by several brain diseases that progressively impair various functions, such as memory, behaviour, intellect and the ability to perform daily activities. It is therefore one of the main causes of disability and dependency for older people worldwide. In Europe, despite the decline in prevalence, the number of people with dementia will double in the coming decades, affecting more than 18.8 million in the entire European region by 2050, with the figure in Spain estimated to be more than 1.7 million (9%). Recent research links obesity, hypertension, diabetes, hearing loss, social isolation, physical inactivity, and air pollution, among others, as risk factors that are closely related to the urban environment. On the other hand, advances in the socio-health field towards a Person-Centred Care model demand that cities and public spaces are planned and designed with this perspective, to improve opportunities to prevent cognitive decline and to improve the quality of life of people with dementia and their caregivers. On the one hand, the design of public space should enable and facilitate the person to maintain daily routines, but also promote social interaction. On the other hand, services and activities in the city must also adapt and provide inclusive spaces for people with dementia to continue to participate in the community. This research addresses both issues from the perspective of urban planning and design through a literature and document review and an ethnographic study of 12 case studies. The selected case studies are located in 3 European countries: Belgium, the United Kingdom and the Netherlands. For each of them, an analysis has been carried out based on direct observation of the visit, an analysis based on urban cartographies and schemes based on Lynch's concept of legibility. In addition, interviews were conducted with key actors in each of the local contexts. In Belgium, 3 residences for people with dementia based on the concept of "normalised living in small-scale settings" and 2 dementia-friendly cities were visited. In the UK, a total of 4 projects were studied, 3 of them dementia friendly facilities, one of them a new concept of 'dementia village'; and on the other hand, the visit to several projects and initiatives within a single 'dementia friendly' city and home of the National Innovation Centre on Ageing (NICA). In the Netherlands, we visited the well-known De Hogeweyk project, the first dementia village and another project focused on the design of bio-health paths integrated in the public space and in connection with a social and health care facility. From the literature review and the analysis of these experiences, specific needs of people with dementia have been identified that can be solved or improved with a public space design that incorporates the concepts of familiarity, identity, legibility, inclusion, comfort, positive stimulation and safety. Beyond universal accessibility, there are urban planning and public space design criteria that need to be addressed from a multi-scale perspective. It also identifies the relevance of urban planning and city design not only for the prevention and reduction of dementia risk, but also for improving the quality of life of people with dementia, their families and caregivers.