معماری و شهرسازی آرمان شهر

معماری و شهرسازی آرمان شهر

عوامل محیطی مرتبط با بیماری دمانس؛ یک مرور نظام‌مند

نوع مقاله : مقاله پژوهشی

نویسندگان
1 پژوهشگر دکتری شهرسازی اسلامی، دانشکده معماری و شهرسازی، دانشگاه هنر اسلامی تبریز، تبریز، ایران.
2 استادیار طراحی شهری، دانشکده معماری و شهرسازی، دانشگاه شهید بهشتی تهران، تهران، ایران (نویسنده مسئول).
10.22034/aaud.2025.515101.2969
چکیده
به دنبال افزایش جمعیت سالمندان، بیماری دمانس (یا زوال عقل) به چالش عمده‌ای در حوزه سلامت جهانی تبدیل شده است. دمانس به عنوان یک سندرم، شامل اختلالات تدریجی در عملکرد مغز می‌باشد که به‌طور خاص بر حافظه، توانایی انجام فعالیت‌های روزمره و سایر قابلیت‌های شناختی مانند تفکر، استدلال و قضاوت تاثیر می‌گذارد. شواهد نشان داده است که عوامل محیط مصنوع و طبیعی می‌تواند در تسهیل زندگی مبتلایان به دمانس کمک‌کننده باشد. شناسایی ابعاد و عوامل تاثیرگذار محیطی بر افراد مبتلا به دمانس و ارائه چارچوب نظری محیط حامی این افراد جهت کاهش اختلال‌های شناختی، رفتاری و بهبود عملکردهای روزمره آن‌ها در محیط‌های مختلف شهری می‌باشد. این پژوهش یک مطالعه‌ی مروری نظام‌‌مند با استفاده از چک‌لیست پریزما است که از طریق جستجو در پایگاه‌های علمی Web of  Science, Scopus و  Google Scholarبا کلیدواژه‌های مرتبط در بازه زمانی 2000 تا اکتبر 2024 انجام شد. از میان 930 مقاله شناسایی‌شده، 27 مقاله معیارهای ورود به مطالعه را دارا بودند و با استفاده از تحلیل محتوای کیفی مورد بررسی قرار گرفتند. بر اساس یافته‌ها عوامل محیطی در چهار بعد اصلی طبقه‌بندی می‌شوند: طبیعت، کالبد و فعالیت، معنا و ادراک، و اجتماع. کلیدی‌ترین عوامل شناسایی‌شده شامل ایمنی (13 تکرار) و قابلیت پیاده‌روی (10 تکرار) در بعد کالبد، خوانایی (11 تکرار) و آشنا بودن محیط (9 تکرار) در بعد معنا، دسترسی به پارک و فضای سبز (11 تکرار) در بعد طبیعت، و تعاملات اجتماعی (9 تکرار) در بعد اجتماع بودند. نتیجه این‌که، طراحی فضاهای آشنا و قابل درک با نشانه‌های واضح، خیابان‌های امن و قابل پیاده‌روی، دسترسی به فضاهای سبز و فرصت‌های تعامل اجتماعی برای حفظ استقلال و سلامت افراد مبتلا به دمانس حیاتی است. این چارچوب نظری می‌تواند مبنایی برای طراحی و برنامه‌ریزی شهری دوستدار دمانس باشد.
کلیدواژه‌ها

عنوان مقاله English

Environmental Factors Associated with Dementia: A Systematic Review

نویسندگان English

Hanieh Sivani Amirkhiz 1
Pantea Hakimian 2
1 Ph.D. Candidate in Islamic Urban Planning, Faculty of Architecture and Urban Planning, Tabriz Islamic Art University, Tabriz, Iran.
2 Assistant Professor of Urban Design, Faculty of Architecture and Urban Planning, Shahid Beheshti University of Tehran, Tehran, Iran (Corresponding Author).
چکیده English

Following the increase in the elderly population, dementia has become a significant challenge in the field of global health. Dementia, as a syndrome, involves progressive impairments in brain function that specifically affect memory, daily activities, and other cognitive abilities such as thinking, reasoning, and judgment. Evidence shows that built and natural environmental factors can improve the lives of people with dementia. This study aims to identify the dimensions and factors that shape the environment for people with dementia and to provide a theoretical framework for a supportive environment that reduces cognitive and behavioral disorders and improves their daily functioning across different urban environments. This study is a systematic review using the PRISMA checklist, conducted by searching the Web of Science, Scopus, and Google Scholar databases for relevant keywords between 2000 and October 2024. Of the 930 identified articles, 27 met the inclusion criteria and were examined using qualitative content analysis. Based on the findings, environmental factors are categorized into four main dimensions: nature, body and activity, meaning and perception, and community. The key factors identified included safety (13 repetitions) and walkability (10 repetitions) in the body dimension, readability (11 repetitions) and familiarity of the environment (9 repetitions) in the meaning dimension, access to parks and green spaces (11 repetitions) in the nature dimension, and social interactions (9 repetitions) in the community dimension. The conclusion is that designing familiar, understandable spaces with clear signs, safe, walkable streets, access to green spaces, and opportunities for social interaction are vital for maintaining the independence and health of people with dementia. This theoretical framework can serve as a basis for dementia-friendly urban design and planning.

کلیدواژه‌ها English

Health
Dementia
Urban Design
Systematic Review
Theoretical Framework
Abedi Jafari, Abed, and Mojtaba Amiri. 2019. Meta-Synthesis as a Method for Synthesizing Qualitative Researches. Methodology of Social Sciences and Humanities 99: 73-87. https://doi.org/10.30471/mssh.2019.1629. [in Persian]
Atkinson, Rob, Thomas Dörfler, Mustafa Hasanov, Eberhard Rothfuß, and Ian Smith. 2017. Making the case for self-organisation : Understanding how communities make sense of sustainability and climate change through collective action. International Journal of Sustainable Society 9(3): 193-209. Doi: 10.1504/IJSSOC.2017.088300.
Besser, Lilah M., et al. 2018. Neighborhood Built Environment and Cognition in Non-Demented Older Adults: The Multi-Ethnic Study of Atherosclerosis. Social Science & Medicine 200(March): 27-35. https://doi.org/10.1016/j.socscimed.2018.01.007.
Biglieri, Samantha, and Jennifer Dean. 2021. “Everyday Built Environments of Care: Examining the Socio-Spatial Relationalities of Suburban Neighbourhoods for People Living with Dementia.” Wellbeing, Space and Society 2: 100058. https://doi.org/10.1016/j.wss.2021.100058.
Blackman, Tim, Mitchell Louise, Elizabeth Burton, Mike Jenks, Margaret Parsons, Shibu Raman, and Katie Williams. 2003. “The Accessibility of Public Spaces for People with Dementia: A New Priority for the ‘Open City.’” Disability & Society 18(3): 357-371. https://doi.org/10.1080/0968759032000052914.
Brittain, Katie, and Cathrine Degnen. 2022. Living the everyday of dementia friendliness: Navigating care in public spaces. Sociology of health & illness 44(2): 416-431. doi:10.1111/1467-9566.13442.
Cassarino, Marica, and Annalisa Setti. 2015. Environment as ‘Brain Training’: A review of geographical and physical environmental influences on cognitive ageing. Ageing research reviews 23: 167-82. doi:10.1016/j.arr.2015.06.003.
Cavuoto, Marina G., et al. 2024. “Cross-Sectional Associations between Neighborhood Characteristics, Cognition and Dementia Risk Factor Burden in Middle-Aged and Older Australians.” Preventive Medicine Reports 41: 102696. https://doi.org/10.1016/j.pmedr.2024.102696.
Clark, Andrew, Sue Campbell, John Keady, Agneta Kullberg, Karim Manji, Kirstein Rummery, and Richard Ward. 2020. “Neighbourhoods as Relational Places for People Living with Dementia.” Social Science & Medicine 252: 112927. https://doi.org/10.1016/j.socscimed.2020.112927.
Craig, Stephanie, et al. 2024. “Dementia Friendly Communities (DFCs) to Improve Quality of Life for People with Dementia: A Realist Review.” BMC Geriatrics 24(1): 776. https://doi.org/10.1186/s12877-024-05343-0.
Crous-Bou, Marta, et al. 2020. “Impact of Urban Environmental Exposures on Cognitive Performance and Brain Structure of Healthy Individuals at Risk for Alzheimer’s Dementia.” Environment International 138: 105546. https://doi.org/10.1016/j.envint.2020.105546.
Gan, Daniel R. Y., Habib Chaudhury, Jim Mann, and Andrew V. Wister. 2022. “Dementia-Friendly Neighborhood and the Built Environment: A Scoping Review.” The Gerontologist 62(6): e340-e356. https://doi.org/10.1093/geront/gnab019.
Dijkers, Marcel P., et al. 2012. “Systematic Reviews for Informing Rehabilitation Practice: An Introduction.” Archives of Physical Medicine and Rehabilitation 93(5): 912-18. 10.1016/j.apmr.2011.10.032.
Duong, Silvia et al. 2017. Dementia: What pharmacists need to know. Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC 150(2): 118-129. doi:10.1177/1715163517690745.
Eshmawey, Mohamed, et al. 2023. “Démences : recommandations actuelles de prise en charge” [Dementia : current guidelines for clinical management]. Revue medicale suisse 19(844): 1797-1802. doi:10.53738/REVMED.2023.19.844.1797.
Ferdous, Farhana. 2020. “Positive Social Interaction by Spatial Design: A Systematic Review of Empirical Literature in Memory Care Facilities for People Experiencing Dementia.” Journal of Aging and Health 32(9): 949-61. https://doi.org/10.1177/0898264319870090.
Fleming, Richard, et al. 2016. “The Relationship between the Quality of the Built Environment and the Quality of Life of People with Dementia in Residential Care.” Dementia 15(4): 663-80. https://doi.org/10.1177/1471301214532460.
Gan, Daniel R. Y., et al. 2024. “Dementia Care and Prevention in Community Settings: A Built Environment Framework for Cognitive Health Promotion.” Current Opinion in Psychiatry 37(2): 107-22. doi:10.1097/YCO.0000000000000917.
World Health Organization. 2021. Global Status Report on the Public Health Response to Dementia. Geneva: WHO.
Ho, Hin Ching, Yiran Song, Wenzhen Cheng, Yan Liu, Yanjun Guo, Shanshan Lu, Terry Lum, Ruby L. H. Chiu, and Chris Webster. 2023. “How Do Forms and Characteristics of Asian Public Housing Neighbourhoods Affect Dementia Risk among Senior Population? A Cross-Sectional Study in Hong Kong.” Public Health 219: 44-52. https://doi.org/10.1016/j.puhe.2023.03.014.
Ho, Hin Ching, Kit N. K. Fong, Tze C. Chan, et al. 2020. “The Associations between Social, Built and Geophysical Environment and Age-Specific Dementia Mortality among Older Adults in a High-Density Asian City.” International Journal of Health Geographics 19: 53. https://doi.org/10.1186/s12942-020-00252-y.
Hutton, Brian, Georgia Salanti, Deborah M. Caldwell, Anna Chaimani, Christopher Schmid, Cindy Cameron, John P. A. Ioannidis, et al. 2015. “The PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-Analyses of Health Care Interventions: Checklist and Explanations.” Annals of Internal Medicine 162: 777-784.
Innes, Anthea, Vanina Dal Bello-Haas,  Equity Burke, Dylan Lu, Mason McLeod, and Constance Dupuis. 2024. Understandings and Perceived Benefits of Outdoor-Based Support for People Living with Dementia. International journal of environmental research and public health 21(8): 1072. https://doi.org/10.3390/ijerph21081072.
Javed, Sarah, and Filzah Kakul. 2023. “Psychological Theories of Dementia.” Journal of Gerontology and Geriatrics: 1-6. https://doi.org/10.36150/2499-6564-N610.
Keady, John, et al. 2012. “Neighbourhoods and Dementia in the Health and Social Care Context: A Realist Review of the Literature and Implications for UK Policy Development.” Reviews in Clinical Gerontology 22(2): 150-63. https://doi.org/10.1017/S0959259811000268.
Liberati, Alessandro, Douglas G. Altman, Jennifer Tetzlaff, Cynthia Mulrow, Peter C. Gøtzsche, John P. A. Ioannidis, Mike Clarke, et al. 2009. “The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies that Evaluate Healthcare Interventions: Explanation and Elaboration.” BMJ 339: b2700. https://doi.org/10.1136/bmj.b2700.
Liu, Chih-Ching, Yu Sun, Shih-Feng Kung, et al. 2020. “Effects of Physical and Social Environments on the Risk of Dementia among Taiwanese Older Adults: A Population-Based Case-Control Study.” BMC Geriatrics 20: 226. 10.1186/s12877-020-01624-6.
Liu, Chih-Ching, et al. 2019. “Association of Environmental Features and the Risk of Alzheimer’s Dementia in Older Adults: A Nationwide Longitudinal Case-Control Study.” International Journal of Environmental Research and Public Health 16(16): 2828. doi:10.3390/ijerph16162828.
Mangili, Silvia, Anna Brambilla, Marco Trabucchi, and Stefano Capolongo. 2023. “Built Environment Impact on People with Dementia (PwD) Health and Well-Being Outcomes: A Systematic Review.” Acta Biomedica 94(S3): e2023155. 10.23750/abm.v94iS3.14284.
Mansoori, Sima, Farhang Mozaffar, Mohsen Faizi, and Hassan Ashayeri. 2019a. Non-pharmacological treatment of color, illumination, type, and texture of environmental materials on people with dementia Alzheimer type. Advances in Cognitive Sciences 21(1) :59-74. http://icssjournal.ir/article-1-981-fa.html. [in Persian]
Mansoori Sima, Farhang Mozaffar, Maryam Noroozian, Mohsen Faizi, and Hassan Ashayeri. 2019b. Relationship Between Neuropsychological and Physical Environmental Perception in Patients With Dementia and Alzheimer Disease. IJPCP 24(4): 426-443. http://ijpcp.iums.ac.ir/article-1-2820-fa.html. [in Persian]
Marquardt, Gesine, et al. 2014. “Impact of the Design of the Built Environment on People with Dementia: An Evidence-Based Review.” HERD 8(1): 127-57. https://doi.org/10.1177/193758671400800111.
Mitchell, Louise, Elizabeth Burton, Shibu Raman, Tim Blackman, Mike Jenks, and Katie Williams. 2003. “Making the Outside World Dementia-Friendly: Design Issues and Considerations.” Environment and Planning B: Planning and Design 30(4): 605-632. https://doi.org/10.1068/b29100.
Moghimi, Farhad, and Mohammad Alalhesabi. 2014. “Provide Quality Components to Facilitate the Presence of Psychiatric Patients in Urban Space (Case Study: Dementia Disease).” Environmental Sciences 12(4). https://envs.sbu.ac.ir/article_97484.html. [in Persian]
Moher, David, et al. 2009. “Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement.” BMJ 339: b2535. doi:10.1371/journal.pmed.1000097.
Mouratidis, Kostas. 2021. “Urban Planning and Quality of Life: A Review of Pathways Linking the Built Environment to Subjective Well-Being.” Cities 115: 103229. 10.1016/j.cities.2021.103229.
Oh, Sarah Soyeon et al. 2024. “A Multivariable Prediction Model for Mild Cognitive Impairment and Dementia: Algorithm Development and Validation.” JMIR medical informatics 12: e59396. doi:10.2196/59396.
Piran, Parviz. 2003. “Social Policy, Social Development and Its Necessity in Iran: The Criticism of Copenhagen Convention.” Refahj 3(10): 121-154. http://refahj.uswr.ac.ir/article-1-1994-fa.html. [in Persian]
Pozo Menéndez, Elisa, and Ester Higueras García. 2022. “Best Practices from Eight European Dementia-Friendly Study Cases of Innovation.” International Journal of Environmental Research and Public Health 19(21): 14233. https://doi.org/ 10.3390/ijerph192114233.
Quirke, Mary, Kim Bennett, Ho-Wan Chau, Tomas Preece, and Eric Jamei. 2023. “Environmental Design for People Living with Dementia.” Encyclopedia 3(3): 1038-1057. https://doi.org/10.3390/encyclopedia3030076.
Röhr, Susanne, et al. 2022. “How Can Urban Environments Support Dementia Risk Reduction? A Qualitative Study.” International Journal of Geriatric Psychiatry 37(1). https://doi.org/10.1002/gps.5626.
Seyvani Amirkhiz, Haniyeh, and Pantea Hakimian. 2024. Preparing of the conceptual framework of urban design principles effective in reducing the the elderly with dementia. Journal of Sustainable Urban & Regional Development Studies (JSURDS) 5(2): 19-33. DOI: 20.1001.1.27830764.1403.5.2.2.6. [in Persian]
Shannon, Stephen. 2002. “Critical Appraisal of Systematic Reviews.” Canadian Association of Radiologists Journal 53(4): 195.
Song, Yiling et al. 2024. “Effects of neighborhood built environment on cognitive function in older adults: a systematic review.” BMC geriatrics 24(1): 194. doi:10.1186/s12877-024-04776-x 
Sturge, Jodi, et al. 2021. “Features of the Social and Built Environment That Contribute to the Well-Being of People with Dementia Who Live at Home: A Scoping Review.” Health & Place 67: 102483. https://doi.org/10.1016/j.healthplace.2020.102483.
Woodbridge, Rebecca, Mary Sullivan, Elizabeth Harding, et al. 2016. “Use of the Physical Environment to Support Everyday Activities for People with Dementia: A Systematic Review.” Dementia 17(5): 533-572. doi:10.1177/1471301216648670.
World Health Organization. 2016. Global Report on Urban Health: Equitable, Healthier Cities for Sustainable Development. Geneva: WHO.
Wu, Yu-Tzu et al. 2017. “The Built Environment and Cognitive Disorders: Results From the Cognitive Function and Ageing Study II.” American journal of preventive medicine 53(1): 25-32. doi:10.1016/j.amepre.2016.11.020 
Wu, Yu-Tzu, A. Matthew Prina, and Carol Brayne. 2015. “The Association between Community Environment and Cognitive Function: A Systematic Review.” Social Psychiatry and Psychiatric Epidemiology 50(3): 351-362. https://doi.org/10.1007/s00127-014-0945-6.
Zabetian, Elham, and Ali Akbar Taqhvaei. 2009. Elderly Friendly Cities through People Participation. JHRE 28(128): 60-71. http://jhre.ir/article-1-53-fa.html. [in Persian]
Zandieh Mahdi. 2012. Tailoring of Cityscape for the Elderly. Salmand: Iranian Journal of Ageing 7(2) :7-18. http://salmandj.uswr.ac.ir/article-1-622-fa.html. [in Persian]
دوره 18، شماره 52
پاییز 1404
صفحه 95-112

  • تاریخ دریافت 16 فروردین 1404
  • تاریخ بازنگری 17 آبان 1404
  • تاریخ پذیرش 21 آبان 1404