How can urban environments support dementia risk reduction? A qualitative study

Objective Interventions to reduce the risk of cognitive decline and dementia largely focus on individual‐level strategies. To maximize risk reduction, it is also necessary to consider the environment. With the majority of older people living in cities, we explored how urban environments could support risk reduction. Materials and Methods In our qualitative study, we conducted semi‐structured interviews with community members aged ≥65 years and stakeholders, all living in Leipzig, Germany. Interview guides were informed by the framework on modifiable risk factors for dementia of the Lancet Commission on Dementia Prevention, Intervention, and Care. Interviews were audio‐recorded, verbatim‐transcribed, and thematically analysed. Results Community members (n = 10) were M = 73.7 (SD = 6.0) years old and 50% were women. Stakeholders (n = 10) were aged 39–72 years, and 70% were women. Stakeholders' fields included architecture, cultural/arts education, environmental sciences, geriatrics, health policy, information and technology, philosophy, psychology, public health, and urban sociology. Across interviews with both older individuals and stakeholders, three main themes were identified: (i) social participation and inclusion (emphasizing social contacts, social housing, intergenerationality, neighbourhood assistance, information and orientation, digital and technological literacy, lifelong learning, co‐creation/co‐design), (ii) proximity and accessibility (emphasizing proximity and reachability, mobility, affordability, access to health care, access to cultural events, public toilets), (iii) local recreation and wellbeing (emphasizing safety in traffic, security, cleanliness and environmental protection, urban greenery, climate change and heat waves, outdoor physical activity). Discussion The design of urban environments holds large potential to create favourable conditions for community‐dwelling individuals to practice lifestyles that promote brain health. Public policy should involve community members in co‐creating such environments. Key points When asked about how urban environments could support dementia risk reduction, older community members and stakeholders referred to three main themes, namely: social participation and inclusion, proximity and accessibility, and local recreation and wellbeing Research findings highlight the need for policy makers to involve community members in co‐creating urban environments that promote brain health