Integrated Model for Indoor Built Environment and Cognitive Functional ability of Older Residents with Dementia in Care and Attention Homes

Older people with dementia normally suffer from declined cognitive functional ability (CFA), including impaired cognition, deteriorated self-care abilities, and limited mobility. Although some games and exercises have been adopted to mitigate the harmful effects of dementia, an appropriate indoor built environment (IBE) in care and attention (C&A) homes may also play a significant and permanent role in supporting their CFA. This study aims to investigate how IBE influences the CFA of older people with dementia through the establishment of an integrated IBE–CFA model that can be used to reveal the relationships between twelve factors of three components of IBE in C&A homes (i.e., architectural design, building services, and supporting facilities) and the CFA of older people with dementia (i.e., memory loss, disorientation, confusion, self-care, and mobility). Ninety-six residents with mild or moderate dementia (tested by the Mini-Mental State Examination) in C&A homes were successfully recruited to take part in the questionnaire survey, and the data were analyzed using a series of statistical methods (i.e., a reliability test, regression analysis, and structural equation modeling). Based on the ecological theory of aging, the study found some significant relationships, including: 1) Memory loss was negatively affected by satisfaction with lifts and furniture; 2) finishes and signage had a negative impact on the disorientation of older residents with dementia; 3) dissatisfaction with finishes induced confusion in older residents with dementia; and 4) only one building services factor (temperature) positively influenced the self-care and mobility of older residents with dementia. Several practical recommendations are proposed accordingly.