Association of the spatial layout of the home and ADL abilities among older adults with dementia

Abstract

We investigated the relationship between architectural space syntax measures describing the spatial layout of a home and activities of daily living (ADL) among people with dementia. We visited the homes of 82 participants in a dementia care comparative effectiveness clinical trial and measured the space syntax variables intelligibility and convexity along with several clinical variables, including ADLs. In regression models, we estimated the cross-sectional association between space syntax measures and ADLs. Higher convexity was associated with worse performance of basic but not instrumental ADLs (adjusted β =19.2, P = .02). Intelligibility was not associated with ADLs. These results imply that enclosed rooms with a clearly legible meaning and function might be better memorized and associated with the spatial layout of the home resulting in better basic ADL performance. These results warrant further research on space syntax measures in the home environment of people with dementia, including longitudinal study, which we are pursuing.

Figures

Figure 1

a, Floor plan of an exemplary home. The participant spends most of her time on the ground floor, in the dining room. b, Convex map of the home. Blank nodes represent circulation areas and stairs, solid nodes represent rooms with an assigned function / meaning. c, Convex map of the home, justified to the care recipients’ place. Depth levels (0-4) are assigned to all spaces in relation to the participant’s place.