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Abstract Background Effective strategies to develop dementia-friendly communities (DFCs) are needed in aging societies. We aimed to propose a strategy to develop DFCs from a Japanese perspective and to evaluate an intervention program that adopted the strategy. Methods This study implemented a multi-level intervention that emphasized nurturing community social capital in a large apartment complex in the Tokyo metropolitan area in 2017. We offered an inclusive café that was open for extended hours as a place to socialize and a center for activities that included monthly public lectures. Individual consultation on daily life issues was also available for free at the café. Postal surveys were sent out to all older residents aged 70 years and older in 2016 and 2019. With a one-group pre-test and post-test design, we assessed changes in the proportion of older residents who had social interaction with friends and those who were confident about living in the community, even if they were living with dementia. Results Totals of 2633 and 2696 residents completed the pre and post-intervention surveys, respectively. The mean age of the pre-intervention respondents was 77.4 years; 45.7% lived alone and 7.7% reported living with impaired cognitive function. The proportion of men who had regular social interaction and were confident about living in their community with dementia increased significantly from 38.8 to 44.5% (p = 0.0080) and from 34.1 to 38.3% (p = 0.045), respectively. Similar significant increases were observed in the subgroup of men living with impaired cognitive function, but not in the same subgroup for women. Conclusions The intervention benefitted male residents who were less likely to be involved in the community’s web of social networks at baseline. A strategy to create DFCs that emphasizes nurturing community social capital can form a foundation for DFCs. Trial registration This study was retrospectively registered in the University hospital Medical Information Network (UMIN) Clinical Trial Registry (registry number: UMIN000038193 , date of registration: Oct 3, 2019).

Promoting dementia‐friendly communities is an important strategy for improving quality of life for people with dementia and dementia‐family caregivers. The process of building dementia‐friendly communities should include all people living in the community. The objective of this study was to compare perceived dementia friendliness in the community among people with dementia, family caregivers, service providers, and the general public. In Taiwan, we surveyed 60 people with dementia, 140 family caregivers, and 200 members of the general public face to face, with 200 service providers surveyed by mail. Participants completed the Perceived Community Dementia Friendliness measure, consisting of seven subscales: care services, community members, community environment, community interactions, transportation, hospitals, and stores and organisations. This measure has acceptable convergent validity, construct validity, and internal consistency reliability for use in Taiwan. Differences in perceived dementia friendliness were examined by chi‐square tests/analysis of variance. Among the seven subscales, hospitals were rated with good dementia friendliness by 70% of people with dementia (n = 42); however, care services were rated poor by 23.3% of people with dementia (n = 14). Hospitals were also rated with good dementia friendliness by 39.2% of family caregivers (n = 54). Care services were rated as having good dementia friendliness by 43.5% of service providers (n = 87) and 47% of the general public (n = 86). Furthermore, community interactions were rated as good by small percentages of family caregivers (11.4%, n = 16), service providers (22.2%, n = 44), and the general public (30.9%, n = 58). Family caregivers, service providers, and the general public rated hospitals with the highest mean dementia‐friendliness score and community interactions with the lowest. Perceived community‐dementia friendliness among participants with dementia differed from that of participants without. People with dementia prioritised improving care services, while people without dementia rated facilitating community interactions as more vital. These differences provide vital insights into understanding the policies and administration of dementia‐friendly communities. [ABSTRACT FROM AUTHOR]

Background: A quantitative assessment of the dementia-friendliness of a community can support planning and evaluation of dementia-friendly community (DFC) initiatives, internal review, and national/international comparisons, encouraging a more systematic and strategic approach to the advancement of DFCs. However, assessment of the dementia-friendliness of a community is not always conducted and continuous improvement and evaluation of the impact of dementia-friendly initiatives are not always undertaken. A dearth of applicable evaluation tools is one reason why there is a lack of quantitative assessments of the dementia-friendliness of communities working on DFC initiatives. Purpose: A scoping review was conducted to identify and examine assessment tools that can be used to conduct quantitative assessments of the dementia-friendliness of a community. Design and methods: Peer-reviewed studies related to DFCs were identified through a search of seven electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, EMCare, HealthSTAR, and AgeLine). Grey literature on DFCs was identified through a search of the World Wide Web and personal communication with community leads in Australia, Canada, New Zealand, the United Kingdom, and the United States. Characteristics of identified assessment tools were tabulated, and a narrative summary of findings was developed along with a discussion of strengths and weaknesses of identified tools. Results: Forty tools that assess DFC features (built environment, dementia awareness and attitudes, and community needs) were identified. None of the identified tools were deemed comprehensive enough for the assessment of community needs of people with dementia. [ABSTRACT FROM AUTHOR]

Purposes: Dementia-friendly initiatives (DFI) are community-based movements aimed to address stigma, exclusion, and discrimination associated with dementia. This study examined the challenges faced and strategies used by DFI prior to and during the COVID-19 pandemic from the perspectives of stakeholders in the USA and China. Methods: Qualitative interviews with 17 stakeholders involved in DFI from the United States and mainland China were conducted via the Zoom platform. Semi-structured interview questions focused on DFI challenges and strategies prior to and during the pandemic. Thematic analysis was used to analyze the data. Results: Three major challenges prior to the COVID-19 pandemic included low participation of persons with dementia, difficulties in building community collaborations, and limited funding and resources needed to sustain DFI. During the COVID-19 pandemic, challenges included exacerbated difficulties of involving persons with dementia and reduced policy support for DFI. Strategies implemented prior to COVID-19 included partnerships with community organizations to outreach and engage persons with dementia, and coordination of resources and diversification of funding sources to sustain DFI. Strategies during the COVID-19 pandemic centered on the implementation of person-centered technology to support persons with dementia and family caregivers, and the development of new programs that integrated efforts to address the impact of COVID-19. Implications: DFI in the USA and mainland China shared similar challenges for DFI prior to and during COVID-19. During the COVID-19 pandemic, DFI in both countries showed resourcefulness through reliance on technology, community collaboration, and COVID-19–related resources to provide support and services. While it remains critical to advocate to the central government to fund DFI, DFI in both societies need to be open to other funding sources, hire persons with dementia as key staff members of DFI, and demonstrate its effectiveness through rigorous evaluation. [ABSTRACT FROM AUTHOR]

Background: Effective strategies to develop dementia-friendly communities (DFCs) are needed in aging societies. We aimed to propose a strategy to develop DFCs from a Japanese perspective and to evaluate an intervention program that adopted the strategy.Methods: This study implemented a multi-level intervention that emphasized nurturing community social capital in a large apartment complex in the Tokyo metropolitan area in 2017. We offered an inclusive café that was open for extended hours as a place to socialize and a center for activities that included monthly public lectures. Individual consultation on daily life issues was also available for free at the café. Postal surveys were sent out to all older residents aged 70 years and older in 2016 and 2019. With a one-group pre-test and post-test design, we assessed changes in the proportion of older residents who had social interaction with friends and those who were confident about living in the community, even if they were living with dementia.Results: Totals of 2633 and 2696 residents completed the pre and post-intervention surveys, respectively. The mean age of the pre-intervention respondents was 77.4 years; 45.7% lived alone and 7.7% reported living with impaired cognitive function. The proportion of men who had regular social interaction and were confident about living in their community with dementia increased significantly from 38.8 to 44.5% (p = 0.0080) and from 34.1 to 38.3% (p = 0.045), respectively. Similar significant increases were observed in the subgroup of men living with impaired cognitive function, but not in the same subgroup for women.Conclusions: The intervention benefitted male residents who were less likely to be involved in the community's web of social networks at baseline. A strategy to create DFCs that emphasizes nurturing community social capital can form a foundation for DFCs.Trial Registration: This study was retrospectively registered in the University hospital Medical Information Network (UMIN) Clinical Trial Registry (registry number: UMIN000038193 , date of registration: Oct 3, 2019). [ABSTRACT FROM AUTHOR]

Dementia is a great public health concern worldwide. Despite this, little is known from a health-promoting perspective about dementia in general as a public health issue, in dialog with people living with dementia, applicable at individual, group, and societal levels with regard to policies and practice. This study therefore aims to explore the experiences related to living with dementia in the local community by advancing a health-promoting perspective. Semi-structured individual and group interviews were conducted with participants (n = 22) with lived, professional, and personal experiences of dementia living in a medium-sized municipality in Sweden. Transcripts were analyzed by thematic analysis. Four themes emerged: health promotion through knowledge and public awareness, health promotion through opportunities to be active, health promotion through meaningful meeting places, and health promotion through improvements in the welfare system. We found that more knowledge and public awareness about dementia are needed to advance a health-promoting perspective and increase the prominence of dementia as a public health issue. Further research and policy need to focus more on how professionals in dementia care practice could be involved in promoting health and well-being for people with dementia. [ABSTRACT FROM AUTHOR]

Due to the growing number of people with dementia worldwide, the role of dementia supporters is becoming increasingly important. In 2005, a national campaign called the Dementia Supporter Caravan was launched in Japan. However, the impact these trainings have on facilitating the work of dementia supporters is not quite understood. This study aimed to assess the challenges faced by dementia supporters in conducting activities for people with dementia. Our results showed that even after a period of six months since the training session, only half of the supporters had commenced new support activities. Future studies should examine the impact activities conducted by dementia supporters have on people with dementia and their family caregivers. [ABSTRACT FROM AUTHOR]

Aims: This scoping review explores key strategies of creating inclusive dementia-friendly communities that support people with dementia and their informal caregiver. Background: Social exclusion is commonly reported by people with dementia. Dementia-friendly community has emerged as an idea with potential to contribute to cultivating social inclusion. Methods: This scoping review follows the Joanna Briggs Institute scoping review methodology and took place between April and September 2020. The review included a three-step search strategy: (1) identifying keywords from CINAHL and AgeLine; (2) conducting a second search using all identified keywords and index terms across selected databases (CINAHL, AgeLine, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google); and (3) hand-searching the reference lists of all included articles and reports for additional studies. Results: Twenty-nine papers were included in the review. Content analysis identified strategies for creating dementia-friendly communities: (a) active involvement of people with dementia and caregivers (b) inclusive environmental design; (c) public education to reduce stigma and raise awareness; and (d) customized strategies informed by theory. Conclusion: This scoping review provides an overview of current evidence on strategies supporting dementia-friendly communities for social inclusion. Future efforts should apply implementation science theories to inform strategies for education, practice, policy and future research. [ABSTRACT FROM AUTHOR]

The current spread of dementia is engendering an emergency that is not limited to the medical issues but also involves its social dimension. Accordingly, it is necessary to promote a perspective change about the disease that supports a more inclusive view of people with dementia. To ensure this, Dementia-Friendly Communities (DFCs) have recently been developed. Nonetheless, it is not always effortless to deal with people with dementia in an inclusive way because of misconceptions about how they perceive everyday contexts and react in everyday situations. We asked 170 individuals (aged between 13 and 75) to “put themselves in the shoes of a person with dementia” for a few minutes, facilitating this through the use of a 360° video, and to try to experience how activities such as going shopping feel from the first-person perspective. Before and after the experience, participants expressed their opinions about the needs and the autonomies that are deemed to be granted to a person with dementia. The results revealed changes to social perspective after having experienced firsthand what living with dementia could be like. A deeper comprehension of what it is like to live with dementia appeared to be gained, and participants’ beliefs about the needs and daily autonomies of those with dementia were modified after the experience. It is possible to conclude that, through the change of perspective, people are more willing to be inclusive toward people with dementia, as is wished for in the DFC approach, although a wider formative intervention on how to be really inclusive still seems to be required.

The current spread of dementia is engendering an emergency that is not limited to the medical issues but also involves its social dimension. Accordingly, it is necessary to promote a perspective change about the disease that supports a more inclusive view of people with dementia. To ensure this, Dementia-Friendly Communities (DFCs) have recently been developed. Nonetheless, it is not always effortless to deal with people with dementia in an inclusive way because of misconceptions about how they perceive everyday contexts and react in everyday situations. We asked 170 individuals (aged between 13 and 75) to "put themselves in the shoes of a person with dementia" for a few minutes, facilitating this through the use of a 360° video, and to try to experience how activities such as going shopping feel from the first-person perspective. Before and after the experience, participants expressed their opinions about the needs and the autonomies that are deemed to be granted to a person with dementia. The results revealed changes to social perspective after having experienced firsthand what living with dementia could be like. A deeper comprehension of what it is like to live with dementia appeared to be gained, and participants' beliefs about the needs and daily autonomies of those with dementia were modified after the experience. It is possible to conclude that, through the change of perspective, people are more willing to be inclusive toward people with dementia, as is wished for in the DFC approach, although a wider formative intervention on how to be really inclusive still seems to be required. [ABSTRACT FROM AUTHOR]

A community is the totality of human relationships, in which individuals live with and for others. This article discusses promoting dementia‐friendly community from the perspective of human relationships within a community. Improving the social well‐being of aging people is important; it is especially important for people with dementia, as dementia is a life‐changing syndrome that affects all aspects of one's life, including human relationships. Dementia‐friendly community requires support from the community in improving the social adaptation of people with dementia, as they experience greater difficulties in social interaction as a result of cognitive decline, especially deterioration of social cognition. They need to be empowered to stay motivated for the opportunity to maintain an active and meaningful life, despite dementia. Flexible provisions of such tailored support can be effective to improve the support network in the community to meet the individual's needs. As social and human resources are limited, it is also necessary to discuss how to share socioeconomic burdens to meet both social sustainability demands and the welfare of aging adults. More discussions that include people with dementia and their family members are required to achieve the purpose of dementia‐friendly community. This is important to enhance the well‐being of individuals with and without dementia, as well as the society as a whole, through dementia support and dementia prevention activities. Geriatr Gerontol Int 2020; ••: ••–••. [ABSTRACT FROM AUTHOR]

Aims: To identify dementia‐friendly communities' indicators and their current conditions in Taiwan from the perspectives of people with dementia and dementia‐family caregivers. Design: This qualitative study explored the opinions and experiences of people with dementia and dementia‐family caregivers regarding dementia‐friendly communities. Methods: Participants (16 people with dementia and 20 family caregivers) were recruited from neurological clinics, day care centres for people with dementia and support groups for family caregivers in the Taipei community from July ‐ October, 2016. Data were collected in face‐to‐face interviews, which were tape recorded and transcribed verbatim. Transcripts were analysed by Miles and Huberman's (1994) guidelines. Results: Similar indicators for dementia‐friendly communities were identified in Taiwan as in other countries, including dementia‐friendly care services, dementia‐friendly hospitals, dementia‐friendly community environment, dementia‐friendly transportation, dementia‐friendly stores and shops, dementia friendly people, integrated dementia‐related information and community contribution‐ and ‐involvement opportunities for people with dementia. However, Taiwanese people with dementia and family caregivers described no emphasis on the potential of people with dementia to contribute to developing dementia‐friendly communities and more top‐down expectations for the government's role. Conclusion: These indicators can be a guide for developing and evaluating dementia‐friendly communities in Taiwan. Differences between Taiwan and Western developed countries in indicators for dementia‐friendly communities can be further explored. Community nursing assessment, interventions, and evaluation based on these dementia‐friendly communities indicators can be further developed. Impact: This study developed indicators for dementia‐friendly communities in an Asian country. These indicators can be used as a guide for developing and evaluating dementia‐friendly communities. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to elucidate the effects of a sense of attachment to the community (attachment) and participation in community activities (participation) on motivation to participate in dementia prevention and support activities (motivation). Methods: We conducted a nationwide Web‐based questionnaire survey of 1693 men and women aged ≥20 years. The questionnaire items used in the analysis asked about the following: (i) demographic characteristics (i.e. gender, age, marital status, household income (monitor‐registered data), elderly family members, number of years of residency); (ii) attachment; (iii) participation; (iv) self‐assessment of dementia knowledge; (v) nursing care experience; (vi) contact with individuals with dementia; (vii) attitudes towards dementia and people with dementia; and (viii) motivation. Results: Positivity towards dementia and negativity towards dementia were extracted as factors in exploratory factor analysis of attitudes towards dementia and people with dementia. Multiple regression analysis with extracted factors as dependent variables showed that attachment and participation exerted positive effects on attitudes towards dementia (both P < 0.001). The direct effects of attachment and participation on motivation were significant in hierarchical multiple regression analysis (both P < 0.001), and path analysis demonstrated the paths of the effects of attachment and participation on motivation (both P < 0.001). The bias‐corrected bootstrap method showed that both attachment and participation exerted direct and indirect (via the mediation of attitudes towards dementia) effects on motivation to participate in the community (all P < 0.001). Conclusion: The results showed that attachment and participation were both determinants of positive attitudes towards dementia and, thus, exerted effects on motivation, both directly and indirectly. These findings suggested that the enhancement of attachment and promotion of participation could lead to the promotion of dementia prevention and support activities in communities and increase dementia awareness. [ABSTRACT FROM AUTHOR]

Objectives: The dementia-friendly community (DFC) initiative was set up to enable people living with dementia to remain active, engaged, and valued members of society. Dementia prevalence varies nationally and is strongly associated with the age and sex distribution of the population and level of social deprivation. As part of a wider project to evaluate DFCs, we examined whether there is a relationship between provision of DFCs and epidemiological need.Methods: Dementia-friendly communities were identified through the formal recognition process of DFC status by the Alzheimer's Society and mapped against areas defined by English Clinical Commissioning Groups. We tested whether provision of a DFC was associated with: (1) dementia prevalence, (2) number of known cases, and (3) known plus estimated number of unknown cases.Results: Of the 209 English Clinical Commissioning Group areas, 115 had at least one DFC. The presence of a DFC was significantly associated with number of known dementia cases (mean difference = 577; 95% CI, 249 to 905; P = 0.001) and unknown dementia cases (mean difference = 881; 95% CI, 349 to 1413; P = 0.001) but not prevalence (mean difference = 0.03; 95% CI, -0.09 to 0.16; P = 0.61). This remains true when controlling for potential confounding variables.Conclusions: Our findings suggest that DFC provision is consistent with epidemiological-based need. Dementia-friendly communities are located in areas where they can have the greatest impact. A retrospective understanding of how DFCs have developed in England can inform how equivalent international initiatives might be designed and implemented. [ABSTRACT FROM AUTHOR]

Background: Dementia-friendly community has been promoted in Macao since 2016. There is no study investigating the understanding of nor attitudes towards dementia among public contact staff in Macao. This study aimed to (i) understand the level of knowledge of dementia, (ii) examine the attitudes towards people living with dementia, and (iii) explore the associated factors of the willingness to help people with dementia symptoms among police officers, bank officers, bus drivers, and building superintendents., Methods: A cross-sectional survey was conducted between January and May 2019 using a structured questionnaire., Results: A total of 351 valid questionnaires were received. Building superintendents had more knowledge while police officers and bank officers had more positive attitudes. All practitioners were more willing to help people with dementia symptoms when they were on official duty. Participants who had more knowledge about dementia were associated with a higher willingness to help people with dementia symptoms.

Introduction: Over the past 20 to 30 years, alternative dementia care models have been developed. Dementia villages challenge popular perceptions about life with dementia and contrast to the traditional model of long-term care facilities that are often seen as institutional, impersonal, and risk-averse. The first dementia village, De Hogeweyk, was developed in 2009 and is located in Weesp, Netherlands. Hogeweyk aims to create a safe environment, enabling the person with dementia to live an "ordinary life" with as much autonomy as possible and also maintaining integration with the local community. Other dementia villages have been established in several countries, following De Hogeweyk model. Objectives: The aim of this presentation is to describe the functioning of dementia villages and evaluate its benefits on dementia patients. Methods: A non-systematic review of the literature was performed on PubMed, PsycINFO and Web of science using selected keywords. We also consult the official websites of the institutions. Results: Dementia villages seem to improve functioning and reduce the need for medication. Anxiety, restlessness and homesickness can still persist, but are reduced by the homelike and hospitable setting in which residents live. In fact, antipsychotic medication use at the residence has decreased from approximately 50% of residents, before the dementia village was introduced, to approximately 12% in 2019. The staff also reported greater job satisfaction. Although dementia villages are growing throughout the Western world, this concept has also been criticized, arguing that this type of living is dishonest, misleading the residents to believe that they are still living in the 'real community'. Conclusions: Dementia villages are guided by the principles "deinstitutionalize, transform and normalize" care for people with advanced dementia. Although its intuitive advantages, there is no research evidence to demonstrate that this environment has any beneficial effect in behaviour, functional ability or cognition. In future studies, clinical outcomes could be used as a measure of quality of care. Hogeweyk concept has made societies rethinking dementia care and has been inspiring the development of other innovative models of dementia care. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationship between knowledge and attitudes towards dementia among adults. A cross-sectional online survey with purposive sampling was conducted in four district health centers in Taichung, Taiwan, in 2018. Knowledge was measured by the Taiwanese version of the Dementia Knowledge Assessment Scale. Attitudes towards people with dementia were measured by four kinds of feelings: discomfort, shame, avoidance, and fear. In total, 347 persons completed the questionnaire. Knowledge of dementia was modest. Higher education, a care-related background, chronic health conditions, experience caring for people with dementia, and knowledge of family history were related to higher knowledge of dementia. Attitudes towards people with dementia were grouped into four clusters: uncomfortable (22.2%), ashamed (2.6%), unfriendly (22.5%), and non-negative (52.7%). Knowledge of dementia was significantly related to the ashamed cluster but not to the other clusters. Lower education, a lack of caring experience, and a lack of knowledge of family history were related to uncomfortable feelings, and poorer financial satisfaction was related to uncomfortable, afraid, and avoidant feelings. The open-question expression of feelings towards dementia was more likely to be negative (55.3%). The public should be educated on knowledge of and friendly attitudes towards dementia., Competing Interests: The authors declare no conflict of interest.