Exploring the cognitive aspects of walking in the neighborhoods among people living with dementia

BACKGROUND AND OBJECTIVES: The population living with dementia has been growing globally. Supportive neighborhood environments are essential for maintaining their autonomy, independence, and social participation. This article explores the cognitive aspects (e.g., attention, task execution, recognition, spatial navigation) of the walking experiences of people living with dementia in neighborhoods, identifying attributes that support and hinder their ability to walk outside the home. RESEARCH DESIGN AND METHODS: This qualitative study presents findings based on 26 participants living with mild to moderate dementia in Metro Vancouver, Canada. Each participant (or dyad with care partner) took part in four sessions, encompassing a structured questionnaire, semi-structured sit-down and walk-along interviews with concurrent photo and video documentation. Reflexive thematic analysis was performed. RESULTS: Five themes were generated: (1) Comfort of Knowing supported decision making and reduced anxiety, (2) Planning and Coping Strategies mitigated stress, (3) Routines in walking routes and frequency, (4) Paying Attention to prevent injuries, and (5) Use of Technology for independence, motivation, and stimulation reduction. DISCUSSION AND IMPLICATIONS: The findings underscore the significant role of familiarity and daily routines in supporting independence, the active role people living with dementia play in planning walking routes and coping with challenges, the potential environmental hazards requiring attention, and the emerging role of technology. These insights offer practical implications for policymakers, urban planners, and researchers to design dementia-inclusive neighborhoods, promote volunteer-accompanied walking programs, expand supportive housing options, and develop accessible technologies to enhance safety and autonomy for people living with dementia.