Outdoor space and dementia: A systematic review

This study examined the impact of gardens and outdoor spaces on the mental and physical well-being of people with dementia who are resident in care homes.

It systematically reviewed quantitative and qualitative evidence to understand the views of people with dementia, their carers, and care home staff on the value of gardens and outdoor spaces.

It was conducted in collaboration with colleagues from PenCLAHRC (Rebecca Abbott, Alison Bethel, Jo Thompson Coon, Rebecca Whear) and found evidence for promising impacts on levels of agitation in care home residents with dementia who spend time in a garden.

It has highlighted that future research would benefit from a focus on key outcomes measured in comparable ways, with a separate focus on what lies behind limited accessibility to gardens within the residential care setting.

Fourteen databases were searched from inception to February 2013. Forward and backward citation chasing of included articles was conducted; 38 relevant organisations were contacted to identify unpublished reports. Titles, abstracts, and full texts were screened independently by 2 reviewers in a 2-stage process and were discussed with a third reviewer where necessary. Results were synthesized narratively.

Seventeen studies were included: 9 quantitative, 7 qualitative, and 1 mixed methods. The quantitative studies were of poor quality but suggested decreased levels of agitation were associated with garden use.

The full study is published in the Journal of the American Medical Directors Association and is available here:


This review is Prospero registered, number CRD42012003119.