17th May, 2016

New research into dementia and the role of the natural environment

People living with dementia and their carers were asked about their engagement with nature and the outdoors in one of the largest projects of its kind.

A group of people who are living with dementia enjoy a sensory experience in the great outdoors
Enjoying a scent sensation in the great outdoors © Dementia Adventure

A new report published by Natural England (11 March 2016) highlights how engagement with nature and the great outdoors could be improved for the benefit of people living with dementia and their carers.

In one of the biggest surveys of its kind so far, people living with dementia and their carers were asked about the outdoor activities that they take part in and the places where they go, or most want to go. It reveals what motivates them to go outside and what barriers they think need to be overcome to improve their access to the outdoors and maximise the beneficial effect this brings for them.

The new study – Is it nice outside? Consulting people living with dementia and carers about engaging with the natural environment – is the result of a collaborative project between Natural England, Dementia Adventure, the Mental Health Foundation and Innovations in Dementia. 

The report reveals that engaging in outdoor activities that have a purpose and those that involve being with other people provide the greatest motivation for people living with dementia.

Only 20% of the people living with dementia considered that their condition was a barrier to using outdoor spaces, whereas 83% of carers believed that dementia limited the person’s ability.

Findings from the report include:

  • Informal walking outdoors was the most frequently mentioned activity (38%) and was also seen as vitally important by carers for its beneficial effect
  • Wildlife or bird watching is one of the most popular activities for people living with dementia and 25% of the people interviewed said that they took part several times a week or every day
  • The most popular places to visit for people with dementia were associated with water (45%), such as lakes, rivers or the coastline and city parks and public gardens were also popular (30%)
  • The survey found that some urban green spaces such as allotments, city farms and community gardens are underused by people with dementia

The top barriers to taking part in outdoor activities and having contact with nature were:

  • lack of confidence
  • fears and safety concerns
  • not having transport
  • insufficient information about what places have to offer and their suitability for visitors with dementia
  • lack of support to get to locations, to use facilities, and to participate in outdoor activities

The report makes a series of recommendations that could encourage greater use of natural spaces by people living with dementia and their carers. For example, managers of outdoor spaces could work with local dementia action alliances to develop a Trip Advisor-style ratings system to provide information about local dementia-friendly open spaces.

Other recommendations from the report address ways to make visits to green spaces more dementia-friendly through implementing the principles of dementia friendly communities at outdoor sites by: training staff to be dementia aware; improving training on how to sensitively and effectively support people living with dementia; and, improving understanding by managers of outdoor spaces of the types of facilities, activities and information that people living with dementia say they need.

Jim Burt, Principal Adviser for Natural England’s Outdoors for All programme said:

There is already strong evidence to show the positive benefits of engagement with the natural environment for people living with dementia and this survey adds to that body of evidence. Importantly, it heard directly from both those living with dementia and their carers, and the research has revealed important new information and insights. This work will now help our partners and the wider health community to take action that will enable people with dementia to have more and better quality opportunities to be active in the great outdoors.

Dementia Adventure’s Managing Director, Neil Mapes says of the project:

Dementia Adventure is really pleased to share the results of this partnership project which builds on our previously published research.  We hope it will be beneficial to people and organisations across the UK and encourage people to read and share the research report and take action on its recommendations.

Is it nice outside?  For many people living with dementia and their family carers the answer is yes, people want and need to get out into the fresh air, to walk, be near water and watch and listen to the birds.  The fact that these simple outdoor pleasures are not equally accessible for some of the thousands of families living with dementia is another reminder for us to work across care and conservation boundaries and implement the solutions contained in the report.

Toby Williamson, Head of Development and Later Life at the Mental Health Foundation says:

The benefits of outdoor activity for peoples’ wellbeing, whether it’s walking, wildlife watching, or just ‘being in nature’, are well known. But concerns about safety and access can mean that many people with dementia do not share in those benefits.

The research that the Mental Health Foundation and Innovations in Dementia undertook for Natural England and Dementia Adventure in this report showed that people with dementia, and their families and friends, wanted to continue to visit green spaces, such as parks and rivers, and participate in outdoor activities. It identifies simple, practical changes that organisations responsible for green spaces can make to ensure they are dementia accessible and inclusive, so people with dementia and their carers can continue to enjoy being outdoors.

The findings from this project will now be used to help design a large-scale demonstration project to deliver services in the natural environment for people living with dementia and their carers. The recommendations will also be valuable to other natural environment providers in shaping projects to further their work with people living with dementia.

The report can be downloaded from Natural England’s Access to Evidence publications catalogue.


Dementia directly affects around 800,000 people and a further 670,000 carers. Costs to the health service, local government and families are currently around £23 billion, and estimates suggest this may treble by 2040. With an ageing population the number of people living with dementia in the UK is estimated to double in the next 30 years.

Spending time in the natural environment has been shown by many studies to have a beneficial effect on people’s overall sense of wellbeing. Less research has been carried out about its effects on people living with dementia. In 2013 Natural England published Greening Dementia which provides a useful summary of the evidence.

Dementia Adventure is a multi-award winning social enterprise and charity, provide training, research, and consultancy services based around the needs of the individual living with dementia, being connected to the outdoors and the benefits of positive-risk taking. We also provide supported short breaks and holidays for people living with dementia and their carers to enjoy together.

The Mental Health Foundation is a UK charity that undertakes social research, service development and policy work on issues affecting people with mental health problems, dementia and learning disabilities.

Innovations in Dementia is a community interest company that works nationally with people with dementia, partner organisations and professionals. Its aim is to develop and test projects that will enhance the lives of people with dementia.