The short answer
A dementia-friendly city keeps people living with dementia oriented, safe and socially included in everyday life. There is no single legal standard: it is a working arrangement of physical places, services and behaviour built on WHO's framework for dementia-inclusive societies. Work should start small and evidence-led: convene residents, carers and a few organisations, raise basic awareness, audit one walkable district, and fix a handful of cheap, high-impact issues rather than launching a city-wide building programme.
Key takeaways
- A dementia-friendly city is not a reserved zone: it is an ordinary place whose physical environment and social culture let a person stay oriented, safe and engaged in daily life.
- WHO deliberately avoids a fixed standard: its toolkit for dementia-friendly initiatives offers four modules — starting, integrating into an existing programme, monitoring and evaluation, and scaling up.
- WHO's global goal for the dementia action plan (extended to 2031): every country runs at least one awareness campaign, and half of countries run at least one dementia-friendly initiative.
- Research identifies legibility and distinctiveness as the qualities that matter outdoors: clear streets, rest stops and toilets, safe crossings, and recognisable landmarks such as public art.
- The most durable programmes are co-designed with people living with dementia and carers, following the loop of learning, collaboration and action.
- Stigma keeps people home more often than physical barriers, so training public-facing staff and reducing stigma is as much part of a friendly city as kerbs and signs.
What dementia-friendliness really means
A dementia-friendly city is not a reserved zone or a separate housing district. It is an ordinary place where the layout, services, shops and neighbours are arranged so that a person living with dementia can read a street, cross a road calmly, find a toilet or a seat, and be met with patience and respect on a bus or in a café rather than with confusion.
The concept overlaps with age-friendly design but is not identical. WHO positions dementia-inclusive work as a distinct layer within the healthy-ageing agenda: people living with dementia need more environmental support for memory, attention and wayfinding than older people in general, so a city that works well for physically fit older adults can still disorient them.
- Physical layer: legible predictable streets, safe crossings, benches, accessible toilets, clear signage and recognisable landmarks.
- Social layer: staff who understand dementia, respectful communication, and dementia-aware businesses and services.
- Process layer: initiatives are built with people living with dementia and carers, not designed for them from the top down.
The WHO framework and global targets
WHO has treated dementia as a public-health priority since the Global action plan on the public health response to dementia 2017–2025 was endorsed and later extended to 2031. One action area is specifically about awareness and friendliness, carrying measurable global targets: every country should run at least one functioning public awareness campaign on dementia, and half of all countries should have at least one dementia-friendly initiative to foster a dementia-inclusive society.
To translate those goals into practice, WHO published the toolkit Towards a dementia-inclusive society in 2021. It sets out a conceptual framework and then offers four practical modules that can be used together or separately: starting a new dementia-friendly initiative; integrating dementia into an initiative that already exists, such as an age-friendly programme; monitoring and evaluating an initiative; and scaling it up.
- No single global standard: the WHO framework is deliberately adaptable to local culture, resources and needs.
- Scale of the challenge: WHO estimated that about 57 million people lived with dementia worldwide in 2021, with roughly 10 million new cases each year.
- The toolkit urges communities to start from their own reality rather than copy a fixed checklist.
What research shows about streets and public space
A 2026 Simon Fraser University study walked and talked with 14 people living with dementia across different parts of Vancouver to understand how they experience neighbourhoods on foot. Participants tied physical details of the street to confidence and distress: uneven, poorly maintained sidewalks raised fear of falling; cyclists and scooters on footpaths caused anxiety; and crossings were stressful when cars turned during a crossing, timings were too short or kerbs were high.
The same people said places to rest and public washrooms matter a great deal, and that familiar landmarks — including public art and other memorable features — help them know where they are. The authors summarised two qualities cities should aim for as legibility (how clearly an environment conveys spatial information) and distinctiveness (how one area can be told apart from another), and stressed that planners should work from lived experience rather than assumptions.
- Benches and accessible toilets are rarely nice-to-haves; they can determine whether someone leaves home at all.
- Clear, consistent, dementia-friendly signage beats novelty that adds visual clutter.
- Distinct memorable features aid orientation more than uniform, over-cleaned streetscapes.
Where to start: a staged path
A large budget or a master plan is not required to begin. The lowest-risk first move is to raise awareness and gather the right people: a few residents living with dementia, carers, a local shop, a transport operator, a library or clinic, and a local-authority contact. This mirrors the approach of national programmes such as Dementia Australia's Dementia-Friendly Communities, whose core loop is learn, collaborate and act, and the WHO toolkit, whose first module walks a group through starting an initiative.
Pick one small, walkable area — a high street, a district around a clinic, or a park-and-transport hub — and audit it together rather than the whole city at once. Most early fixes are cheap: a bench near a crossing, simpler signs, staff training, a longer crossing time. Make one concrete change within the first weeks so the group can point to something real, then measure how it is used before deciding whether to scale to another district.
- Step 1 — learn: give key partners basic dementia awareness; stigma is a leading reason people stay home.
- Step 2 — collaborate: co-design with people living with dementia and family carers.
- Step 3 — audit one district: map seating, toilets, crossings, signage and barriers.
- Step 4 — fix a few visible items quickly to build trust and momentum.
- Step 5 — train public-facing staff and recognise participating businesses.
- Step 6 — monitor use and outcomes, then extend to the next area or fold into age-friendly work.
Why the social layer matters as much as kerbs and signs
A city can have perfect kerbs and still feel unfriendly if a person is met with impatience, or if dementia is treated as a shameful secret. National movements therefore combine work on the environment with a change in everyday behaviour: employees of shops, banks, transport and emergency services learn to recognise when someone is disoriented, to communicate calmly and to offer help without taking over. Awareness reduces stigma, and less stigma in turn encourages earlier diagnosis and keeps people socially engaged for longer.
Carers and family members are central, not incidental. WHO's iSupport programme exists precisely because most dementia care worldwide is provided by relatives and friends, often with little training, and their wellbeing determines whether a person can keep living in the community. A realistic city strategy should make life easier for carers too, through reliable services, peer support, clear information and spaces where the person and their family feel welcome together.
- Train the people who interact most: drivers, ticket staff, cashiers, librarians and first responders.
- Recognise businesses that commit to real practice rather than simply handing out a sticker.
- Plan memory and carers' cafés so staying engaged has a low barrier.
- Communicate in plain language, large clear type and calm environments.
Limitations worth being honest about
Dementia changes how a person experiences the world and it progresses, so no single design will work for everyone at every stage. Some needs pull in opposite directions: a visually calm environment aids orientation for some people yet feels empty or under-stimulating for others, and slowing traffic can conflict with the speed expectations of cyclists. These are trade-offs to discuss with the people who actually use the space, not problems to settle once with a fixed rule.
Friendly is easy to claim and hard to verify. Recognition badges, logos and pledges mean little unless they change real behaviour, which is why monitoring is a full module in the WHO toolkit. Communities should decide early how they will check that promised changes are used and maintained; otherwise dementia-friendliness can become a label without substance, especially where fragmented maintenance lets sidewalks and washrooms quietly deteriorate.
- Design for different stages: what helps early on may not work later.
- Set verification criteria before handing out badges and logos.
- Budget for maintenance, not just installation.
Put it into practice
A 90-day starter plan for a dementia-friendly district
A working checklist for a small group — a municipality, nonprofit, businesses or resident initiative. The aim is to deliver several visible changes in one walkable district within three months and to build a basis for scaling up.
- Weeks 1–2: recruit a working group that includes at least two people living with dementia and two family carers.
- Run basic dementia awareness for the whole group so everyone shares a common language.
- Map one walkable district: note every bench, toilet, crossing, sign and barrier on a simple plan.
- Walk the route with participants and log where they hesitate, turn back or ask for help.
- Rank the findings: safety first, then places to rest and toilets, then clear wayfinding.
- Choose three affordable fixes and set an owner and a date for each.
- Train public-facing staff in two or three organisations and agree how to offer help politely.
- Run a public event (a memory café or community talk) to reduce local stigma.
- Agree simple measures of success: use of benches and crossings, complaints received, how many organisations joined.
- Review at day 90: what changed, what is actually used, and which district to take next.
Questions people ask
What is the difference between an age-friendly and a dementia-friendly city?
Age-friendly design supports the physical and social wellbeing of older people in general. Dementia adds a distinct layer of cognitive accessibility: a person needs extra support for memory, attention and orientation — legible environments, clear wayfinding, calm crossings and places to rest. A city that is comfortable for a physically fit older adult can still disorient someone living with dementia, which is why WHO treats this as a separate task within the healthy-ageing agenda.
What single low-cost change usually has the biggest effect?
There is no universal recipe, but research and practice most often point to a combination of basic staff awareness training and simple legible streets: a bench or rest point near a crossing, an accessible toilet, large clear signs and recognisable landmarks. These lower anxiety and help a person leave home at all. The effect depends on the district, so start by asking people living with dementia what blocks them most.
Who should be in the room when a community starts this work?
At minimum, people living with dementia and their family carers — their participation is mandatory, not token. Beyond them, useful members are a local-authority contact, a transport operator, a shop or library, a clinic or social-care service, and someone with the authority to change crossings, sidewalks and toilets. National programmes are built around such a cross-sector core in which the voice of the person with dementia stays decisive.
Is there an official certification for dementia-friendly cities?
There is no single international legal standard. WHO provides a conceptual framework and targets but does not certify cities. Individual countries and regions run their own recognition schemes — for example, national dementia-friendly movements in Australia and the United Kingdom recognise communities and organisations that commit to specific criteria. Names, criteria and processes differ, so check the current scheme in your country before applying.
How does the physical environment actually help someone with dementia stay oriented?
The environment acts as external memory: clear signs, consistent layout and distinctive landmarks such as buildings, art or noticeable details reduce cognitive load. Research highlights two key qualities — legibility, how clearly a space tells you where you are, and distinctiveness, how one area differs from another. With these supports in place, a person feels less anxious, gets lost less often and is more confident about leaving home.
Do carers need to be part of a dementia-friendly city programme?
Yes, otherwise the programme will not hold. Most dementia care worldwide is provided by relatives and friends, often with little training, and their wellbeing directly determines whether a person can remain in the community. WHO even created the iSupport programme to train carers. A practical city therefore supports carers with reliable services, peer groups, clear information and spaces where the person and their family can come together.
Sources and further reading
Sources were checked when this page was generated. Confirm changing dates, rules and prices with the original publisher.
- WHO fact sheet: DementiaWorld Health Organization
- Towards a dementia inclusive society: WHO toolkit for dementia-friendly initiativesWorld Health Organization
- New WHO toolkit promotes inclusion of people with dementia in societyWorld Health Organization
- Global Health Observatory: Dementia awareness and friendlinessWorld Health Organization
- iSupport: программа обучения и поддержки для лиц, ухаживающих за людьми с деменциейВсемирная организация здравоохранения
- SFU study pushes for more inclusive urban design for people living with dementiaSimon Fraser University
- About Dementia-Friendly CommunitiesDementia Australia