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Perceived and objective availability of green and blue spaces and quality of life in people with dementia: results from the IDEAL programme

Lookup NU author(s): Dr Yu-Tzu WuORCiD, Professor Fiona MatthewsORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021, The Author(s).Purpose: The aim of this study was to investigate the associations between quality of life and both perceived and objective availability of local green and blue spaces in people with dementia, including potential variation across rural/urban settings and those with/without opportunities to go outdoors. Methods: This study was based on 1540 community-dwelling people with dementia in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme. Quality of life was measured by the Quality of Life in Alzheimer’s Disease (QoL-AD) scale. A list of 12 types of green and blue spaces was used to measure perceived availability while objective availability was estimated using geographic information system data. Regression modelling was employed to investigate the associations of quality of life with perceived and objective availability of green and blue spaces, adjusting for individual factors and deprivation level. Interaction terms with rural/urban areas or opportunities to go outdoors were fitted to test whether the associations differed across these subgroups. Results: Higher QoL-AD scores were associated with higher perceived availability of local green and blue spaces (0.82; 95% CI 0.06, 1.58) but not objective availability. The positive association between perceived availability and quality of life was stronger for urban (1.50; 95% CI 0.52, 2.48) than rural residents but did not differ between participants with and without opportunities to go outdoors. Conclusions: Only perceived availability was related to quality of life in people with dementia. Future research may investigate how people with dementia utilise green and blue spaces and improve dementia-friendliness of these spaces.

Publication metadata

Author(s): Wu Y-T, Clare L, Jones IR, Nelis SM, Quinn C, Martyr A, Victor CR, Lamont RA, Rippon I, Matthews FE

Publication type: Article

Publication status: Published

Journal: Social Psychiatry and Psychiatric Epidemiology

Year: 2021

Volume: 56

Pages: 1601-1610

Print publication date: 01/09/2021

Online publication date: 23/01/2021

Acceptance date: 06/01/2021

Date deposited: 06/01/2021

ISSN (print): 0933-7954

ISSN (electronic): 1433-9285

Publisher: Springer


DOI: 10.1007/s00127-021-02030-y


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Funder referenceFunder name
‘Improving the experience of Dementia and Enhancing Active Life: living well with dementia. The IDEAL study’ was funded jointly by the Economic and Social Research Council (ESRC)
and the National Institute for Health Research (NIHR) through Grant ES/L001853/2.
support of ESRC, NIHR and Alzheimer’s Society is gratefully acknowledged.
The IDEAL-2 study’ is funded by Alzheimer’s Society, grant number 348, AS-PR2-16-001.