Strategy to expand cognitive health design
Presenter: Jeon Mi-ja (Korea Institute of Welfare and Environmental Design)
1. Background and understanding of cognitive health design for City of Seoul
Cognitive health design project, which is one of Seoul’s representative design policies to resolve social issues, began in 2014 to apply the design that reflects the physical, emotional and social characteristics centered on residential environment of senior citizens to respond to aging society and sudden growth in the elderly with dementia. The concept of cognitive health design that may rather be unfamiliar to the general people is connected to a series of processes that allow us to see objects, acquire information and make judgement in our daily lives.
There are cases where people face unexpected accidents or where functional abilities decline due to aging during the lifetime of humans, and there are also situations that are difficult to be resolved in the medical field. Seoul’s cognitive health design project that can act as a guide in such circumstances is a project that enhances the maintenance and enhancement of cognitive functions such as declined memory, concentration and orientation capability of senior citizens through contents involving physical activities, stimulation of the five senses and social exchange, for the first time in Korea.
When design policies of Seoul were first implemented, there was a lack of universal perception on design, and there were also social barriers that perceived design as something that is difficult to be approached. Therefore, there were many difficult signs in the city that were difficult to interpret, and the floor division or guidance about space was also too vague even in indoor spaces, to often cause citizens to feel intimidated or feel flustered. There were also constraints in widely using and applying design due to the perception that there would be high cost that would be incurred when the design is applied.
As such, in order to resolve issues regarding difficulties in approaching and applying the design to various sites and citizens, perceptions have to be changed, above all, to be able to accept design as something that is familiar, and communication and integration of the society should be led by design for everyone without anyone being excluded. Therefore, discussions had been carried out about the start of a design policy with the goal of creating a convenient design that many can agree with, in consideration of physical, psychological and social characteristics of users, and also design that reflects various characteristics and desires of users while not excluding anyone.
Aging, cognitive disorder and social issues
With the expansion of aging population, many cities that have entered into an aging society as a result of an increase in the gaining population end up facing social issues involving cognitive disorders. Statistics show that dementia prevalence rate for population who are 65 years old or older amounts to 10.3%, and this is four times higher than 10 years ago. One thing to take note of is that with the increase in overall dementia incidence rate, the age for inducing dementia is gradually decreasing at the same time. This is showing that cognitive health is not an issue that has to be of focus in only a certain circumstances or age groups, but should now be cared for in our daily lives across the entire lifetime of people.
In addition, we need to pay attention to the mild cognitive impairment, that is known to be the stage that comes before dementia. Mild cognitive impairment increased by 19 times as compared to 10 years ago at 276,045 people in 2019, and the share of those less than 65 years old accounted for 20% of the whole group, showing that it is being observed in lower age groups as compared to dementia. As it is known that approximately 10~15% of mild cognitive impairment progresses to official dementia, this is an area that should be focused on in terms of cognitive health design.
Next is about solitary deaths and suicidal thoughts of senior citizens. According to an investigation on senior citizens living in Suwon City as of 2020, there has been a surge in the ratio of senior citizens who think about committing suicide due to loneliness and depression with thoughts about the possibility of dying alone at home because they have no families or caretakers. The issue of care and lives of senior citizens living alone is an urgent issue for which our society has to make serious efforts in to come up with countermeasures.
As such, aging and cognitive disorder is undoubtedly a social issue that we are facing. Thereby cognitive health design has to be maintained as an essential companion of the lives of citizens by reflecting the expertise and considering the physical, emotional and social characteristics of senior citizens.
2. Application and expansion of cognitive health design in the City of Seoul
As cities faced the pandemic for the past 2 years, importance for city shelters, health and infection along with various concerns about management of health for citizens have been emphasized. In the midst of this, the healing garden, ‘100 year-old garden’ for the town that was established by Seoul as a part the cognitive health design project, is a use case of space where citizens can interact healthily with neighbors.
Another case of expansion for cognitive health design is the ‘Always Green Cognitive Plaza in Gunpo’, which was designed in consideration of regional characteristic of the Gunpo that has a high proportion of the elderly. This is a case of establishing a shelter for the seniors and the local residents to enjoy light exercises while interacting with one another using an idle space within the Welfare Complex Town, an area in which the welfare center, day care and health center branch is concentrated in. Since Always Green Cognitive Plaza in Gunpo is a space that embraces both children and senior citizens, safe environment was prioritized, and it also aimed to provide the design and programs that can aid in physical and cognitive activities, to form a communication space that centers on the welfare center with an intent to vitalize exchange. After the establishment of the basic plan, opinions of various subjects were gathered through outreach activities and hearings in the design development stage, and also reflected additional plans through the feedbacks and participation of plaza users.
As a result, Always Green Cognitive Plaza in Gunpo implemented the cognitive health design by categorizing the contents for physical activities, contents for emotional enhancement and contents for social and generational exchange, and these were color coded so that anyone can understand the information without much trouble. In terms of facilities, tracks that drive various types of physical activities were installed to enable both cognitive enhancement activities and body enrichment activities, and contents were constructed in such a manner so that they could be used separately and also together by individuals and groups.