Designing for Healthy Cognitive Ageing Project: Outcomes-focused eDelphi Consensus Exercise Data, 2021-2024

Bowes, Alison and Pemble, Catherine and Davison, Lisa (2025). Designing for Healthy Cognitive Ageing Project: Outcomes-focused eDelphi Consensus Exercise Data, 2021-2024. [Data Collection]. Colchester, Essex: UK Data Service. 10.5255/UKDA-SN-857735

As we age, many of us will experience cognitive changes, and for some of us, these will develop into dementia. We know that people's homes can make the experience of cognitive changes more difficult, or can enable continuing inclusion and sense of self-worth and self-esteem. DesHCA worked with people experiencing ageing and cognitive change and those who design and develop housing. DesHCA identified housing innovations that can support living better for longer with cognitive change. Our emphasis on healthy cognitive ageing goes beyond narrow conceptions of 'dementia-friendly design' into a more expansive and inclusive approach to housing innovation.

The multidisciplinary DesHCA team involved stakeholders from all areas of housing provision, including people experiencing ageing and cognitive change, architects and designers, housing experts, planners, builders and housing providers. Older people were integral to DesHCA and their health was at its heart. The project designed homes that act as demonstrators and test-beds for innovations to support healthy cognitive ageing. These designs have been developed and evaluated from stakeholder points of view, then considered at a larger scale to examine their real-world feasibility. DesHCA is feeding directly into the UK and Scottish Government City Region Deal for Central Scotland (Stirling and Clackmannanshire), providing groundwork for local housing developments. The focus of this is sustainable, lifetime health, community and economic development, addressing deprivation and inequality.

To achieve these aims, DesHCA took a co-production approach, with the whole team working to identify innovations that engage with their real-world experiences and aspirations. We used a range of data collection methods and produced analyses informed the design of the demonstrator houses. These designs evolved as stakeholders interacted with them and provided feedback from their different points of view. To collect data, we asked older people to map and evaluate their own homes and to experience and comment on new design features using virtual reality (VR). They then collaborated with builders, architects and housing providers in VR workshops to identify practical, realistic and affordable designs that can support healthy cognitive ageing, and therefore longer healthy, independent life. Partners came together in interactive workshops to convert designs into plans within a fictional town, building and retrofitting homes, creating services and managing budgets. We demonstrated how designs can work out in the real world, and how to bring together the various interests involved. Throughout, issues of costs were considered, to inform business planning and help make decisions on implementation of the new designs.

The impact of DesHCA is achieved through showing what works in housing design for healthy cognitive ageing. Immediately, DesHCA will feed into the City Region Deal and longer term we will provide tools for future developers to inform their decisions about housing for healthy cognitive ageing. Throughout the project, disseminate findings were distributed to the housing, architecture and building sectors through stakeholder networks. We have published rigorous research findings to provide a peer reviewed, high quality research base for innovation. Thus the project goes beyond recommendations and guidance to provide evidence to support delivery at scale, grounded in the co-production approach that draws on the real experience, interests and imperatives that drive different stakeholders.

DesHCA's multidisciplinary team built capacity among early career researchers in research leadership, working across disciplines such as architecture and planning, economics, sociology and across sectors with a range of different industrial and professional stakeholders, such as housing workers, planners and construction companies.

Data description (abstract)

The e-Delphi exercise aimed to address a limitation of previous literature on designing homes for healthy cognitive ageing, namely that outcomes had been researcher-defined and did not reflect the perspectives of older people or professionals working in design, construction and delivery of housing. Preceded by an on-line questionnaire identifying potential outcomes, the e-Delphi exercise itself had three rounds, as follows:

Round 1: Panellists were invited to pick their ‘top ten’ outcomes from a list of options concerning
• the characteristics of a supportive home,
• what activities the home should support,
• how people should feel in a supportive home,
• desired outcomes for communities, and
• desired outcomes for professionals in home design and development, in construction and in housing supply and management.

Round 2: Panellists were presented with results from Round 1 and invited to agree or disagree with a series of consensus statements about characteristics of supportive homes, derived from the results. They were then asked to consider further
• areas of disagreement from Round 1,
• ordering and categorising feeling/emotions when living in a supportive home,
• ordering and categorising activities that a home should support,
• their beliefs about how making changes to a home might or might not support desired activities more easily.

Round 3: Panellists were presented with further results from Round 1 then asked to focus on the impacts of supportive design for industry and government and what kinds of changes might be needed to mainstream supportive design. These included:
• legislative change
• industry regulation
• awareness in industry
• awareness among home owners/tenants

Panellists were older people and professionals involved in designing and delivering housing for healthy cognitive ageing.

Five main outcome areas meaningful to panellists were identified: staying independent, feeling safe, living in an adaptable home, enabling physical activity and enabling enjoyed activities. These were demonstrated to include multiple factors that panellists felt could contribute to them.

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