Nature-based interventions for people living with dementia and their carers: a scoping review.

INTRODUCTION: Nature-based interventions are increasingly recognised as a promising non-pharmacological approach to support people living with dementia and their carers. Although a growing body of research has explored the relationship between nature engagement and dementia, the evidence remains dispersed across a wide range of intervention types, settings and outcome measures. This review aimed to identify and map the available evidence relating to nature-based interventions for people living with dementia and their carers. METHODS: A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with PRISMA-ScR guidelines. Searches were undertaken across PubMed, Scopus, Web of Science, Emerald Insight and the Cochrane Library. Evidence selection was conducted independently by two reviewers. Data were charted and synthesised using narrative synthesis and thematic categorisation. RESULTS: A total of 108 studies were included. Six overarching themes were identified: Therapeutic Gardens and Environmental Design (n = 33), Horticultural and Gardening Interventions (n = 30), Green Care Farms and Nature-Based Services (n = 22), Nature Exposure, Access and Participation (n = 16), Technology-Based Nature Interventions (n = 5), and Development and Implementation of Nature-Based Services (n = 2). Across intervention types, engagement with nature was consistently associated with positive outcomes relating to wellbeing, social participation and meaningful activity. Findings also highlighted the importance of accessibility, environmental design and opportunities for continued participation in everyday life. DISCUSSION: The evidence suggests that nature-based interventions may offer benefits beyond wellbeing alone, supporting identity, social participation and meaningful engagement for people living with dementia and their carers. However, the evidence base remains unevenly developed, with limited research relating to implementation, blue spaces, technology-based approaches and underrepresented populations. Future research should focus on improving accessibility, understanding implementation and broadening the range of nature-based approaches available to people affected by dementia.