Summary: New research suggests people with moderate Alzheimer’s disease may perform daily tasks more effectively when they are in their familiar, personal environments, even if those spaces contain everyday clutter.
Source: University of East Anglia
Clutter-free spaces may not always improve daily functioning for people living with dementia, according to a recent study conducted by researchers at the University of East Anglia (UEA).
The study investigated whether people with dementia completed routine activities—such as making a cup of tea or preparing a simple meal—more successfully at home amid their usual belongings, or in a tidy, clutter-free research bungalow designed to simulate a domestic environment.
Contrary to common assumptions, the research team found that people with moderate dementia were more successful at carrying out daily tasks when they were in their own homes, despite higher levels of household clutter. For people with mild or severe dementia, task performance was similar in both the home and the clutter-free research setting.
Professor Eneida Mioshi of UEA’s School of Health Sciences emphasized the importance of understanding how environmental factors influence independence. “Most people with dementia live at home and want to remain there for as long as possible,” she said. “It’s essential to identify the environmental adjustments that genuinely help people maintain everyday activities.”
As dementia progresses, changes in cognition, perception and physical ability can reduce a person’s capacity to perform everyday tasks. Adapting the physical environment is often proposed as a way to support continued participation in daily living activities. Environmental clutter—defined as an excessive number of objects on surfaces or items not required for a task—is commonly seen as a barrier to independence. Yet empirical evidence testing that assumption has been limited.
To explore this issue, occupational therapist and PhD student Julieta Camino led a study of 65 participants with dementia, categorized into mild, moderate and severe stages. Each participant was asked to perform standard daily tasks in two settings: their own home and UEA’s NEAT research bungalow, a fully furnished, clutter-free domestic research facility.
Researchers assessed participants’ performance on activities of daily living (ADLs) in both locations and quantified the amount of clutter present in each participant’s home. The NEAT bungalow provided a consistent, uncluttered comparison environment.
Camino noted she and the team expected the clutter-free setting to aid performance, but the results challenged that expectation. “We found that people with moderate dementia performed daily tasks more successfully at home, even though their homes contained significantly more clutter than our research bungalow,” she said.
The study also showed that the degree of clutter in a person’s home did not predict task performance. Instead, a participant’s level of cognitive impairment was the primary factor: individuals with severe dementia had similar difficulty completing tasks regardless of the environment.
This research was funded by the Alzheimer’s Society and the National Institute for Health Research (NIHR) Applied Research Collaboration East of England (ARC EoE) programme. Sian Gregory, Research Information Manager at the Alzheimer’s Society, highlighted the value of testing common assumptions. “We sometimes assume simple changes—like de-cluttering—will help someone living with dementia at home. Studies like this are crucial to understand what actually supports people to live well in their own environments.”
About this Alzheimer’s disease research news
Author: Press Office
Source: University of East Anglia
Contact: Press Office – University of East Anglia
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Original Research: Closed access. “A new and tidier setting: how does environmental clutter affect people with dementia’s ability to perform activities of daily living?” by Eneida Mioshi et al., published in Alzheimer’s Disease and Associated Disorders.
Abstract
A new and tidier setting: how does environmental clutter affect people with dementia’s ability to perform activities of daily living?
Background:
The influence of the physical environment on activities of daily living (ADLs) for people with dementia is not well established. Although many professionals assume that a tidy, de-cluttered environment helps people with dementia function better, experimental evidence remains scarce.
Objectives:
This study aimed to evaluate the effects of environment (home versus research lab) and the role of clutter on ADL performance across dementia stages.
Methods:
Sixty-five people living with dementia were assessed using a performance-based ADL measure in both their own homes and a clutter-free research bungalow. Paired t-tests compared ADL performance and measured clutter across environments, and multiple regression analysed factors associated with improved ADL outcomes.
Results:
Overall, participants performed better at home despite the research bungalow having significantly less clutter. When results were stratified by dementia stage, people with moderate dementia showed notably better ADL performance at home.
Conclusion:
The absence of clutter in a controlled research setting did not improve daily task performance. Only those in the moderate stage of dementia appeared to benefit from performing ADLs in their familiar home environment. Further research is needed to clarify how different environmental elements support engagement and independence across dementia stages.