How Digital Twins Could Reframe the Future of Alzheimer’s Care Environments

Designing with Memory in Mind: How Digital Twins Could Transform Alzheimer’s Environments

For people living with Alzheimer’s, particularly early-onset forms, the built environment isn’t just background; it’s treatment. While there is no current cure, architecture and environmental design can help shape perception, reduce anxiety and support memory loss. Yet, care environments remain largely static, built on broad standards that don’t account for the complexity or variability of Alzheimer’s as it progresses. Looking to the future, digital twin technology could radically shift how we design, manage and personalise built environments for cognitive care. By enabling environments to become responsive and context-aware, digital twins could offer a new kind of support: one that evolves as patients do.

The Problem: Design That Can’t Keep Up with the Disease

Alzheimer’s affects people in highly individual ways. Some may struggle with spatial disorientation, others with perception, colour contrast, or depth. Environmental factors, such as patterned flooring, harsh lighting, or visual clutter can unintentionally heighten confusion and anxiety. While many care centres already incorporate dementia-friendly design principles, these environments are fundamentally fixed. The disease, however, is anything but. Designing once for a condition that constantly changes leaves a critical gap in care.

The Gap: Static Design for a Dynamic Condition

We already know that certain environmental features help, such as clear contrast between walls and floors, abundant natural light and familiar spatial layouts. But no two Alzheimer’s patients experience the same progression or respond the same way. What calms one resident might overstimulate another. And even when a design works, it may only work for a while. The central dilemma is that buildings are static, but Alzheimer’s is dynamic. Digital twin technology could change that, by turning fixed environments into flexible, responsive systems that adapt to the individual and their condition in real time. In the future, digital twins could transform care homes from passive structures into active care participants, by monitoring, adapting and optimising the environment based on the changing needs of each resident.

 What’s Already Been Done: Tools That Assess and Inform Better Design

While fully responsive care environments are still on the horizon, groundwork has already been laid in the form of digital assessment tools aimed at improving life for people with dementia. One prominent example is the IRIDIS app, developed by the University of Stirling’s Dementia Services Development Centre in collaboration with Space Architects. This app helps assess how dementia-friendly a space is, whether it's a private home, care facility, or public building. By answering simple questions and uploading photos, users receive targeted recommendations on how to improve lighting, reduce visual confusion, or adjust layout to support navigation. IRIDIS stands out because it’s not just for designers, it’s designed for carers, families and non-specialists too. It also integrates with Building Information Modelling (BIM) systems, allowing design professionals to access certified dementia-friendly products and design guidance. While IRIDIS doesn’t adapt environments in real time, it reflects a growing shift toward data-informed, accessible design, which is an essential foundation for more dynamic systems like digital twins.

What Digital Twins Could Enable in Alzheimer’s Care

Looking ahead, the application of digital twin technology in cognitive care could unlock a new standard of personalisation and adaptability:

Perception-Sensitive Zones

By integrating sensor data and behavioural analytics, a digital twin could identify areas where residents frequently pause, hesitate, or become agitated. These insights could then trigger automated changes to lighting, colour schemes, or spatial cues to ease movement and reduce stress without trial-and-error guesswork.

Individualised Environmental Profiles

Like smart home systems, each resident could have a dynamic environmental profile, adjusting parameters like light temperature, sound levels, or airflow based on time of day or detected emotional state. The goal: proactive support, not reactive response.

Wayfinding & Memory Support

Future systems could use subtle, non-intrusive cues like adaptive lighting paths, ambient sounds, or even scent triggers to gently guide residents through spaces. These cues, controlled by the digital twin, would support memory without trickery, building on natural routine rather than imposed control.

Early Warning Systems for Cognitive Stability

For people with Alzheimer’s, even minor disruptions like flickering lights or HVAC malfunctions can cause distress. Digital twins can continuously monitor building systems and provide early warnings of potential faults, allowing building owners and facilities teams to intervene before these issues impact residents, supporting a safer and more stable environment.

Looking Ahead

Digital twins are already capable of creating personal environments based on either pre-selected preferences or automated adjustments. The real challenge lies in communal areas, where multiple people with different needs coexist, and a single system must balance and adapt to them all. These platforms offer a glimpse into a future where care homes don’t just serve residents, but they learn from them. Buildings have the potential to evolve as cognitive needs change, with responsive environments supporting memory, mood and movement continuously, ethically and intelligently.

We may not yet be able to cure Alzheimer’s, but we can stop designing as if the condition were static. With digital twins, we can create places that remember, even when their residents cannot.