Mapping the Complex Systems That Connects the Urban Environment to Cognitive Decline in Older Adults: A Group Model Building Study

This study aimed to develop a Causal Loop Diagram (CLD) to visualise how urban environment factors impact dementia and cognitive decline, and potential causal mechanisms. In Group Model Building workshops with 12 researchers, a CLD was created to identify factors contributing to cognitive decline, and the dynamic interrelationships between these factors. The factors were classified in nine main themes: urban design, social environment, travel behaviours, urban design by-products, lifestyle, mental health conditions, disease/physiology, brain physiology, and cognitive decline outcomes. Five selected feedback loops illustrated some dynamics in the system. The workshops helped develop a shared language and understanding of different perspectives from an interdisciplinary team. The CLD creation was part of a comprehensive modelling approach based on experts’ knowledge which informed other research outputs such as an evidence gap map and an umbrella review, helped the identification of environmental variables for future studies and analyses, and helped to identify future possible systems-based interventions to prevent cognitive decline. The study highlights the utility of CLDs and Group Model Building workshops in interdisciplinary research projects investigating complex systems.