Where Science and Engineering Meet: Design's impact on Alzheimer's child birth schools and prisons

E&T on the pioneering area of science and engineering which can be called 'neuro-design'.

If you think of yourself as a 'city mouse', no doubt you relish the fast pace of life, the hum of the streets, and unpredictable interactions with strangers that can leave 'country mice' bemused or horrified. This buzz is a large part of the attraction, and the reason why cities tend to be hotbeds of innovation and creativity.

But beware: city-living may not be all good for your brain. Recent studies suggest the very stimulation that helps foster ingenuity can result in a kind of cognitive overload, when the effort required to phase out unwanted distractions reduces our capacity for things such as memory formation, attention and self-control.

Being surrounded by nature, on the other hand, appears to be highly beneficial. Researchers have shown, for example, that hospital patients recover more quickly when they can see trees from their windows; that children with attention-deficit hyperactivity disorder show fewer symptoms when surrounded by animals or trees; and that the degree of domestic violence is reduced in apartments with views of greenery.

Findings such as these are encouraging urban architects and planners to design places that reflect the restorative effects of nature. More than that, they have spawned a whole new academic discipline in which neuroscientists and architects are collaborating on ways to influence people's behaviour, mood and health through design. The idea is to improve quality of life by building places that reflect the way our brains work. The approach has already led to revolutionary new designs in neo-natal units for premature babies and care-homes for Alzheimer's patients, and is causing architects to rethink the way they design schools, offices, homes, prisons, museums and urban outdoor spaces.

John Zeisel is a visiting professor at the University of Salford who has used insights from neuroscience to design care homes for Alzheimer's patients and is planning to do the same for schools and offices. He calls the influence of neuroscience "potentially revolutionary" for architecture. "It's a major shift from thinking about the environment as merely the context for behaviour, to environments having a direct influence on people's behaviour, perception and attitudes via the brain."

Architecture and neuroscience

Empirical evidence demonstrating how buildings affect the function and structure of our brains is still thin on the ground. Fred Gage, a neuroscientist at the Salk Institute in La Jolla, California, says that, while architects have plenty of intuitions, the key will be to construct experiments to test the influence of the spatial environment on the brain. Despite the founding of the Academy of Neuroscience for Architecture (ANFA) in San Diego in 2003 - of which Gage is a director and past-president - "we have not yet accomplished as much as we aspired to," he says. However, neuroscience has taught us much about how our brains construct our sense of place and how certain environments might stimulate the growth of new neurons.

For example, it is clear that the brain structure known as the hippocampus is crucial both to spatial navigation and the formation of autobiographical memories. This means that our memories of events are likely to be strongly dependent on our sense of place, and vice versa.

"Memory is affected by the physical setting in which we experienced it, the situation and place in which we are trying to remember, the purpose to which we want to put the memory, and the length of time the memory has been stored in its disaggregated state," says Zeisel, whose 2006 book 'Inquiry by Design' lays out a research strategy for applying neuroscience to architecture. That goes for any kind of learning, for which context is crucial. "We learn history in classrooms, sports on playing fields, and bicycle riding on flat paved surfaces, and these places can help us learn," says Zeisel.

Neuronal spatial navigation

We know that the ability to construct cognitive maps that reflect the places we live in is crucial to our daily functioning, although most of our understanding of spatial navigation at the neuronal level has come from studies of rats. Researchers have shown that moving an adult animal from a dull environment to a richer, more stimulating, one triggers a dramatic acceleration in the growth of new neurons which, in turn, improves its learning and other cognitive abilities.

Other studies have observed that the firing patterns of certain neurons in rats' brains change according to where the animal is exploring: different environments trigger different patterns of neural activity. Esther Sternberg at the UN National Institute of Mental Health and Matthew Wilson at the Massachusetts Institute of Technology have speculated that people's sense of place is defined by this kind of neural activity, and that knowing what influences it is crucial to understanding the effect that the layout of buildings has on our minds.

Several scientists have begun trying to study such effects in people in real time. One such project is the virtual reality StarCAVE, led by neurophysiologist Eve Edelstein at the California Institute for Telecommunications and Information Technology at the University of California, in which volunteers are asked to navigate through a simulated building while their brain activity is measured via a special scalp cap connected to 256 electrodes.

The idea is to find out more about how people form cognitive maps of places and whether their brains exhibit different neuronal patterns depending on whether they are lost or know where they are going. The team has not yet published results, but Edelstein, who is also senior vice president of research and design at California-based HMC Architects, says they have made some interesting observations about how people orientate themselves in the absence of obvious cues. Often their subjects used subtle cues that took the researchers by surprise, such as the angle of light shining into a corridor. In some cases, this appeared to be subconscious, at least initially.

Does this point to a hardwired wayfaring mechanism? Edelstein says it is too early to say and that such a mechanism could also be based on culture and experience. "Neuroscience is teaching us that the brain is far more malleable than we previously accepted," she says. "We know that our experience can alter it."

Zeisel believes there are already signs that humans have a hard-wired capacity for wayfaring. For example, our brains pay more attention to and process more quickly physical cues that are found below eye level compared to cues found higher up - perhaps a trait that evolved as a survival strategy when our ancestors needed to look out for predators on the ground.

Alzheimer's homes and neo-natal units

Zeisel has used this and other findings in his designs for Alzheimer's homes. His aim is to build places that make it easier for patients to find their way around and to reinforce their sense of where they are and their memories of the past - things that Alzheimer's sufferers often have difficulty with. As a result they become less agitated and disorientated and can act more independently.

Hearthstone Alzheimer Care, of which Zeisel is co-founder and president, manages eight assisted living residences for people with Alzheimer's that use techniques based on findings from neuroscience. These include: embedding navigation information in the architecture rather than relying on patients having to recall it from memory, with destinations clearly visible at the ends of hallways and familiar, attention-grabbing landmarks along the walls; designing features that evoke comforting, long-held memories, such as fireplaces and garden views; making sure each room evokes a specific mood so that patients know when they are entering a different place; and providing ready access to daylight and outdoor spaces so patients have contact with natural daily rhythms. The aim, says Zeisel, is to tax those parts of the patients' brains that are still functioning and give relief to those parts that are damaged.

A similar principle applies to designing environments for the other extreme of life: premature babies. In traditional neo-natal units, babies are exposed to bright lights, noisy equipment and the voices of staff, all of which are likely to damage their underdeveloped auditory and visual pathways, leading to long-term damage such as myopia and speech difficulties. What's needed - and what neuroscientists and designers have started to deliver - are units that mimic the womb, that protect the baby while its brain circuitry and sensory organs continue to develop (see box on facing page).

Recently, architects have been using neuroscientific principles in more public facilities such as schools, prisons and outdoor spaces, and even offices and homes. A study by Kenneth Tanner at the University of Georgia, due to be published later this year in the Journal of Educational Administration, found that factors such as natural light, a view from the classroom and having space to move around in had a significant positive effect on students' performance. More specifically, schools designed for freedom of movement, with well-marked passageways and public spaces that foster a sense of community, scored better in reading comprehension, language, mathematics and science; those with plenty of natural light saw improvements in reading vocabulary and science; and those with external and internal views were stronger on reading vocabulary, language and mathematics. "Where students learn make a difference in their achievement levels," says Tanner.

Prison design

Similarly, research has shown that environmental factors such as noise, light and levels of crowding affect the behaviour of inmates in prisons. To explore this further, ANFA has joined forces with the American Institute of Architects and the US National Institute of Corrections to test hypotheses such as whether maximising natural light will improve sleep patterns among inmates and thus reduce aggression, whether colour affects levels of violence, and whether putting up murals depicting nature scenes reduces stress levels. The results from the first pilot study are due out later this year.

Despite these signs of progress, experts stress it is early days for the field and that it will be some time before findings from neuroscience are applied to architecture as standard practice. "It will take perhaps ten years before a significant amount of research has been done to claim we have a new knowledge base about how the brain responds to the built environment," says John Eberhard, founding president of ANFA. "It's not easy to be pressing a pioneering effort. It won't be the traditional schools of architecture or practicing architects who will change." It'll be up to the new generation.

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